Impact Stories

Improved ANC Attendance Through Challenging Current Practices


Dysfunctional Team and Low ANC Attendance

Salima District faced high attrition rates among health professionals, poor communication, and uneven workload distribution, resulting in a highly dysfunctional team. These issues led to late antenatal care (ANC) attendance and inadequate HIV ascertainment, increasing the risk of mother-to-child HIV transmission. 


Dysfunctional Team and Low ANC Attendance

The Salima District team underwent training in Transformative Leadership, recognizing the importance of human assets within a team. The initiative integrated twelve new managers, promoting frequent meetings to share information and solve challenges collectively. Data-driven discussions were used to evaluate the impact of changes introduced, initially met with resistance but eventually embraced as the benefits became evident. 


Improved Team Functioning and ANC Attendance

The team’s approach included:
Supply Side:
Healthcare workers were trained to investigate pregnancy signs and provide iron tablets, instructing women to return if pregnancy remained unconfirmed.
Demand Side:
Health surveillance assistants (HSAs) collaborated with traditional leaders and “secret mothers” in the community to promote early ANC attendance.


As a result, early ANC attendance increased from 8% to 11%, and HIV ascertainment rose from 82% to 95%. The integrated team felt empowered, demonstrated asset-based thinking, and improved their performance through collective problem-solving and strong mentorship support. This led to a committed and collaborative team, enhancing service delivery and maternal health outcomes. 

Eastern Cape Province, South Africa