Antenatal Visit Coverage - Four Visits

A range of health problems experienced by pregnant women and their babies can be prevented and detected through frequent antenatal checks by skilled or other community healthcare providers. The indicator therefore assesses the proportion of women who received at least four antenatal visits.

Collect the following data by conducting individual interviews with a representative sample of women aged 15 – 49 who in the past 2 years delivered a live child:

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

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

A1: yes / no

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

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

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

To calculate the indicator’s value, divide 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). Multiply the result by 100 to convert it to a percentage.

Disaggregate the data by location (rural/urban; near a health facility/far from a health facility), wealth category and mother’s age.

1) Use the following two questions to assess whether the respondent is “aged 15 – 49 years and had a live birth in the last 2 years”:

Q: What is your age?

A: specify: ______ / won’t say

Q: In the past two years, did you give birth to a child that was alive when it was born?

A: yes / no / won’t say

2) In late 2016, WHO increased the recommended number of antenatal visits from four to eight (see link below). Since different countries have a different pace of adopting this recommendation (and having capacity to implement it), Tearfund continues to measure the original standard of four visits. If you need to ensure that your data is aligned with the WHO or the local Ministry of Health's official recommendations, you might need to adjust the number of visits accordingly (though it should never be less than four).

3) If you need to know exactly who the respondent visited for antenatal care, you will have to ask about each visit individually (i.e. Who 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.

4) Consider also assessing when the first visit took place by asking: "How many months pregnant were you when you first received antenatal care for the pregnancy with your youngest child?"

5) If you are interested in the gender dimension of accessing antenatal care, consider asking: During the pregnancy with your youngest child, did your partner ever come with you to an antenatal care visit?

6) The indicator is based on UNICEF’s Multiple Indicator Cluster Survey (MICS) guidance.