Afya Jamii: Evaluation of a Group Antenatal and Well-Child Care Program in Kenya
Bibliographic record
Abstract
Objectives: Facility-based group antenatal care has been implemented with success in high-income countries (HICs), but there is no literature describing implementation in Sub-Saharan Africa. We assessed the feasibility of implementing antenatal and well-child group care in public health facilities in western Kenya. Methods: We conducted a retrospective analysis of uptake of health services from 5 group care and 9 comparison health facilities. We aimed to determine whether an antenatal and well-child group care model is feasible to implement within the public health system in Kenya. Results: Comparing group care and standard care health facilities, we found a statistically significant difference between the average monthly number of new Family Planning (FP) visits (41.5, 95% CI 36.1-46.9 and 32.3, 95% CI 29.2-35.5, p=0.004), the median monthly number of long-term FP visits (18, Interquartile Range (IQR) 11-29 and 11.5 IQR 4.5-26, p=0.001), and the median monthly number of newborns with low birth weight (0, IQR 0-1 and 1, IQR 0-3, p<0.001) at group and standard care health facilities, respectively. We found no difference in the primary outcome, the mean monthly number of the uptake of 4 or more ANC visits (28.7, 95% CI 25.8 to 31.6 and 25.9, 95% CI 24.0-27.8, p=0.104) or in the mean monthly number of facility deliveries (38.7, 95% CI 26.0-43.7 and 34.9, 95% CI 33.4-44.1, p=0.460) and OPV0 doses (35.1, 95% CI 29.7-40.6 and 36.8, 95% CI 32.7-41.0, p=0.616). Conclusion: Group antenatal care is a feasible health service delivery model in public health facilities in SSA. More research is needed to understand how facility-based group care can improve health outcomes for women and children in SSA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".