Introduction
Methods
Data sources and search strategy
Inclusion and exclusion criteria
Data extraction, analysis, and synthesis
Results
Domains, themes, and factors (facilitators and barriers) of ANC quality
Domains | Themes | Facilitators | Barriers | Countries |
---|---|---|---|---|
Inputs | Organisational factors | Nepal, Sub-Saharan Africa (SSA), Benin, Ghana, Ethiopia, Kenya, SSA, Lao People Democratic Republic, Pakistan | ||
Supplies of commodities | Ghana, Ethiopia, Jordan, Tanzania, LMICs, SSA, | |||
Trained health workforces | Nepal, Rwanda, SSA, Ethiopia, Jordan, Lao PDR, Tanzania, Pakistan, Namibia, | |||
Structural determinants | Malawi, Mexico, Pakistan, Iran, LMICs, Camron, Ethiopia, Tanzania, Nigeria, Nepal, Zambia, East African countries, Egypt, Myanmar, India | |||
Intermediary determinants | insured women [11, 76], women with higher empowerment and decision-making power [52, 58, 65], urban areas [38, 52, 56, 58‐60, 62, 63, 66, 68], attended big hospitals and private HFs [52, 55, 56, 59, 62‐64, 71, 77], non-smokers women, intended pregnancy or first baby, networking women, received the maternal and child health handbook, previous history of complication [52, 60, 61, 65, 68, 73, 78, 79], media exposure and women empowerment [52, 61, 80] | Rural and remote locations, slum areas [64, 65, 70, 75, 80], high birth order, low age at marriage and childbirth (e.g., adolescents), short time intervals, old age, unmarried [52, 65, 68, 70, 72‐75, 80], inadequate ANC, poor priority and awareness, late recognition of pregnancy, single parent, smoker, unplanned place of delivery, without insurance [74, 81, 82] | Kenya, Mexico, LMICs, Nepal, Ghana, Pakistan, Ethiopia, Tanzania, Nigeria, Cameroon, East African countries, Brazil, Malawi, Egypt, Kenya, Myanmar, South Asia, Madagascar, Oman, India, High income countries, Bangladesh, Brazil | |
Services delivery approaches | Cultivating quality care at public facilities, supportive supervision of providers [40, 83], group ANC approach, collaboration with local government clinics [84], task shifting and training of care providers [85], home visitation, community mobilization, training of CHWs, logistical support, monitoring and documentation [84, 85], digital technology [86] | LMICs, Ethiopia, Nepal, Bangladesh, south Asia, East African, Afghan, Uganda Pakistan, | ||
Process of care | Skilled care | India, Tanzania, Ghana, Oman, Nigeria, Ethiopia, Pakistan, | ||
Timely care | Nigeria, Ghana, LMICs, Ethiopia, Cameroon, Peru, Zambia, Lao PDR, Pakistan, Madagascar | |||
Adequate care | Zambia, Mexico, Ghana, Cameroon, Madagascar, Ethiopia, Zambia, Oman, India, Nepal, South Asian countries, Afghan, Brazil, Mexico, Sierra Leone, Nigeria, East African Countries, Peru, Kenya | |||
Adherence to guideline | Peru, Australia, Tanzania, Ethiopia, Bangladesh, LMICs, Brazil, Zambia, eight countries of SSA and SA, Indonesia, west and central Africa, Ghana, Nigeria | |||
Effective communication | Ghana, Malawi, Jordan, Kenya, Namibia, Uganda, LMICs | |||
Client satisfaction | Poor satisfaction with ANC services [106, 109, 110], lack of privacy, discrimination, being left unattended, providers’ attitude, delayed and inadequate care, physical abuse, inappropriate position in the examination, lack of privacy, negative assumptions and disregard for mothers’ options in care, long waiting time [54, 95, 105, 107‐110] | Malawi, Jordan, Ethiopia, Rwanda, Myanmar, Kenya, Zambia, | ||
Outputs | Quality- adjusted coverage | Ethiopia, Zambia, Rwanda, Myanmar, LMICs, Egypt | ||
Equity gaps | Ethiopia, Kenya, LMICs, SSA, eight countries, Brazil, Mexico, East African countries, Rwanda, India, Pakistan, | |||
Effectiveness | Low mortality reduction for people with minorities [115] | LMICs, Mexico |