Bibliographic Info
GuidelineWHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year of Publication2023
Issuing InstitutionWorld Health Organization
Recommendation
Status
Updated
Context specific recommendation
Only in specific contexts
Certainty of evidence
Moderate
Packages of interventions that include household and community mobilization and antenatal home visits are recommended to improve antenatal care utilization and perinatal health outcomes, particularly in rural settings with low access to health services
Notes and Remarks
- 1.The GDG agreed that the extent to which these packages improve communication and support for pregnant women is not clear.
- 2.As a stand-alone intervention, the evidence does not support the use of antenatal home visits by lay health workers during pregnancy to improve ANC utilization health outcomes. While the quality and effectiveness of communication during home visits, and the extent to which they increase support for women, is not clear, antenatal home visits may be helpful in ensuring continuity of care across the antenatal, intrapartum and postnatal periods and in promoting other healthy behaviour.
- 3.Stakeholders need to be clear that antenatal home visits by lay health workers do not replace ANC visits.
- 4.Stakeholders should implement health system strengthening interventions alongside these communitybased interventions.
- 5.Health-care providers need initial and ongoing training in communication with women and their partners. For women’s groups and community mobilization, providers also need training on group facilitation, in the convening of public meetings and in other methods of communication.
- 6.Information for women and community members should be provided in languages and formats accessible to them and programme planners need to ensure that health-care providers/facilitators have reliable supplies of appropriate information materials.
- 7.Programme planners should be aware of the potential for additional costs associated with home visits and community mobilization initiatives, including the potential need for extra staff and travel expenses.
- 8.When considering the use of antenatal home visits, women’s groups, partner involvement or community mobilization, programme planners need to ensure that these can be implemented in a way that respects and facilitates women’s needs for privacy as well as their choices and their autonomy in decision-making. By offering pregnant women a range of opportunities for contact, communication and support, their individual preferences and circumstances should also be addressed.
- 9.Further research is needed on the acceptability and feasibility of mixed-gender communication, the optimal methods for community mobilization, the best model for integration with health systems, continuity elements of home visits, and the mechanisms of effect of these interventions.