Use of a Facilitated Group Process to Design and Implement a Group Antenatal and Postnatal Care Program in Rwanda

Area of Science:

• Global Health
• Maternal and Child Health
• Healthcare Delivery Models

Background:

• Rwanda seeks to reduce prematurity and low birth weight through innovative healthcare strategies.
• Group antenatal care (ANC) and postnatal care (PNC) implementation is being considered within the national healthcare system.
• A cluster randomized controlled trial necessitated a context-specific group care model and trained personnel.

Purpose of the Study:

• To develop and implement a customized group ANC and PNC model for Rwanda.
• To train healthcare workers to effectively facilitate group ANC and PNC sessions.
• To adapt an evidence-based group care model for the Rwandan healthcare context.

Main Methods:

• A technical working group of 10 Rwandan maternal-child health stakeholders adapted the group ANC/PNC model over three months.
• The adaptation process involved reviewing evidence, identifying local priorities and constraints, and defining model content and structure.
• The same group process was used to train healthcare workers as facilitators.

Main Results:

• A customized group ANC and PNC model, along with implementation guidelines, was successfully developed.
• The model was designed for introduction within a cluster randomized controlled trial across 36 health centers.
• The article details the customized model and the comprehensive implementation plan.

Conclusions:

• The collaborative group process is an effective strategy for customizing and implementing innovative health service delivery models.
• This approach fosters local ownership and is crucial for successful adaptation in new contexts.
• The developed model and training are instrumental for the Rwandan trial and potentially broader healthcare improvements.