This is a randomized control clinical trial which compares a revised system of prenatal care to a conventional prenatal care system currently in place in different developing countries. Expert review in this country, Sweden and elsewhere of the content and visits schedule for prenatal care has indicated that there is little scientific evidence which supports the current schedule of visits as well as its content. Several experts and national groups have therefore recommended to limit the number of prenatal visits for low risk women in order to reduce costs to save resources to be used for high risk women. These same groups have also recommended trials to evaluate different models of prenatal care. Since prenatal care is viewed as a major determinant of infant mortality and morbidity, this is a topic of major interest to the institute. The WHO through a technical advisory panel has developed a modified antenatal care model which substantially changes the content of prenatal care and allows a schedule of four visits for low risk women spread across the prenatal period. The emphasis in the revised model is on the recognition and diagnosis of conditions and complications of pregnancy known to affect the health of women and/or the fetus and specific interventions and treatments of such conditions and complications once identified. The DESPR, through its director, has been a member of the Technical Advisory Panel of the WHO, and is currently serving as Chairman of the Steering Committee. The new prenatal care model will be evaluated in five sites by randomizing clinics in each of these five sites to the current system of prenatal care or the new proposed model of prenatal care.
