Antenatal Visit Coverage – Four Visits

Outcome indicator

Indicator Phrasing

% of mothers of children aged 0-23 months who had at least four antenatal health checks by any provider (skilled or unskilled) when they were pregnant with the youngest child
% de mères d'enfants âgés de 0 à 23 mois ayant eu au moins quatre visites prénatales par du personnel de santé (qualifié ou non) lorsqu'elles étaient enceintes du plus jeune enfant
% matek s dětmi ve věku 0-23 měsíců, které měly při jejich posledním těhotenství alespoň čtyři předporodní prohlídky

Indicator Phrasing

English: % of mothers of children aged 0-23 months who had at least four antenatal health checks by any provider (skilled or unskilled) when they were pregnant with the youngest child

French: % de mères d'enfants âgés de 0 à 23 mois ayant eu au moins quatre visites prénatales par du personnel de santé (qualifié ou non) lorsqu'elles étaient enceintes du plus jeune enfant

Czech: % matek s dětmi ve věku 0-23 měsíců, které měly při jejich posledním těhotenství alespoň čtyři předporodní prohlídky

What is its purpose?

A range of health problems experienced by pregnant women and their babies can be prevented and detected through frequent antenatal checks by skilled or unskilled providers. The indicator therefore assesses the proportion of women who attended antenatal visits at the level recommended by WHO.

How to Collect and Analyse the Required Data

Collect the following data by conducting individual interviews with a representative sample of mothers of children aged 0-23.99 months:

 

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: During your pregnancy with your youngest child, did anyone checked your and your baby’s health?

A1: yes / no

 

(ask the following question only if the previous answer is YES)

 

Q2: During your pregnancy with your youngest child, how many times did either a health facility staff, health volunteer or traditional birth assistant checked your and your baby’s health?

A2: once / twice/ three times / four times / five times / six times/ seven times/ eight times / does not remember

 

 

Calculate the indicator’s value by dividing the number of respondents who attended at least four or more antenatal checks by the total number of interviewed respondents (exclude those who did not remember) and multiplying the result by 100.

Important Comments

1) In late 2016, WHO increased the recommended number of antenatal visits from four to eight (see link below). Since different countries are likely to have different pace of adopting this recommendation (and having capacity to implement it), set the minimum number of antenatal visits based on the local Ministry of Health's official recommendations.

 

2) The two indicators of antenatal care (at least one visit and at least four visits) are based on WHO’s standard questions. While the “one visit” indicator focuses on the quality of care (i.e. care provided by a skilled health professional), the “four visits” indicator focuses on the intensity of care (given by either skilled or unskilled provider). Since most national surveys do not collect information on type of provider for each visit, WHO does not measure the number of visits provided by skilled health personnel. See more details in WHO’s guidance.

 

3) Interviewing mothers of children aged 0-23 months is the most common recommendation. However, this assumes that women will remember for up to two and half years how many antenatal visits they attended. If your existing experience or pre-testing shows that many women do not remember the number of antenatal visits accurately and if your data does not need to be comparable with the statistics of other stakeholders, consider interviewing instead mothers of children aged 0-12 months.

 

4) If you need to know whom exactly the respondent visited for antenatal care, you will have to ask about each visit individually (i.e. Whom did you see during the first visit? etc.). However, this should be assessed only if you interview mothers of children aged 0-12 months who are more likely to remember who they saw.

 

5) Disaggregate the data by location (rural/urban; nearby a health facility/far from a health facility), socio-economic characteristics (wealth quintile, education level) and mother’s age.

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