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, 2024 | Georgian Medical Journal News
WHO reframes pregnancy care around positive experience
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. This approach recognises that meaningful interaction, rather than routine check-ups, forms the cornerstone of effective antenatal care.
Recent global health research demonstrates that quality improvements in antenatal care delivery can significantly impact maternal health outcomes across diverse healthcare settings.
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. The evidence reveals that many healthcare systems continue to struggle with implementing comprehensive care models.
Research published in The BMJ has consistently shown that inadequate antenatal care coverage contributes to preventable maternal and neonatal deaths. The challenge extends beyond simple access issues to encompass quality of care delivery and meaningful healthcare provider-patient interactions.
Studies featured in our latest research digest indicate that healthcare systems must address both structural barriers and care quality simultaneously to achieve meaningful improvements in maternal health outcomes.
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. Evidence suggests that traditional visit-based metrics fail to capture the depth of interaction necessary for optimal maternal and perinatal outcomes.
Research published in The New England Journal of Medicine demonstrates that contact-based care models, emphasising meaningful engagement over routine appointments, correlate with improved health outcomes. This approach requires healthcare providers to develop enhanced communication skills and patient-centred care competencies.
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. Studies published in The Lancet consistently show reduced morbidity and mortality rates associated with enhanced antenatal care frequency.
Clinical trials have demonstrated that 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.
Healthcare policy experts emphasise that 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 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?
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?
Evidence demonstrates that more frequent, high-quality engagements reduce maternal and perinatal morbidity and mortality while improving women’s care experience. Studies show that 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. Evidence suggests that countries investing in comprehensive antenatal care transformation can achieve significant reductions in preventable maternal and perinatal mortality while enhancing women’s overall pregnancy experience.
Source: Antenatal care in LMICs: what the data reveal
