Overview of the intervention
During the summer of 2019, research team members with expertise in group ANC from the United States met with research partners in Ghana to conduct a train-the-trainer course for a selected group of midwives that would then serve as champions to train the midwives working at the intervention sites. The training was undertaken in the same manner in which the group ANC would be conducted; in small groups, in a circle, where discussion and participation were encouraged. The ten champion trainers then traveled to the districts where they were supported by members of the research team as they trained an additional 52 midwives as facilitators for group ANC. Each training session lasted 3 full days and included opportunities for each midwife to practice being the facilitator. Each participant was given a Facilitator Guide and a set of facilitation tools to use to prepare for and use during each group ANC meeting.