Number of HIV-positive pregnant women who received antenatal care at least four times prior to delivery

Background

The decision to go to a facility for antenatal care has been linked with the decision to deliver at a health facility, where medications can be provided to prevent mother-to-child transmission. Women are less likely to deliver in a health facility if they have not received at least one antenatal care visit. Involvement of community workers is crucial to the effort to link pregnant women to antenatal care and encourage use of antenatal care services. It has been shown to significantly improve attendance, where HIV testing, counseling, and pregnancy services can be provided, and a birth plan put in place. Antenatal care is part of the cascade of interventions required to prevent mother-to-child transmission, along with HIV testing in pregnancy, use of antiretroviral therapy among HIV-positive pregnant women, safe childbirth and feeding practices, uptake of infant HIV testing, and other postnatal health services. Community workers have been shown to be effective in identifying pregnant women early in their pregnancy and improving uptake of antenatal care services. This indicator tracks progress to increase attendance at all antenatal care visits prior to delivery, to ensure that pregnant women living with HIV have all the tools in place to prevent transmission to their infants.

Numerator

Number of HIV-positive pregnant women who delivered and received at least four antenatal care visits prior to delivery during the reporting period

Unit of measure

Number

Calculation

Sum results across reporting period

Method of measurement

This information can be obtained through coordination with facilities and community-based organizations supporting HIV-positive pregnant women, to prevent vertical transmission of the virus. It can also be obtained by tracking HIV-positive pregnant women throughout the course of their pregnancy. Community workers are key to ensuring that pregnant women vulnerable to HIV are linked to HIV counseling and testing services, to ensure that appropriate treatment is provided before and during delivery. This indicator includes HIV-positive pregnant women who delivered during the reporting period and received at least four antenatal care visits at facilities prior to delivery. Community workers can ask new mothers whether they received all visits, during pregnancy and prior to delivery, to count towards this indicator.

Data source

This information can be collected through community worker monthly community reports, client and antenatal profiles, and client appointment diaries and is often collected by programs that place particular emphasis on supporting pregnant women and mothers.

Disaggregation

  • Youth female (15–24), adult female (25 years and above)

Data quality considerations

This indicator does not track the quality of care provided but the intensity of antenatal care for HIV-positive pregnant women. Recall bias may be a factor if new mothers are not asked within a year of when they delivered their infants. The overall number reported for this indicator equal the sum of individuals in each disaggregation type. Only one type of age disaggregation should be used throughout, and overlap should be avoided.

Reporting frequency

Community workers should collect this information regularly but monitor progress monthly with support from their supervisors. The indicator should be reported on a quarterly basis.

Data element

4+ antenatal care attendance by HIV-positive pregnant women

Category

Prevention of Mother-to-Child Transmission, HIV Prevention

Data use case

To see a data use example for this indicator, please click below.

Uptake of Antenatal Care and Community-Based Data for Decision Making in Ethiopia

References

Perez, F., Aung, K. D., Ndoro, T., Engelsmann, B., & Dabis, F. (2008). Participation of traditional birth attendants in prevention of mother-to-child transmission of HIV services in two rural districts in Zimbabwe: A feasibility study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19061506

Prevention of mother-to-child transmission (PMTCT) of HIV. (2018). Retrieved from https://www.avert.org/professionals/hiv-programming/prevention/prevention-mother-child

Lema, I. A., Sando, D., Magesa, L., Machumi, L., Mungure, E., Sando, M. M., . . . Bärnighausen, T. (2014). Community health workers to improve antenatal care and PMTCT uptake in Dar es Salaam, Tanzania: A quantitative performance evaluation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252140/

Gunn, J. K., Asaolu, I. O., Center, K. E., Gibson, S. J., Wightman, P., Ezeanolue, E. E., & Ehiri, J. E. (2016). Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: A cross-sectional study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718968/

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