Part 1

Evidence base and systematic reviews underpinning WHO Antenatal Care recommendations

The evidence which forms the basis of the WHO recommendations on antenatal care for a positive pregnancy experience is available in detail in the WHO's Reproductive Health Library (RHL).

Part 2

Links to the other relevant WHO guidance
related to maternal health

ANC-relevant recommendations from previous and current guidance produced by WHO departments are available here for the purpose of providing a comprehensive repository for end-users.

Part 3

Tools created for policymakers, programme managers,
health care workers, and digital implementers

Since the publication of the WHO ANC recommendations, the WHO has developed tools to support their adaptation and implementation. These include the WHO ANC recommendations adaptation toolkit, WHO ANC monitoring framework and the WHO ANC SMART Guideline. Please scroll below for access to all of these tools and their components.

Instruction Manual for the WHO ANC recommendations adaptation toolkit

Manual - EN
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Manual - FR
This user-friendly manual aims to guide stakeholders through updating their national ANC policies using the toolkit. It includes detailed instructions on the process to complete the different components of the Baseline Assessment Tool (BAT) and the necessary supplementary materials.

Baseline Assessment Tool (BAT)

The BAT consists of a Microsoft Excel file including sub-components (a-c): Component a, the situational analysis tool; Component b, the recommendations mapping; Component c: the country-specific ANC package (Output 1) & SWOT analysis for implementing new or updated ANC recommendations (Output 2).

Qualitative Evidence Syntheses (QES) Slidedoc®

This PowerPoint built using Duarte Slidedoc® format details how the QES were employed, to inform the ANC recommendations (regarding values and acceptability), and shape the entire guideline development process, explaining the focus on a ‘positive pregnancy experience’.
The framework is based on the new ANC model to track implementation and establish global standards. The framework was created by a three-pronged approach. Results from this process are published in a scoping review and lessons from the South African implementation experience.
ANC SMART Guideline

WHO SMART Guidelines support countries to integrate WHO global data and health recommendations into digital systems accurately and consistently.
They comprise documentation, procedures, and digital health components to support guideline adaptation and implementation through digital systems. There are five knowledge layers with associated products. This new approach to global health in the digital age begins with maternal health and the launch of the WHO SMART Antenatal Care Guidelines.

WHO SMART Guidelines Vision

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This Lancet Digital Health publication explains the SMART — Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable — Guideline approach and related products. It describes WHO’s long term vision for this approach. 

Layer 2 – Digital Adaptation Kit (DAK)

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DAKs include data and health content consistent with WHO’s ANC recommendations, generically applicable to digital systems. They are software-neutral, operational, and structured documentation based on WHO clinical, health system and data use recommendations to systematically and transparently inform the design of digital systems. Components include:  (1) linked health interventions and recommendations; (2) personas; (3) user scenarios; (4) business processes and workflows; (5) core data elements mapped to standard terminology codes (e.g. ICD); (6) decision support; (7) programme indicators; and (8) functional and non-functional requirements.

Layer 3 – FHIR implementation guide

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The third layer (L3) provides code necessary for software developers to incorporate  standardized logic from WHO guidelines into digital systems. A standards-based technical  implementation guide builds upon the DAKs by mapping its content to value sets and Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) standards.  

Layer 4 – WHO digital ANC module & training package

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The module is a digital tool which incorporates decision support and person-centered tracking. It is customizable for content and cadre within the health system and meant to be integrated within the country digital ecosystem (Health Management Information Systems, logistical, and local electronic medical records systems).  The training package includes user and facilitator guides, as well as training presentations, learning assessment tools, and feedback forms. 

Part 4

Other resources – all ANC related
communications materials

From paper to digital pathway: WHO launches first ‘SMART Guidelines’

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New tools to help ensure a positive pregnancy experience for women

Using qualitative research to strengthen guideline development

Positive experiences, key to antenatal care uptake and quality

Technical brief: Imaging ultrasound before 24 weeks of pregnancy: 2022 update to the WHO antenatal care recommendations for a positive pregnancy experience

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Evidence brief: Summary of WHO recommendations on ANC for a positive pregnancy experience

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Evidence brief: Implementing malaria in pregnancy programs in the context of WHO recommendations on ANC for a positive pregnancy experience

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What matters to women during pregnancy: a different approach to antenatal care

WHO maternal health website

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