Midwives
The midwives were able to administer the group ANC curricula with fidelity to the format using the techniques they learned and practiced in the training. The midwives that were interviewed all expressed a preference for group ANC over the standard, individual care model, feeling like it resulted in more education and a stronger sense of community. Each midwife was given a Facilitators Guide which they indicated helped them to cover everything in each meeting. The majority of midwives followed the steps of the ANC visit according to the Facilitators Guide, however there were some components that needed to be reinforced. This included the midwife asking open ended questions to facilitate discussion which may be contrary to the traditional educational delivery approach.In the majority of cases, the midwives conducted the meetings in accordance with the group ANC model of care. The midwives delivered the content intended for that meeting and the observers noted that the pregnant women were encouraged to participate in group discussions. At times, activities such as demonstrations were omitted due to time constraints. The midwives utilized the picture cards and the Facilitators Guide consistently.In Ghana, it is common for midwives to either work in the antenatal or intrapartum area and not in both. Because of that, some participants who gave birth before the final meeting focus group session described a disconnect between what they learned in the meetings and the care they received at the time of birth. Future implementation of group ANC should include training and information for midwives attending births as well as those in the ANC clinics.