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Table 3 Process for employing the WHO Antenatal Care (ANC) Recommendations Adaptation Toolkit

From: Development of the WHO Antenatal Care Recommendations Adaptation Toolkit: a standardised approach for countries

ActivityToolkit component usedTimeline
Introductory meetings held with the Ministry of Health (MoH) and WHO country office staff to ensure government support and set up an integrated MoH team (with representatives from TB, HIV, malaria, adolescent, safe motherhood, nutrition, etc. programmes) to lead the activities.NoneApproximately 1.5-hour meeting
Local consultant hired to work with the MoH team lead to support the following activities:
 1) Completion of the Baseline Assessment Tool (BAT) to produce a situational analysis report of current ANC health service provision,
 2) Conduct a mapping of national ANC Guidelines in comparison with WHO 2016 ANC recommendations, highlighting necessary changes and/or updates
 3) Produce a draft integrated country-specific package of all ANC interventions, detailing what activities will take place at each contact, by whom and at what health system level
 4) Participate in and document stakeholder meeting discussions
 5) Finalise outputs 1 and 2
 6) Draft updated national ANC guideline for validation, based on outputs 1 and 2
 7) Participate and document validation meeting
 8) Finalise updated national ANC guideline
BAT65 working days (~ 3.25 months)
MoH held an ANC stakeholders meeting to update national ANC policies based on WHO 2016 ANC recommendations. Activities included:
· Presentation of Qualitative Evidence Synthesis (QES) Slidedoc®
· Presentation of WHO 2016 ANC recommendations
· Review of situational analysis report
· Review of Outputs 1 and 2 during group work
· Presentation of group work results in plenary discussions
QES Slidedoc®, Outputs 1 and 2, Group work material2 days
MoH team and consultant finalised meeting outputs, including the situational analysis, the proposed country-specific ANC package (Output 1) and SWOT analysis (Output 2), and the country report. An updated national ANC policy and implementation plan, including phasing for national scale up, were also drafted.Situational analysis report, Outputs 1 and 22 months
MoH held validation meeting(s) for stakeholders to approve the proposed country-specific ANC package, updated national ANC guidelines and implementation plan.Situational analysis report, Outputs 1 and 22 days
MoH updated ANC-related facility-based tools, such as paper registers and mother’s case notes, and validated them in a further stakeholder meeting(s).Output 13 days