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Antenatal care coverage - at least four visits (%)
Short name:
Antenatal care coverage - at least four visits (%)
Data type:
Percent
Topic:
Health service coverage
Rationale:
Antenatal care (ANC) coverage is an indicator of access and use of health care during pregnancy. The antenatal period presents opportunities for reaching pregnant women with interventions that may be vital to their health and wellbeing and that of their infants. Receiving antenatal care at least four times increases the likelihood of receiving effective maternal health interventions during the antenatal period. This is one of the indicators in the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) Monitoring Framework, and one of the tracer indicators of health services for the universal health coverage (SDG indicator 3.8.1).
Definition:
The percentage of women aged 15-49 with a live birth in a given time period that received antenatal care four or more times. Due to data limitations, it is not possible to determine the type of provider for each visit. Numerator: The number of women aged 15-49 with a live birth in a given time period that received antenatal care four or more times. Denominator: Total number of women aged 15-49 with a live birth in the same period.
Method of measurement
The number of women aged 15-49 with a live birth in a given time period that received antenatal care four or more times during pregnancy is expressed as a percentage of women aged 15-49 with a live birth in the same period. (Number of women aged 15-49 attended at least four times during pregnancy by any provider for reasons related to the pregnancy/total number of women aged 15-49 with a live birth) *100. The ANC4+ indicator is based on a standard question that asks if and how many times the health of the woman was checked during pregnancy. Unlike antenatal care coverage (at least one visit), the indicator antenatal care coverage (at least four visits) includes care given by any provider, not just by skilled health personnel. This is because the key national level household surveys do not collect information on type of provider for each visit. Household surveys that can generate this indicator includes Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), Fertility and Family Surveys (FFS), Reproductive Health Surveys (RHS) and other surveys based on similar methodologies. Registry/facility reporting system can be used where the coverage is high, usually in industrialized countries.
M&E Framework:
Outcome
Method of estimation:
WHO compiles empirical data from nationally-representative household surveys . Before data are included into the global databases, WHO undertake a process of data verification that includes correspondence with field offices to clarify any questions regarding estimates.
Method of estimation of global and regional aggregates:
Regional and global aggregates are weighted averages of the country data, using the number of live births for the reference year in each country as the weight. No figures are reported if less than 50 per cent of the live births in the region are covered.
Other possible data sources:
Facility reporting system
Preferred data sources:
Household surveys
Unit of Measure:
N/A
Expected frequency of data dissemination:
Annual
Expected frequency of data collection:
Annual
Comments:
The World Health Organization has issued a new series of recommendations to improve quality of antenatal care to reduce the risk of stillbirths and pregnancy complications and give women a positive pregnancy experience. By focusing on a positive pregnancy experience, these guidelines seek to ensure not only a healthy pregnancy for the woman and the baby, but also an effective transition to positive childbirth and ultimately to a positive experience of motherhood. An important feature of these guidelines is their comprehensiveness. Not only do they provide recommendations on standard maternal and foetal assessments, but also on nutrition during pregnancy, on prevention and treatment of physiological problems commonly experienced during pregnancy (e.g. nausea, heartburn, etc.), and on preventative interventions for certain contexts (e.g. malaria and/or HIV endemic areas). The guidelines also include recommendations on counselling and supporting women who may be experiencing intimate partner violence. Guidance on how antenatal care services can be provided more effectively and in different contexts is also included. For more information: WHO recommendations on antenatal care for a positive pregnancy experience - http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/
Contact person email:
mollera@who.int
Name:
Ann-Beth Moller
Links:
Demographic and Health Surveys (DHS) || http://www.measuredhs.com/
Multiple Indicator Cluster Surveys || https://mics.unicef.org/
Sexual and Reproductive Health and Research (SRH) || https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)
Sustainable Development Goals (SDG) indicators || https://unstats.un.org/sdgs/
Global Strategy Indicator and Monitoring Framework || https://www.who.int/life-course/publications/gs-Indicator-and-monitoring-framework.pdf?ua=1
WHO recommendations on antenatal care for a positive pregnancy experience || https://www.who.int/publications/i/item/9789241549912
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