40An antenatal care indicator based on contact with services and content developed for 63 countries. (2nd September 2021)

• Record Type: Journal Article
• Authors: Arroyave, Luisa; Saad-Haddad, Ghada; Victora, Cesar G; Barros, Aluisio
• Is Part Of: International journal of epidemiology. Volume 50(2021)Supplement 1
• Publication Date: 2021-09-02
• Subjects: Epidemiology -- Periodicals; 614.4
• DOI: 10.1093/ije/dyab168.040
• Languages: English
• ISSNs: 0300-5771

Abstract

Abstract: Background: Most antenatal care (ANC) indicators in use are criticized for considering only contact with services and not taking into account content of care. We aimed to create and validate a new indicator measured as a score, considering both contact and content, that can be used for monitoring. Methods: We used data from national surveys conducted in low and middle-income countries (LMICs). Information on ANC was used to build an adequacy score (ANCq) that would be applicable to all women in need of ANC. We used a convergent validation approach, exploring the association of our proposed indicator with neonatal mortality. Results: The ANCq score was derived from seven variables related to contact with services and content of care ranging from zero to ten. Surveys from 63 countries with all variables were used. The overall mean of ANCq was 6.7, ranging from 3.5 in Afghanistan to 9.3 in Cuba and the Dominican Republic. In most countries, the ANCq was inversely associated with neonatal mortality and the pooled for all surveys Odds Ratio was 0.90 (95% CI = 0.88-0.92). Conclusions: The ANCq presented good validity properties, being a useful tool for assessing ANC coverage and adequacy of care in monitoring and accountability exercises. Key messages: ANCq provides a standardized and comparable measure of ANC adequacy, allowing for comparisons between country population subgroups and between countries.