Group Care in the first 1000 days: implementation and process evaluation of contextually adapted antenatal and postnatal group care targeting diverse vulnerable populations in high-, middle- and low-resource settings

Abstract

Background Group care (GC) improves the quality of maternity care, stimulates women’s participation in their own care and facilitates growth of women’s social support networks. There is an urgent need to identify and disseminate the best mechanisms for implementing GC in ways that are feasible, context appropriate and sustainable. This protocol presents the aims and methods of an innovative implementation research project entitled Group Care in the first 1000 days (GC_1000), which addresses this need. Aims The aim of GC_1000 is to co-create and disseminate evidence-based implementation strategies and tools to support successful implementation and scale-up of GC in health systems throughout the world, with particular attention to the needs of ‘vulnerable’ populations. Methods By working through five inter-related work packages, each with specific tasks, objectives and deliverables, the global research team will systematically examine and document the implementation and scale-up processes of antenatal and postnatal GC in seven different countries. The GC_1000 project is grounded theoretically in the consolidated framework for implementation research (CFIR), while the process evaluation is guided by ‘Realistic Evaluation’ principles. Data are gathered across all research phases and analysis at each stage is synthesized to develop Context-Intervention-Mechanism-Outcome configurations. Discussion GC_1000 will generate evidence-based knowledge about the integration of complex interventions into diverse health care systems. The 4-year project also will pave the way for sustained implementation of GC, significantly benefitting populations with adverse pregnancy and birthing experiences as well as poor outcomes.

Understanding parental perspectives on young children’s oral health (≤ 4 years) growing up in a disadvantaged neighbourhood of Amsterdam, the Netherlands: an exploratory study

“…A more child-friendly approach is recommended for general dentists. The Group Care (GC) model offered by child health clinics) model is a promising approach that fits parents’ wish for more help in parenting and managing their hectic family life [ 55 ]. Such a GC model helps strengthen families in parenting through conversations with peers from their social surroundings while backed by a professional leading the group [ 56 ].…”

Maternal satisfaction with group care: a systematic review

“…The eligibility criteria for papers to be considered for inclusion in the review are presented in Table 1 . To be included, studies had to report data on women receiving perinatal group care, that is, care within 1000 days of care from the start of the pregnancy 11 , 28 ; the intervention was centering-based perinatal care, 1 or synonym model known as G-ANC, 2 , 3 , 4 , 5 or similar models like Group Based Antenatal Care, 9 Expect With Me, 8 Pregnancy Circles 10 or Connecting Pregnancy 7 ; the control group was standard individual care; and, studies reported a measure of overall satisfaction with care. Group care is provided during antenatal and postnatal periods; therefore, it is important to examine satisfaction during all stages of perinatal care.…”

“…Given the importance of satisfaction in understanding the impact of group care in efforts to expand and scale up the centering-based group care globally, 11 , 28 we examined the quantitative relationship between group care and overall maternal satisfaction compared with standard individual care.…”

“…Since its introduction in maternity care, the model has been adopted in many countries and settings worldwide, often as a service to marginalized groups, to provide effective and culturally appropriate care for pregnancy and postpartum. 11 , 12 , 13 With scale up, there has been a continuous interest and effort to understand its impact on maternal and newborn outcomes, resulting in many studies documenting the effects of group care. 13 , 14 , 15 , 16 , 17 Among them, self-reported maternal satisfaction has been one of the key outcomes of interest since the model's inception.…”

Implementing group care in Dutch and Surinamese maternity and child care services: The vital importance of addressing outer context barriers

“…The innovative implementation research project 'GC during the rst 1000 days (GC_1000)' aims to identify and disseminate contextually appropriate, sustainable mechanisms for implementing GC 24 . For this purpose, GC is implemented in seven countries with preceding contextual analyses.…”