Submission ID 118431
| Issue/Objective | In low-and-middle-income countries (LMICs), adolescent pregnancy (aged 10-19) poses substantial risks to both maternal and neonatal health and well-being, and Pakistan is no exception. Globally, it is well established that adolescent girls often seen antenatal care (ANC) less frequently and later in pregnancy than their adult counterparts, and when they do access care, it is not tailored to their unique needs. This scoping review investigates and analyzes the landscape of ANC for adolescent girls in Pakistan, emphasizing the barriers they face in accessing and utilizing tailored services. |
|---|---|
| Methodology/Approach | In partnership with the Government of Pakistan, Nutrition International conducted a mixed methods scoping review, combining a systematic review of academic and grey literature with key informant interviews. Stakeholders included policymakers, healthcare providers, community leaders, and development partners. The review also examined global literature for best practices in tailoring ANC for adolescents in LMICs, with a focus on nutrition. |
| Results | Global guidance for tailored services in LMICs is essentially non-existent. Findings reveal a critical gap in adolescent-specific ANC policies and programs in Pakistan and beyond. Existing maternal health initiatives group adolescents with older women of reproductive age (WRA), failing to address their distinct needs. Barriers to ANC access include financial constraints, lack of education, stigma, gender norms, and restricted mobility. The quality of healthcare services is inadequate, with facilities lacking resources to provide adolescent-friendly care. Maternal micronutrient supplementation is an essential recommendation for adolescents in LMICs due to their heightened risks for nutritional deficiencies. Despite evidence that micronutrient supplements can improve maternal and birth outcomes in WRA, the authors could not find any studies specifically designed for adolescents, and sub-analyses of datasets which include older women raise questions around how adolescents may respond differently to antenatal supplementation. |
| Discussion/Conclusion | To improve ANC for adolescents in Pakistan and beyond, tailored research and policies, improved provider training, and adolescent-friendly services are urgently needed. Care models and communication strategies must account for adolescents' limited autonomy. Enhanced community engagement and cross-sector collaboration are also key. Addressing these gaps can increase ANC uptake and support adherence to antenatal nutrition recommendations, which can ultimately support healthier pregnancies for adolescent girls. |
| Presenters and affiliations | Jen Hatchard Nutrition International Richard Ninamou Nutrition International Huma Chishti Nutrition International Soha Shafqat Momentum Ventures Saima Sadaf Momentum Ventures Muhammad Awais Bhatti Momentum Ventures |
