Health Services Coverage Statistics
Antenatal care coverage (percentage)
Rationale for use
Antenatal care coverage is an indicator of access and utilization of care during pregnancy.
Percentage of women who utilised antenatal care provided by skilled birth attendants for reasons related to pregnancy at least once during pregnancy among all women who gave birth to a live child in a given time period.
Antenatal care includes recording medical history, assessment of individual needs, advice and guidance on pregnancy and delivery, screening tests, education on self-care during pregnancy, identification of conditions detrimental to health during pregnancy, first-line management and referral if necessary.
A skilled birth attendant is an accredited health professional – such as a midwife, doctor or nurse – who has 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. Traditional birth attendants, trained or not, are excluded from the category of skilled attendant at delivery. In developed countries and in many urban areas in developing countries, skilled care at delivery is usually provided in a health facility. However, birth can take place in a range of appropriate places, from home to tertiary referral centre, depending on availability and need, and WHO does not recommend any particular setting. Home delivery may be appropriate for a normal delivery, provided that the person attending the delivery is suitably trained and equipped and that referral to a higher level of care is an option.
Live birth refers to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life - e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles - whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born.
Antenatal care coverage rates are calculated from:
Routine health service statistics: Number of women receiving antenatal care (numerator). Census projections or in some cases vital registration data are used to provide the denominator (numbers of live births).
Household surveys: Birth history - detailed questions on the last child or all children a woman has given birth to during a given period preceding the survey (usually 3 to 5 years). The number of births in the survey provides the denominator.
Methods of estimation
Empirical data from health facilities and/or household surveys are used.
By location (urban/rural, major regions/provinces) and socio-economic characteristics (e.g. women's education level, wealth quintile).
Coverage of maternity care
Antenatal care in developing countries. Promises, achievements and missed opportunities
The World Health Report 2005 - make every mother and child count
A single antenatal visit is not a good indicator of the quality of care. Additional indicators may include the number of visits (at least four per pregnancy are recommended) and the timing of the first visit.