Group care for mothers and their partners

Maternal and new born mortality and morbity

Poor quality of maternal and child health services (content and delivery) has been identified as a root factor in avoidable maternal and new-born mortality and morbidity. Poor quality of care is also a major contributing factor to inadequate use of maternity and child health services.

Improvements in clinical-medical services alone have not led to increased uptake of services. Tackling the vicious cycle of poor quality and inadequate use of services is necessary to optimize health services and health outcomes for all women and children during and after pregnancy, especially for vulnerable populations.

Our proven solution: group care

Group care based on the Centering model is a new model of care where (future) parents receive guidance in groups of about eight to twelve women with a baby of about the same age. Apart from individual medical assessments of mother and/or baby, this form allows for group discussion on topics based on the group’s need, experiences and interest.

Evidence shows that women receiving group care have fewer preterm births, better mental health outcomes, fewer low birth weight babies, increased rates of breastfeeding, longer pregnancy spacing and increased satisfaction with care. The evidence of benefits is especially strong for groups of marginalized women in underserved populations.

Approved EU project

Despite many successes, group care has not yet succeeded in penetrating the health care system as a model of standard care. The WHO highlighted group care as a promising model to improve quality of care, noting that further study is essential to identify the best mechanisms to implement the model in ways that are feasible and sustainable.

Recently, the EU approved our large project CG_1000 to implement group care in vulnerable populations in Ghana, South Africa, Suriname, Kosovo, Belgium, United Kingdom and the Netherlands. Implementation sites in these countries represent the wide diversity of contexts found throughout the world in terms of health systems, organization of care, and of end-users.

The main deliverables for the four-year project are:

• Country-specific blueprints for sustainable implementation in the seven target countries
• Implementation strategy Toolbox
• An open access database with anonymized data from the GC_1000 project available to the research community.

With this project we contribute to the SDGs 2 on improved nutrition (sub target 2), SDG 3 on health (sub targets 1 and 2 on maternal and child health), SDG 5 on gender equality (sub targets 1 and 6) and SDG  10 (on reducing inequality within and between countries).

Role TNO

TNO is the coordinator of the project and contributes to all work packages. Researcher Marlies Rijnders : ”TNO has had major impact in the Netherlands with the implementation and development of 'group care for the first 1000 days'. With this new EU project, all our knowledge and expertise can be shared to make this innovative health care model sustainable for the world. That will improve health care for mothers, babies and families. Personally I consider it a huge privilege to be able to work on that.”