Pilot-testing the KwaZulu-Natal Integrated Antenatal and Postnatal Policy and Guidelines
Council researchers are conducting a trial of the KwaZulu-Natal ANC/PNC guidelines in three priority districts in South Africa: Amajuba, Zululand, and Umkhanyakude.
HIV prevalence in pregnant South African women is 28 percent nationally and 37 percent in KwaZulu-Natal (KZN). In the absence of an intervention, HIV-exposed women are prone to high-risk pregnancies. Current maternity care guidelines in South Africa do not address HIV services in an integrated manner.
The Population Council, in collaboration with the KZN Department of Health, developed the integrated antenatal (ANC) and postnatal care (PNC) policy and guidelines. The policy and guidelines aim to integrate HIV services into ANC and PNC care; maintain women’s health during pregnancy; decrease maternal and perinatal mortality; and establish a postnatal framework for the care of mother and baby.
This project supports the HIV & AIDS and STI Strategic Plan for South Africa goals of reducing vulnerability to HIV infection and the impact of AIDS; addressing the special needs of pregnant women and children; and reducing mother-to-child-transmission of HIV. It contributes to the reduction of maternal and child deaths by encouraging pregnant women to schedule antenatal care and ensuring that these women are screened for HIV and other threatening conditions. The policy and guidelines also ensure that mothers and children are followed up after birth and that mothers may continue to access HIV counseling, testing, and treatment at postnatal services.
The trial of the guidelines is being conducted in nine KZN facilities in three of the eighteen national priority districts identified by South Africa Department of Health, namely Amajuba, Zululand, and Umkhanyakude districts. The Population Council conducted the baseline survey against which results will be measured. The survey consisted of inventorying selected facilities for services available, accessibility, staffing and skills, organizational structure, equipment and supplies, availability of guidelines and protocols, and referral systems.
The Population Council recruited and trained nine retired midwives to observe antenatal and postnatal services. Using materials developed by the Council for the trial, the midwives completed 399 observations. Twenty-five professional nurses from pilot facilities were trained; they in turn trained others in-service. The pilot facilities were given five months to implement the policy and guidelines. Council researchers currently are in the process of collecting post-trial data while training the remaining districts for implementing the project on a greater scale.
In the year ahead, the Population Council will continue to support KZN in implementing the integrated antenatal and postnatal guidelines at the rest of the facilities and evaluating their impact. Council researchers also will provide technical assistance to provinces that indicated their interest in adapting the KwaZulu-Natal policy and guidelines to their context.
KwaZulu-Natal Department of Health policy and guidelines for integrated ante and postnatal care at district hospital community health centre and clinic level (PDF)
Publication date: 2009
Location: South Africa (Amajuba, Zululand, and Umkhanyakude districts, KwaZulu-Natal)
Duration: 10/2007 - 9/2010
Population Council researchers:
KwaZulu-Natal Department of Health
Masimanyane Women"s Support Centre
University of Fort Hare, Nursing Department