Updated 25/05/2026
New evidence published in The Lancet Global Health reveals persistent gaps in both coverage and quality of antenatal care across low- and middle-income countries, despite its recognition as one of the most effective platforms for improving maternal and perinatal health outcomes. The analysis highlights the urgent need to shift from quantity-focused metrics to quality-centred care delivery.
WHO antenatal care evolution
Shift from visit-based to contact-based care model, 2016-2024
previous model
current guideline
care frequency
Source: WHO Antenatal Care Guidelines, based on The Lancet Global Health | Georgian Medical Journal News
WHO reframes pregnancy care around positive experience
According to The Lancet Global Health, the World Health Organization’s updated antenatal care guideline represents a fundamental shift in approach, moving beyond traditional clinical risk detection to emphasise respectful, person-centred care. This reframing positions antenatal care around the goal of achieving a positive pregnancy experience for all women.
The transition from “visits” to “contacts” reflects evidence that more frequent, high-quality engagements reduce maternal and perinatal morbidity and mortality while improving women’s overall care experience, as reported in The Lancet Global Health. This approach recognises that meaningful interaction, rather than routine check-ups, forms the cornerstone of effective antenatal care.
Coverage gaps persist despite proven effectiveness
Despite antenatal care being recognised as one of the most effective platforms for improving maternal and perinatal health outcomes, significant coverage and quality gaps persist across low- and middle-income countries, according to The Lancet Global Health analysis. The evidence reveals that many healthcare systems continue to struggle with implementing comprehensive care models.
Quality metrics require fundamental reassessment
The shift from quantity-focused metrics to quality-centred approaches requires healthcare systems to fundamentally reassess their antenatal care delivery models. The Lancet Global Health analysis suggests that traditional visit-based metrics fail to capture the depth of interaction necessary for optimal maternal and perinatal outcomes.
The contact-based care model, emphasising meaningful engagement over routine appointments, represents a significant departure from previous approaches. Implementation challenges remain significant, particularly in resource-constrained settings where healthcare infrastructure limitations can impede the delivery of comprehensive, quality-focused antenatal care services.
Evidence supports increased contact frequency
The recommendation for a minimum of eight antenatal contacts is grounded in robust evidence demonstrating that more frequent, high-quality engagements improve both clinical outcomes and patient experience. According to The Lancet Global Health, increased contact frequency allows for better monitoring of pregnancy progression, earlier detection of complications, and more comprehensive health education delivery.
This approach also facilitates stronger therapeutic relationships between healthcare providers and pregnant women. Successful implementation requires adequate resource allocation and healthcare system strengthening, particularly in low-resource settings where the greatest impact potential exists.
More frequent, high-quality antenatal contacts reduce maternal and perinatal morbidity and mortality while improving women’s experience of care globally
— WHO Antenatal Care Guidelines (The Lancet Global Health, 2024)
Key takeaways
- WHO now recommends minimum 8 antenatal contacts, doubling previous guidance of 4 visits
- Quality of care and respectful, person-centred approaches are prioritised over routine clinical assessments
- Evidence from The Lancet Global Health demonstrates that increased contact frequency reduces maternal and perinatal morbidity and mortality rates
Frequently asked questions
What is the difference between antenatal visits and contacts?
According to WHO guidelines reported in The Lancet Global Health, contacts emphasise meaningful, active interaction between healthcare providers and pregnant women, rather than routine check-ups. This approach focuses on quality engagement and comprehensive care delivery rather than simple appointment attendance.
Why did WHO increase the recommended frequency from 4 to 8 contacts?
The Lancet Global Health reports that evidence demonstrates more frequent, high-quality engagements reduce maternal and perinatal morbidity and mortality while improving women’s care experience. Increased contact frequency allows for better monitoring and earlier detection of complications.
How can low-income countries implement these enhanced antenatal care guidelines?
Implementation requires healthcare system strengthening, adequate resource allocation, and provider training in person-centred care approaches. Countries must address both infrastructure limitations and care quality simultaneously to achieve meaningful improvements.
The evolution of antenatal care guidelines represents a critical opportunity to transform maternal health outcomes globally, particularly in low- and middle-income countries where the greatest impact potential exists. Successful implementation of quality-centred, contact-based care models will require sustained commitment to healthcare system strengthening and provider capacity building.
Source: Antenatal care in LMICs: what the data reveal
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