Methods	Cluster-randomised trial. Unit of randomisation was rural health centres in Gutu district, Zimbabwe
Participants	13,517 women attending 23 rural clinics. All women booking for care were eligible for recruitment. (The sample included both low- and high-risk women although women in high-risk groups may have been referred for a higher level of care or received additional visits.)
Interventions	Reduced visits: 5 visits with a goal-oriented programme and reduced routine procedures at these visits. Standard ANC: standard care for rural areas.
Outcomes	Women: number and timing of the visits, utilisation of rural health centres for delivery, eclampsia, hypertensive disorders, labour interventions. Babies: perinatal mortality (stillbirths after 28 weeks’ gestation plus early neonatal deaths), low birthweight (< 2500 g and < 1500 g)
Notes	68.7% of women in the control group and 77.1% in the experimental group had 5 or less visits. Data from pregnancy health records for 78% of participants. For women whose records were not retrieved, maternal and neonatal outcome was from birth registers in the health centres or follow up in the community. Some deaths identified through follow up in the community and included in the calculation of perinatal mortality may have been late neonatal deaths
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Unclear	Method not stated.
Allocation concealment?	Unclear	Not described.
Incomplete outcome data addressed? All outcomes	Unclear	13,517 were randomised. Full records were available for 78%; some outcome data were available for a further 20%. There was no information for 2% of those randomised

ANC: antenatal care

APCVS: alternative prenatal care visit schedule

APH: antepartum haemorrhage

IOL: induction of labour

PI: principal investigator

PPH: postpartum haemorrhage

SCBU: special care baby unit

SD: standard deviation

TPCVS: traditional prenatal care visit schedule

UTI: urinary tract infection