Implementation of the Group Antenatal Care Model in Kole district, Uganda: Experiences of pregnant mothers, community health workers, and facility midwives

Background: Antenatal care (ANC) plays a vital role in maternal and child health, yet traditional ANC models face challenges in terms of accessibility and utilization, particularly in remote or underserved areas. Group antenatal care (G-ANC) has emerged as a promising alternative, offering increased access to information, social support networks, and patient satisfaction and eventually improving maternal and child health outcomes. However, little is known about the perspectives of community health workers and facility midwives in implementing G-ANC, especially in postwar settings such as Northern Uganda. Therefore, this study assessed the experiences of pregnant mothers, community health workers and facility midwives in providing group ANC services in the Kole district. Methods: This qualitative study involved key informant interviews and focus group discussions with community health workers, facility midwives, and pregnant women participating in G-ANC in the Kole district, Uganda. A total of nine key informant interviews and four focus group discussions were conducted using their respective guides. Qualitative data were audio recorded and transcribed. We used ATLAS.ti 23 software to support the subsequent analysis. Thematic analysis was used to examine the qualitative information gathered from focus group discussions and one-on-one interviews. Results: A number of issues came to light, such as awareness of and training in G-ANC, perceptions of facility midwives, perceptions of village health teams, and wishes for project continuation. While highlighting G-ANC's success in increasing ANC attendance, participants also mentioned its drawbacks, including inadequate time management, problems with coordination, and logistical limitations. Notwithstanding the benefits, problems, including critical medication shortages and a lack of transportation support, made it difficult to carry out the programme effectively. Conclusion: This study provides valuable insights into the implementation of G-ANC at the community level, offering practical recommendations to improve maternal and child health outcomes. By addressing the identified challenges and leveraging the lessons learned, policymakers and healthcare providers can optimize G-ANC delivery and contribute to reducing maternal and perinatal mortality rates in resource-limited settings.