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| Special emphasis must be placed on antenatal and post-natal care, essential obstetric care and care for newborns, particularly for those living in areas without access to services | Target 5.B: Achieve, by 2015, universal access to reproductive health |
The challenge
The antenatal period presents important opportunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and that of their infants.
Regular contact with a doctor, nurse or midwife allows health personnel to manage the pregnancy and provide a variety of services, such as treatment of hypertension to prevent eclampsia; tetanus immunization; intermittent preventive treatment for malaria and distribution of insecticide-treated mosquito nets; prevention of mother-to-child transmission of HIV; micronutrient supplementation; and birth preparedness, including information about danger signs during pregnancy and childbirth. The antenatal period is also an ideal opportunity to supply information on birth spacing, which is recognized as an important factor in improving infant survival.
The World Health Organization (WHO) recommends a minimum of four antenatal visits. WHO guidelines recommend, at a minimum, the measurement of blood pressure, testing of urine for bacteriuria and proteinuria, and blood tests to detect syphilis and severe anaemia.
Antenatal care is common across the developing world
According to the latest estimates, 79 per cent of women in the developing world receive antenatal care (ANC) from a skilled health provider at least once during pregnancy. Regional averages range from a low of 70 per cent in South Asia to a high of 95 per cent in Central and Eastern Europe/Commonwealth of Independent States (CEE/CIS) and Latin America and the Caribbean. Coverage is also high in East Asia and the Pacific, where 90 per cent of pregnant women receive care from a skilled provider at least once.
Majority of pregnant women – at least 7 in 10 in all developing regions – receive antenatal care from a skilled health professional
Percentage of women attended at least once during pregnancy by a doctor, nurse, midwife or auxiliary midwife, 2005–2009
Source: UNICEF global databases, based on Multiple Indicator Cluster Surveys (MICS), Demographic and Health Surveys (DHS) and other national surveys.
Coverage of four or more ANC visits must be improved
Half of all pregnant women in developing countries receive the minimum recommended four antenatal visits. The data do not, however, reflect the quality of care, which is difficult to measure. It is essential to ensure a high quality of antenatal care so that services provided actually contribute to improved maternal health.
Although ANC coverage is high, just half of women in developing world receive recommended minimum of four visits
Percentage of women attended at least four times during pregnancy by any provider, 2005–2009
* Excludes China.
Source: UNICEF global databases, based on MICS, DHS and other national surveys.
Note: Data are insufficient for calculation of Middle East and North Africa and CEE/CIS regional averages.
Substantial improvements in ANC coverage since 1990
Every region has made substantial progress in extending coverage of antenatal care for women at least once during pregnancy. South Asia, the Middle East and North Africa, and East Asia and the Pacific experienced the largest improvements during this time period, each with about a 20 percentage point increase.
Antenatal care coverage has improved in every region
Percentage of women attended at least once during pregnancy by a doctor, nurse, midwife or auxiliary midwife, 1990–2009
Source: UNICEF global databases, based on MICS, DHS and other national surveys.
Note: Regional aggregates presented within trend charts may differ from the latest regional estimates presented elsewhere. In analysing trends, the same subset of countries must be included in the calculation for each point in time. This can yield a different result from the latest regional estimate, which is calculated using all available data for the most recent year.
References
UNICEF, Progress for Children: A report card on maternal mortality, 2008.
UNICEF/WHO, Antenatal Care in Developing Countries: Promises, achievements and missed opportunities, 2003.
WHO/The Partnership for Maternal, Newborn and Child Health, Strategy and Workplan 2009–2011, 2009.