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Scheduling Group Care in Routine Perinatal Care: Identifying Implementation Modifications Across Belgium, Kosovo, and
Astrid Van Damme1, Florence Talrich1, Deborah L Billings2,3
1Nursing and Midwifery Research Group (NUMID), Faculty of Medicine and Pharmacy, Primary Care (PRIM), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101-103, 1090 Brussels, Belgium.
Healthcare (Basel, Switzerland)
|June 26, 2026
Summary
Integrating group antenatal care (GAC) into existing healthcare systems is challenging. Modifications like combining sessions or digital integration are needed, but the dominant one-to-one model impacts perceived value and implementation success.
Area of Science:
- Maternal Health
- Healthcare Systems Research
- Implementation Science
Background:
- Group Care (GC) is an innovative antenatal/postnatal model offering combined clinical care and education in group sessions.
- Integrating GC into traditional individual care models presents significant site and system-level challenges.
- Understanding modifications is key to successful implementation of group-based maternal care.
Purpose of the Study:
- To identify and analyze scheduling-related modifications made to Group Care (GC) implementation across diverse healthcare settings.
- To explore the processes, drivers, and impact of these modifications using a structured framework.
- To assess the sustainability of modifications in relation to the dominant care model.
Main Methods:
- An explanatory sequential design with mixed qualitative methods was employed across seven implementation sites in Belgium, Kosovo, and the UK.
- A qualitative survey based on the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME) was administered to stakeholders.
- In-depth interviews were conducted to further explore modification processes and long-term sustainability.
Main Results:
- Two primary modifications were identified: combining GC sessions with individual consultations and integrating GC into digital booking/medical record systems.
- The dominant one-to-one antenatal care model significantly influenced modifications, particularly in obstetrician-led systems, affecting the perceived value of GC.
- Integration into booking systems was crucial for administrative functions like payment and scheduling.
Conclusions:
- Sustainable integration of Group Care (GC) into predominantly one-to-one care systems is challenging and requires careful planning.
- Early coordination and shared ownership among clinical, administrative, and IT departments are essential for successful GC implementation.
- Addressing the perceived value of GC and adapting to existing care pathways are critical for its long-term success.
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