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Antenatal care policy in high-income countries with a universal health system: A scoping review

Soares Goncalves, A., Maria Ferreira, I., Pestana-Santos, M. , McCourt, C. ORCID: 0000-0003-4765-5795 & Paula Prata, A. (2022). Antenatal care policy in high-income countries with a universal health system: A scoping review. Sexual and Reproductive HealthCare, 32, 100717. doi: 10.1016/j.srhc.2022.100717

Abstract

The availability, effectiveness, and access to antenatal care are directly linked with good maternal and neonatal outcomes, making antenatal care an important determinant in health. But to be effective, care must always be appropriate, not excessive, not insufficient. Perinatal outcomes vary within and between countries, raising questions about practices, the use of best evidence in clinical decisions and the existence of clear and updated guidance. Through a scoping review methodology, this study aimed to map the available antenatal care policies for low-risk pregnant women in high-income countries with a universal health system, financed by the government through tax payments. Following searches on the main databases and grey literature, the authors identified and analysed ten antenatal care policies using a previously piloted datachart: Australia, Denmark, Finland, Iceland, Italy, Norway, Portugal, Spain, Sweden and the United Kingdom. Some policies were over 10 years old, some recommendations did not present a rationale or context, others were outdated, or were simply different approaches in the absence of strong evidence. Whilst some recommendations were ubiquitous, others differed either in the recommendation provided, the timing, or the frequency. Similarly, we found wide variation in the methods/strategy used to support the recommendations provided. These results confirm that best evidence is not always assimilated into policies and clinical guidance. Further research crossing these differences with perinatal outcomes and evaluation of cost could be valuable to optimise guidance on antenatal care. Similarly, some aspects of care need further rigorous studies to obtain evidence of higher quality to inform recommendations.

Publication Type: Article
Additional Information: © 2022. This article has been published by Elsevier in Sexual and Reproductive HealthCare. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: High-income countries, Health policy, Pregnancy, Antenatal care, Scoping review
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RG Gynecology and obstetrics
Departments: School of Health Sciences > Midwifery & Radiography
[img] Text - Accepted Version
This document is not freely accessible until 3 March 2023 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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