Best Practices for the Design, Implementation and Evaluation of Prenatal Health Programs

Abstract

Introduction Prenatal health programs provide health education, reproductive care and related services to women. Programs may be administered individually or collaboratively by agencies including public health units, hospitals, health clinics, community and non-governmental organizations. Prenatal health disparities among populations at-risk may be reduced through the provision of accessible health education, services and resources to help women mitigate modifiable risks to pregnancy. Although standardized guidelines inform clinical screening, testing and maternity care, gaps exist regarding the design, implementation and evaluation for comprehensive prenatal health programs. Methods Using a multijurisdictional approach, prenatal health guidance documents released by clinical associations and regional governments across Canada, Australia, the United States, the United Kingdom and Ireland were systematically evaluated to identify standards and practices regarding the design, implementation and evaluation of prenatal health programs. Results Evidence-based, surveillance/monitoring, and expert/stakeholder collaborations were principles affirmed by guidance documents across all jurisdictions. Each jurisdiction described tailored strategies to optimize prenatal health in their respective communities. Divergence between jurisdictions was noted for patient care models and promotion of providers and companions of choice. Discussion A best practices model is proposed describing recommendations as follows: prenatal health programs should be grounded in a theoretical approach, fundamentally woman-centered and designed to address interacting prenatal health determinants across the lifespan. Accessible and inclusive prenatal health care can be achieved through provider training and community stakeholder collaborations. Identification of best practices for prenatal health program design, implementation and evaluation ensures that service standards are harmonized across communities, thereby optimizing maternal and child health.

Health‐related behaviours and weight status of expectant fathers

“…Antenatal programs are routinely provided for pregnant women, but there is little focus on the needs of expectant fathers. There is an identified need for explicit consideration of fathers in such programs to better reflect their important role during pregnancy and beyond 44 . The results of the present study indicate the utility of further work exploring whether their partner's pregnancy constitutes a period during which men are receptive to lifestyle changes that will benefit themselves, their partners and their children.…”

“…There is an identified need for explicit consideration of fathers in such programs to better reflect their important role during pregnancy and beyond. 44 The results of the present study indicate the utility of further work exploring whether their partner's pregnancy constitutes a period during which men are receptive to lifestyle changes that will benefit themselves, their partners and their children. An additional advantage of this approach could be that sharing the responsibility for adopting a healthier lifestyle during pregnancy between men and women may assist in alleviating any perceptions by expectant mothers that they are alone in facing expectations of self-sacrifice for the benefit of their babies.…”

Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants

“…Respondents recommended that mitigation of modifiable prenatal health risks was best achieved prior to conception, emphasizing the need for preconception health promotion as an extension of school-based sexual health education programs. As almost half of the Canadian pregnancies are unplanned, and the most critical period of fetal organ development occurs before the first prenatal healthcare visit, 21 a proactive, lifespan approach, the cornerstone of prenatal programs in the United States, 22 – 24 would optimize maternal–fetal health outcomes. 21 , 25 , 26 …”

County‐level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program

“…The concept of community resilience [22] identifies a role for adversity and social strain to stimulate community capacities for collective action. Collective action is central to the model where community partners play important roles in care delivery [23]. From this perspective, we can hypothesize that counties with poor performance on metrics for child abuse/neglect, infant mortality, and number of poor mental health days took steps toward collective action around these issues and those collective actions had the collateral effect of improving the ability of a low income pregnant woman to receive dental care.…”