Use of antenatal cards for literate health personnel and illiterate traditional birth attendants: an overview.

A review of the existing literature on various risk-oriented antenatal cards developed during the last 15 years, makes apparent a multitude of action-oriented cards available for trained health personnel (obstetric nurses, midwives and doctors). Few antenatal cards, however, have been developed for use by illiterate traditional birth attendants (TBAs). A revised version of an illiterate antenatal card is presented, that has been developed over the past 3 years in Mali. It contains some important improvements, notably its use at the various levels of the health care pyramid both by illiterate TBAs and by trained midwives. It also includes specific 'standing orders', based on generally accepted 'at-risk' criteria. Suggestions for its adaptation elsewhere in Africa as part of current Safe Motherhood policies are discussed.