Abstract
While group antenatal care (G-ANC) has been delivered and studied in high-resource settings for over a decade, it has only recently been introduced as an alternative to individualised care in sub-Saharan Africa (Thapa et al, 2019; Lori et al, 2022; Sawtell, et al, 2023). G-ANC pilot projects are reported to have been conducted in 22 sub-Saharan countries. Data from three pilot studies in Ghana, Malawi Senegal and Tanzania found antenatal care delivered in groups to be feasible and acceptable to both women and midwives.
Group antenatal care was piloted in two purposely selected Community Health Care centers in Soweto, Gauteng Province, South Africa during 2022. The evaluation of the program was conducted during 2023 through a focus group discussion and an in-depth interview to determine the women’s experiences and acceptance of the group care. The findings of the evaluation revealed a positive impact of group care as per responses shared by women.
The ethics of care, also referred to as care ethics, is a feminist philosophical perspective that uses relational and context-bound approaches to morality (Brugère, 2019). According to Nortvedt et al (2011), ethics is perceived as a social responsibility in caring for others, while relationships bring out trustworthiness, which serves as a frame for evaluating ethical issues. Empathetic relationships as a point of departure for care ethics are deemed essential in identifying vulnerability and dependency as features that prevent one from flourishing, specifically for women receiving antenatal care services (Doherty & Purtilo, 2016).
The ethics of care is aligned to the four universal and fundamental ethical principles which are: beneficence (do good), non-maleficence (do no harm), autonomy (respect for the person's ability to act in her own best interest), and justice (Black 2020). Each principle has a prima facie obligation that must be fulfilled.
A norm of respect and support is respect autonomous, whereby one will have the capacity to deliberate on the course of action and to put that plan into action (Beauchamp & Childress 2013). According to Beauchamp and Childress (2013), moral rules of respect for autonomy include: being truthful; respect other peoples’ privacy; be confidential: obtain consent to intervene with patients; and, when asked, helping others to make critical decisions.
Notes
References:
Beauchamp, TL & Childress, JF. 2013. Principles of biomedical ethics. 7th edition. Oxford: Oxford University Press.
Black, BP. 2020. Nursing pathways to professionalism. In: Professional nursing: Concepts and challenges, edited by BP Black. 9th edition. Missouri: Elsevier:1-155.
Brugère, F. 2019. Care ethics: The introduction of care as a political category with a preface, edited by J Tronto. Belgium: Peeters, Leuven.
Doherty, R & Purtilo, R. 2016. Ethical dimensions in the health professions. 6th edition. London: Elsevier Saunders.
Lori, J.R., Williams, J.E.O., Kukula, V.A., Apetorgbor, V.E.A., Awini, E.A., Amankwah, G., Zielinski, R., Lockhart, N., James, K.H & Moyer, AC. 2022. Group Antenatal Care in Ghana: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc. 11(9): e40828. Doi:10.2196/40828.
Nortvedt, P, Hem, MH & Skirbekk, H. 2011. The ethics of care: Role obligations and moderate partiality in health care. Nursing Ethics 18:192-200.
Sawtell, M., Wiggins, M., Wiseman, O., Mehay, A., McCourt, C., Sweeney, L., Hatherall, B., Ahmed, T., Greenberg, L., Hunter, R., Hamborg, T., Eldridge, S & Harden, A. 2023. Group antenatal care: findings from a pilot randomized controlled trial of REACH Pregnancy Circles. Pilot and Feasibility Studies. BMC. 9(42): 1-15. https://doi.org/10.1186/s40814-023-01238-w
Thapa, P., Bangura, A.H., Nirola, I., Citrin, D., Belbase, B., Bogati, B., Nirmala, B.K., Khadka, S., Kunwar, L., Halliday, S. Choudhury, N., Ozonoff, A., Tenpa, J., Schwarz, R., Adhikari, M., Kalaunee, S.P. Rising, S., Maru, D., & Maru, S. 2019. The power of peers: an effectiveness evaluation of a cluster-controlled trial of group antenatal care in rural Nepal. Reproductive Health. BMC. 16(150):1-14. https://doi.org/10.1186/s12978-019-0820-8.
Sigma Membership
Chi Xi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Primary Care, Academic-clinical Partnership, Policy and Advocacy, Antenatal Care, Group Antenatal Care, South Africa
Recommended Citation
Mathibe-Neke, Johanna Mmabojalwa, "The Impact of Group Antenatal Care on “The Ethics of Care”: Women’s Responses to Program Evaluation" (2025). International Nursing Research Congress (INRC). 241.
https://www.sigmarepository.org/inrc/2025/presentations_2025/241
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
The Impact of Group Antenatal Care on “The Ethics of Care”: Women’s Responses to Program Evaluation
Seattle, Washington, USA
While group antenatal care (G-ANC) has been delivered and studied in high-resource settings for over a decade, it has only recently been introduced as an alternative to individualised care in sub-Saharan Africa (Thapa et al, 2019; Lori et al, 2022; Sawtell, et al, 2023). G-ANC pilot projects are reported to have been conducted in 22 sub-Saharan countries. Data from three pilot studies in Ghana, Malawi Senegal and Tanzania found antenatal care delivered in groups to be feasible and acceptable to both women and midwives.
Group antenatal care was piloted in two purposely selected Community Health Care centers in Soweto, Gauteng Province, South Africa during 2022. The evaluation of the program was conducted during 2023 through a focus group discussion and an in-depth interview to determine the women’s experiences and acceptance of the group care. The findings of the evaluation revealed a positive impact of group care as per responses shared by women.
The ethics of care, also referred to as care ethics, is a feminist philosophical perspective that uses relational and context-bound approaches to morality (Brugère, 2019). According to Nortvedt et al (2011), ethics is perceived as a social responsibility in caring for others, while relationships bring out trustworthiness, which serves as a frame for evaluating ethical issues. Empathetic relationships as a point of departure for care ethics are deemed essential in identifying vulnerability and dependency as features that prevent one from flourishing, specifically for women receiving antenatal care services (Doherty & Purtilo, 2016).
The ethics of care is aligned to the four universal and fundamental ethical principles which are: beneficence (do good), non-maleficence (do no harm), autonomy (respect for the person's ability to act in her own best interest), and justice (Black 2020). Each principle has a prima facie obligation that must be fulfilled.
A norm of respect and support is respect autonomous, whereby one will have the capacity to deliberate on the course of action and to put that plan into action (Beauchamp & Childress 2013). According to Beauchamp and Childress (2013), moral rules of respect for autonomy include: being truthful; respect other peoples’ privacy; be confidential: obtain consent to intervene with patients; and, when asked, helping others to make critical decisions.
Description
Although the ethics of care has been convincing in dealing with vulnerable individuals accessing healthcare services, the question is how the framework has been implemented. The presentation will share a background on the process of the pilot project for group care in South Africa, a reflection of the women’s evaluation responses, and those reflected in related literature and its alignment to “the ethics of care”, in order to position group care as a better alternative to individual care.