title: Measuring antenatal care use in Europe: is the content and timing of care in pregnancy tool applicable?
abstract: OBJECTIVE
  Measuring of antenatal care utilisation is important from a public health perspective. The Content and Timing of care in Pregnancy tool (CTP) focuses on the care process and includes aspects on quality of care. The aim of the study is to gain insight in the applicability of the CTP tool across Europe.
  
  
  METHODS
  National guidelines for routine antenatal care were examined, analysing the degree to which the four items in the CTP tool were included in these guidelines.
  
  
  RESULTS
  From the 30 countries, 22 had a national guideline for routine antenatal care. The CTP tool is applicable in over 60% of the European countries with a national guideline.
  
  
  CONCLUSIONS
  The CTP tool can be used to measure antenatal care delivery in Europe. The tool is useful to evaluate the care process, focusing on rates of interventions as the closest approximation to the delivery of health care, with a focus on content of visits rather than simply the number of visits. Together with indicators measuring structure and outcome of health care, conclusions about the quality of care can be made.
authors.affiliation: Department of Public Health, Faculty of Medicine and Pharmacy, Nursing and Midwifery Research unit, Vrije Universtiteit Brussel, Brussel, Belgium. katrien.beeckman@uzbrussel.be.|Department of Nursing and Midwifery, Nursing and Midwifery research group, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussel, Belgium. katrien.beeckman@uzbrussel.be.
authors.forename: Katrien
authors.initials: K
authors.lastname: Beeckman
authors.affiliation: Department of Health Services Research, The University of Liverpool, Liverpool, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Frith
authors.affiliation: Faculty of Nursing-Department of Midwifery, University of Iceland Reykjavik, Reykjavik, Iceland.
authors.forename: Helga
authors.initials: H
authors.lastname: Gottfreðsdóttir
authors.affiliation: Hannover Medical School, Midwifery Research and Education Unit, Hannover, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Bernloehr
mesh_terms: D005060:Europe; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011295:Prenatal Care / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires
keywords: Antenatal care; Care process indicators; Clinical guidelines; Content of care; Health services research; Quality of care