Antenatal care quality assessment methods in India: a systematic review

Antenatal care (ANC) is one of the most important pillars in improving maternal health. There is a considerable gap between the coverage of ANC and quality of ANC in India. Although monitoring the number of visits or contacts remains important, the WHO ANC guidelines’ focus is on the quality and content of the care received. We did a review of literature regarding the quality of ANC assessment in India from 2017 to 2023. The literature review was done by two researchers independently on electronic databases: PubMed/Medline, PubMed central, Embase and ScienceDirect, to search the methods that are used to assess the quality of ANC in India. We included the studies that have done assessment of the quality of ANC with specific ‘content’ and ‘criteria’ to define quality ANC (QANC). There are two dimensions for assessing ANC quality. ANC Visits (their number and time of registration) and the services received during ANC visits. We found three types of approaches to ANC quality assessment: 1) making categories depending on content of ANC visits and/or number of ANC visits; 2) scoring system where score is assigned to each service and a particular cut off is set to be called QANC and 3) combination of both (using scores to form categories). The literature on quality assessment of ANC is scarce. There is a need for a standard quality of care method and terminology to assess the quality of ANC that can be applied throughout the country.