Peer-reviewed article
Potential antenatal care-mediated benefits of delivering maternal immunization in five low- and middle-income countries: a modeling analysis.
Boshen Jiao, Isabelle Iversen, Ryoko Sato, Fentabil Getnet Yimer, Meseret Zelalem Tadesse et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This modeling study examines how integrating maternal immunization into antenatal care services could improve health outcomes for mothers and children in five low- and middle-income countries. Using data from Ethiopia, Ghana, Kenya, Pakistan, and South Africa, the researchers projected that combining these services could increase facility delivery rates, postnatal care use, and childhood vaccination coverage while reducing infant mortality. The benefits would be largest in populations with currently low use of antenatal care services.
Key points
- Under full coverage, infant mortality in Ethiopia's poorest quintile was projected to decline from 60 to 50 deaths per 1000 live births
- In-facility delivery rates estimated to increase from 11% to 35% across the five countries
- Postnatal care utilization projected to rise from 4% to 11%
- Measles-containing vaccine coverage expected to increase from 43% to 71%
- DPT3 immunization coverage projected to rise from 36% to 63%
Limitations
This is a modeling analysis based on projected scenarios rather than empirical data from actual implementation. The study cannot demonstrate whether integrating maternal immunization into antenatal care would actually achieve these outcomes in real-world settings, or what barriers to implementation might exist.
Abstract
BACKGROUND: Maternal immunization (MI) can prevent major infectious diseases in mothers and children by boosting the immunity of pregnant women. Antenatal care (ANC) delivery platforms could be leveraged to effectively provide MI. Adding MIs into ANC could potentially enhance ANC services, positively influencing both maternal and infant health outcomes and yielding broader benefits. We model these potential ANC-mediated health benefits in five low- and middle-income countries: Ethiopia, Ghana, Kenya, Pakistan, and South Africa. METHODS: We first developed a conceptual framework delineating pathways through which MI-ANC could enhance ANC utilization and quality, leading to improved care-seeking for facility delivery, postnatal care, and major childhood vaccinations (e.g., measles, diphtheria-pertussis-tetanus [DPT] third dose), as well as decreased infant mortality. Using a decision-analytic model informed by Demographic and Health Survey data, we simulated the potential benefits of MI-ANC delivery across socioeconomic groups at varying hypothetical MI coverage levels. RESULTS: MI-ANC integration would be associated with improvements in maternal and child health outcomes across all countries studied, mediated through enhanced engagement with ANC services. Under a scenario of full MI-ANC coverage, for example, infant mortality in Ethiopia's poorest quintile was projected to decline from approximately 60 to 50 deaths per 1000 live births. In-facility delivery rates were estimated to increase from 11% to 35%, postnatal care utilization from 4% to 11%, measles-containing vaccine coverage from 43% to 71%, and DPT3 immunization from 36% to 63%. These improvements would vary substantially by country and socioeconomic group, with the largest gains observed in populations with lower baseline ANC utilization. CONCLUSIONS: Integrating MIs into ANC services has the potential to yield ANC-mediated health benefits, particularly in settings with low baseline ANC utilization. These findings can help inform priority-setting, support the design of targeted pilot programs, and guide future empirical implementation research on the possible broader impacts of MI-ANC delivery.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Integration of maternal immunization into antenatal care delivery platforms
- Population
- Pregnant women and their infants across five low- and middle-income countries (Ethiopia, Ghana, Kenya, Pakistan, South Africa), with specific focus on different socioeconomic groups