There are wide disparities in antenatal care across countries

Regular contact with a doctor, nurse or midwife during pregnancy allows women to receive services vital to their health and that of their future children. The World Health Organization (WHO) recommends a minimum of eight antenatal care contacts to reduce perinatal mortality and improve women’s experience of care. However, global, regional and comparable country reported data are only available for the previous recommendation which was a minimum of four visits. Currently available data indicate that women receive at least 4 antenatal care visits.

Data

Antenatal care coverage

  • Maternal and newborn health coverage

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Notes on the data

Definition of indicators

Antenatal care coverage (at least one visit) is the percentage of women aged 15 to 49 with a live birth in a given time period that received antenatal care provided by skilled health personnel (doctor, nurse or midwife) at least once during pregnancy.

Skilled health personnel refers to workers/attendants that are accredited health professionals – such as a midwife, doctor or nurse – who have been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns. Both trained and untrained traditional birth attendants are excluded.

Antenatal care coverage (at least four visits) is the percentage of women aged 15 to 49 with a live birth in a given time period that received antenatal care four or more times. Available survey data on this indicator usually do not specify the type of the provider; therefore, in general, receipt of care by any provider is measured.

Antenatal visits present opportunities for reaching pregnant women with interventions that may be vital to their health and well-being and that of their infants. WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. WHO guidelines are specific on the content of antenatal care visits, which should include:

  • blood pressure measurement
  • urine testing for bacteriuria and proteinuria
  • blood testing to detect syphilis and severe anaemia
  • weight/height measurement (optional).

Measurement limitations.  Receiving antenatal care during pregnancy does not guarantee the receipt of interventions that are effective in improving maternal health. Receiving antenatal care at least four times, which is recommended by WHO, increases the likelihood of receiving effective maternal health interventions during antenatal visits. Importantly, although the indicator for ‘at least one visit’ refers to visits with skilled health providers (doctor, nurse or midwife), ‘four or more visits’ refers to visits with any provider, since standardized global national-level household survey programmes do not collect provider data for each visit. In addition, standardization of the definition of skilled health personnel is sometimes difficult because of differences in training of health personnel in different countries.