Guidelines-based indicators to measure quality of antenatal care
Related Experiment Video
Updated: May 13, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Paola Bollini1, Katharina Quack-Lötscher
1Services for Medical Research, Evolène, Switzerland.
Insights
This study developed new indicators to measure the quality of antenatal care, moving beyond simple visit counts. These indicators help identify specific quality gaps for diverse patient groups.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Health Services Research
Background:
- Current measures of antenatal care quality are insufficient, often relying on surrogate markers like visit frequency.
- This limits understanding of the actual content and effectiveness of care received during pregnancy.
Purpose of the Study:
- To develop comprehensive quality indicators for antenatal care based on clinical guidelines.
- To address the gap in measuring the actual content of antenatal care provided.
Main Methods:
- A systematic review of clinical guidelines from the National Institute for Clinical Excellence and a research group's recommendations.
- Development of indicators across three domains: service utilization, screening, and interventions.
- Definition of eligibility, standard, and moderator criteria for each indicator.
Main Results:
- Developed 4 service utilization, 25 screening, and 17 intervention indicators for antenatal care quality.
- Established detailed criteria for each indicator, enabling assessment.
- Identified limitations in retrospective data collection for communication and counseling quality.
Conclusions:
- The developed indicators provide a robust framework for assessing antenatal care quality.
- These indicators, combined with socio-demographic data, can reveal quality disparities among different women.
- Facilitates targeted improvements in antenatal healthcare delivery for vulnerable populations.
Rationale, Aims And Objectives:
No comprehensive measurement of quality of antenatal care is available. Late booking or low number of checks are often used as surrogate for poor quality, leaving uncertainty on the actual content of the care received. In order to fill this gap, we have reviewed two sets of clinical guidelines and developed corresponding indicators of quality.
Method:
A group of clinicians and methodologists reviewed the National Institute for Clinical Excellency Clinical Guidelines on antenatal care, and the list of prenatal care interventions recommended by the Research and Development Group, both based on evidence of effectiveness of specific interventions. We identified single aspects in three domains: (1) services utilization; (2) screening; and (3) interventions. For each indicator, we defined: (1) eligibility, that is the characteristics of the women to whom the indicator applies; (2) standard, that is the situation when the target is met; and (3) moderators, that is all conditions which legitimately hamper the fulfilment of the standard.
Results:
We developed four indicators of service utilization, 25 of screening and 17 of intervention. The respective eligibility, standard and moderators criteria were described for each indicator. While many indicators could be retrospectively evaluated from medical charts, quality of communication with provider, screening for sensible issues and counselling on behaviours to be avoided could only be obtained with a prospective data collection.
Conclusions:
The indicators of quality of antenatal care, complemented by measures of social position, social support and immigrant/ethnic status, allow for a careful description of the gaps in quality of care for specific groups of women.
Related Concept Videos
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care evaluation by...
01:30Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions