Table 2

Identified measurement areas for ANC guideline monitoring and evaluation by topic areas

Topic area	What to be measured?	Measures identified by the scoping review	Scoping review sources
Health systems
Service delivery models	ANC contacts (eight or more).	x	16
	Pregnant women carrying their own case notes.	x	40
	Service-specific availability and readiness: midwife-led continuity of care.*
	Timing of first ANC visit.	x	16 19–26 41–44
Health workforce organisation	Health worker density and distribution.*	x	45
	Health units with at least one service provider trained to care for and refer sexual and gender-based violence survivors.*	x	17 46 47
	Policy on task shifting for ANC (counselling and provision of selected interventions).
Community engagement	Communities offering facilitated participatory learning and action cycles with women’s groups to improve maternal and newborn health.*
Content of care
Maternal and fetal assessment and management	Assessment for tobacco use and secondhand smoke exposure.	x	4 44
	Assessment for use of alcohol and other substances.
	Ultrasound scan before 24 weeks.
	On-site haemoglobin testing for anaemia.*
	On-site testing for asymptomatic bacteriuria.*
	Treatment for asymptomatic bacteriuria.
	Symphysis-fundal height measurement.*
	Monitoring of fetal heart rate.†
	Monitoring of blood pressure.†	x	43 48–54
Nutritional interventions	Iron and folic acid supplementation.*	x	4 16–18 34 49 53 55–58
	Availability of balanced energy and protein dietary supplementation.
	Calcium supplementation.*
	Vitamin A supplementation coverage.*
	Caffeine intake information.
Infectious disease testing and management	Pregnant women counselled and tested for HIV and know their results.	x	4 17 40 49 56 59–65
	Testing for syphilis.	x	17 33 49 61 66
	Treatment for helminths.*	x	17 18 49
	Newborns protected at birth from tetanus.	x	15 17 18 34 40 49 53 55–57 67
	Intermittent preventive therapy for malaria.*	x	45 53 56 68 69
	Testing for tuberculosis.*
	Antiretroviral pre-exposure prophylaxis to prevent HIV infection.*	x	70
Counselling and information sharing	Counselling on diet and exercise in pregnancy.*
	Counselling on birth preparedness.†	x	49 50 71
	Counselling on family planning.†	x	49 56
Experience of care
Management of physiological symptoms	Information and treatment for common physiological symptoms (eg, leg cramps, constipation, nausea).

This table condenses measures by intervention type. For example, ‘iron and folic acid supplementation’ includes all measures for recommendations A.2.1 (daily oral iron and folic acid supplementation) and A.2.2 (intermittent oral iron and folic acid supplementation).
*Measurement area is for an ANC recommendation that is unique to specific contexts (eg, undernourished populations, high-prevalence settings, malaria-endemic areas).
†Measurement area is for a good clinical practice within ANC.
ANC, antenatal care.