Study setting
Fourteen health centers in eastern Ghana that provided antenatal care were included in the GRAND study. Only the 7 sites randomized for the group ANC intervention were included for collection of process evaluation data since the evaluation was of group ANC implementation. Research team members traveled to the health facility intervention sites to observe group ANC meetings (completing the Fidelity and Learning Methods Checklists), to conduct interviews with the midwife facilitators and facilitate focus groups with group ANC pregnant participants.