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Original Articles
Open Access

The quality–coverage gap in antenatal care: toward better measurement of effective coverage

Stephen Hodgins and Alexis D'Agostino
Global Health: Science and Practice May 2014, 2(2):173-181; https://doi.org/10.9745/GHSP-D-13-00176
Stephen Hodgins
aSave the Children, Washington, DC, USA
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  • For correspondence: shodgins@savechildren.org
Alexis D'Agostino
bJohn Snow, Inc., Arlington, VA, USA
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Figures & Tables

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  • FIGURE.
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    FIGURE.

    Coverage for Key ANC Services Among Pregnant Women With 4+ ANC Visits,a Across 41 Demographic and Health Surveys

    a Self-reported receipt of services among women delivering during the 2 years preceding the survey and reporting 4+ ANC visits.

    Abbreviations: ANC, antenatal care; ANC<4mo, first antenatal care visit before 4 months gestation; BP, blood pressure; DSs, counseled on pregnancy danger signs; HIV, HIV counseling and testing; IFA, iron–folic acid supplementation for 90+ days; SP2+, at least 2 doses of sulfadoxine/pyramethamine for malaria prevention; TT2+, protected against tetanus; Ur, urine specimen taken.

    The horizontal line in the middle of each solid box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively. The “whiskers,” or lines, below and above the box mark the minimum and maximum values, respectively. Numbers in parentheses in the x-axis refer to the number of surveys providing data for that particular indicator.

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    TABLE 1. Receipt of Specific Services Among Pregnant Women With 4+ ANC Visitsa (%)
    SurveyANC4+ANC<4moIFA90+TT2+DSsBPUrHIVSP2+AVG
    Colombia 201087826283100988585
    Dominican Rep 2007968466927099978685
    Nepal 20115372789787947283
    Maldives 20098793658651979581
    Honduras 2005–067979737568977978
    Rwanda 201036737488439675
    Peru 2007–088875176984988171
    India 2005–063680329334898569
    Philippines 20087661358075966068
    Senegal 2010–1148786875489888394768
    Burkina Faso 201033655091569789415067
    Ghana 200876654477759893325167
    Bolivia 20087276106670987766
    Cambodia 2010648114948396424865
    Guyana 2009775330426496947865
    Haiti 2005–06517332765098763663
    Pakistan 2006–072970298433927063
    Cameroon 201159476587509689303562
    Swaziland 2006–07772730825498915362
    Malawi 201043232790818531886161
    Timor-Leste 2009–105464209161952058
    Indonesia 20078184315643954258
    Lesotho 200966409845997734658
    Namibia 2006–0770362956639792731157
    Benin 20065961617442999320457
    Ethiopia 20111740812983564956
    Zambia 200757264183757921397455
    Kenya 2008–094426383538976832054
    Liberia 2007667213864087521452
    Tanzania 20103926293567158753452
    Guinea 200546493586299365552
    Zimbabwe 2010–115925564668860821050
    Uganda 20114633690576628783149
    Nigeria 200844282277648675261048
    Congo (Brazzaville) 2005725517544095958346
    Mali 200636572478329253111746
    Sierra Leone 200856391587608742121444
    Madagascar 2008–0946428795283348839
    Niger 20061546255728904651339
    Burundi 2010333979140501246136
    Dem Rep Congo 200747282474273518832
    Mean57553079589167492560
    • Abbreviations: ANC4+, 4 or more antenatal care visits; ANC<4mo, first antenatal care visit before 4 months gestation; BP, blood pressure; DSs, counseled on pregnancy danger signs; HIV, HIV counseling and testing; IFA, iron–folic acid supplementation for 90+ days; SP2+, at least 2 doses of sulfadoxine/pyramethamine for malaria prevention; TT2+, protected against tetanus; Ur, urine specimen taken.

    • AVG: Average coverage across the 8 interventions (or fewer, if specific intervention(s) not included in the survey). Country data are presented in order, from highest average coverage to lowest.

    • ↵a Self-reported receipt of services among women delivering during the 2 years preceding the survey and reporting 4+ ANC visits.

    • View popup
    TABLE 2. Receipt of Specific Services Among All Pregnanciesa (%)
    SurveyANC4+ANC<4moIFA90+TT2+DSsBPUrHIVSP2+AVGALL
    Dominican Rep 200796816591699996868434
    Maldives 2009879064865197958128
    Colombia 2010877459799694808034
    Honduras 2005–06796561716089686910
    Rwanda 201036408471843692688
    Peru 2007–0888681566789375667
    Nepal 2011535052846676516322
    Guyana 20097746294262949171624
    Philippines 2008765028746789526010
    Ghana 2008765436706794862746605
    Senegal 2010–11485856704293803040593
    Swaziland 2006–077722257850968650582
    Burkina Faso 2010334034865093813139571
    Bolivia 20087260858608965573
    Cambodia 20106463108873843438562
    Malawi 2010431215877882278555551
    Namibia 2006–07703024565892886811530
    Indonesia 200781742550398837524
    Lesotho 2009663067549886342501
    Zambia 2007571828797075193966491
    Cameroon 2011593243744079722326492
    Haiti 2005–065161186238825524498
    Timor-Leste 2009–1054431278488215461
    Benin 200659404261348881143450
    Tanzania 201039141915064476827450
    Liberia 2007665911773879460442
    Kenya 2008–0944141724077617015440
    Uganda 201146203854955217227420
    Zimbabwe 2010–115916354557550688410
    India 2005–0636431576194844414
    Sierra Leone 2008562913815681371012400
    Congo (Brazzaville) 20057242134534828270380
    Guinea 20054632192272474320
    Madagascar 2008–09462546843712367310
    Burundi 2010331938735449400300
    Nigeria 200844161248385346156290
    Mali 200636301257216431611290
    Dem Rep Congo 2007471813733624267260
    Pakistan 2006–072931126017523200252
    Ethiopia 20111710499311716221
    Niger 2006151372312411810140
    Mean57402169497855432050
    • Abbreviations: ANC4+, 4 or more antenatal care visits; ANC<4mo, first antenatal care visit before 4 months gestation; BP, blood pressure; DSs, counseled on pregnancy danger signs; HIV, HIV counseling and testing; IFA, iron–folic acid supplementation for 90+ days; SP2+, at least 2 doses of sulfadoxine/pyramethamine for malaria prevention; TT2+, protected against tetanus; Ur, urine specimen taken.

    • AVG: Average coverage across the 8 interventions (or fewer, if specific intervention(s) not included in the survey). Country data are presented in order, from highest average coverage to lowest.

    • ↵a Self-reported receipt of services among all women delivering during the 2 years preceding the survey.

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Global Health: Science and Practice: 2 (2)
Global Health: Science and Practice
Vol. 2, No. 2
May 01, 2014
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The quality–coverage gap in antenatal care: toward better measurement of effective coverage
Stephen Hodgins, Alexis D'Agostino
Global Health: Science and Practice May 2014, 2 (2) 173-181; DOI: 10.9745/GHSP-D-13-00176

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The quality–coverage gap in antenatal care: toward better measurement of effective coverage
Stephen Hodgins, Alexis D'Agostino
Global Health: Science and Practice May 2014, 2 (2) 173-181; DOI: 10.9745/GHSP-D-13-00176
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