Table 13.1 summarises the basic differences between the traditional and focused antenatal care approaches.
Substance use includes tobacco, alcohol, khat, illegal drugs, hashish, cocaine and others
| Characteristics | Traditional antenatal care | Focused antenatal care |
|---|---|---|
| Number of visits | 16–18 regardless of risk status | 4 for women categorised in the basic component (as described later in this study session) |
| Approach | Vertical: only pregnancy issues are addressed by health providers | Integrated with PMTCT of HIV, counselling on danger symptoms, risk of substance use, HIV testing, malaria prevention, nutrition, vaccination, etc. |
| Assumption | More frequent visits for all and categorising into high/low risk helps to detect problems. Assumes that the more the number of visits, the better the outcomes | Assumes all pregnancies are potentially 'at risk'. Targeted and individualised visits help to detect problems |
| Use of risk indicators | Relies on routine risk indicators, such as maternal height <150 cm, weight <50 kg, leg oedema, malpresentations before 36 weeks, etc. | Does not rely on routine risk indicators. Assumes that risks to the mother and fetus will be identified in due course |
| Prepares the family | To be solely dependent on health service providers | Shared responsibility for complication readiness and birth preparedness |
| Communication | One-way communication (health education) with pregnant women only | Two-way communication (counselling) with pregnant women and their husbands |
| Cost and time | Incurs much cost and time to the pregnant women and health service providers, because this approach is not selective | Less costly and more time efficient. Since majority of pregnancies progress smoothly, very few need frequent visits and referral |
| Implication | Opens room for ignorance by the health service provider and by the family in those not labelled 'at risk', and makes the family unaware and reluctant when complications occur | Alerts health service providers and family in all pregnancies for potential complications which may occur at any time |