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Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16770&th=7824#msg_16770
1. Counseling about healthy eating during pregnancy
Definition: The proportion of women 15-49 who attended ANC for the most recent live birth in the 5 years* preceding the survey that received counseling about what foods to eat during pregnancy.
2. Weight measured during at least 2 ANC visits
Definition: The proportion of women 15-49 who attended ANC for the most recent live birth in the 5 years* preceding the survey that reported weight being measured over at least two ANC visits.
Currently DHS module "Supplemental Module on Maternal Health Care" asks about weight measured during at least once ANC visit.
3. Monitoring of weight gain during pregnancy (weight assessed + talk with provider)
Definition: The proportion of women 15-49 who attended ANC for the most recent live birth in the 5 years* preceding the survey that reported weight being measured over at least two ANC visits AND discussed weight with provider.
4. Received food or cash assistance during pregnancy from government, religious institution or NGO program
Definition: The proportion of women 15-49 who gave birth in the 5 years* preceding the survey that received food or cash assistance while pregnant for their most recent birth.
*We support the forthcoming newborn community's recommendation to modify all Section 4. Pregnancy and Postnatal Care to include live births occurring in the previous 2 years. This would be advantageous to reduce data collection burden, align with MICS, and improve data quality. If this recommendation is adopted, the recall period for this proposed recommendation can be changed to 2 years.
Attached to this post is a completed submission form with full justification for the recommendation.
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This recommendation originated in a consultation focused on measuring coverage of programs to support breastfeeding and complementary feeding, co-convened by Alive & Thrive, the International Food Policy Research Institute (IFPRI), and Data for Decisions to Expand Nutrition Transformation (DataDENT). It was further discussed and endorsed at the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments--a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), and coordinated by DataDENT. The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.
This recommendation was authored by IFPRI and reviewed by Laurence Grummer-Strawn (WHO), Chika Hayashi (UNICEF), Chessa Lutter (RTI), and Monica Kothari (PATH).
This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 1 of 3 (critical data need).
This recommendation is also endorsed by Countdown to 2030, Alive & Thrive, the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.]]>DataDENT2019-03-01T18:44:04-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16841&th=7824#msg_16841
I would recommend a small change on question 4: The proportion of women 15-49 who gave birth in the 5 years* preceding the survey that received food or cash assistance while pregnant for their most recent birth.
"received food or cash" should be more specific as for example: "received food or cash from government, United Nations, or NGO program". Otherwise the question could capture food or cash donations from family or friends.
]]>Marie Ruel2019-03-07T21:57:22-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16894&th=7824#msg_16894
I see Indicator 4 on receipt of food or cash assistance being especially relevant in countries with large-scale conditional cash transfers (CCT) programs. It is my understanding that ENDES (Peru DHS) captures such data in relation to the JUNTOS CCT, although it is not specifically asked in the context of pregnancy. In some CCT programs, antenatal care contacts could be a "condition" met for receiving the cash or food, therefore it may also be valuable to capture this additional information for programmatic purposes. ]]>sjiwani12019-03-13T19:29:47-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16901&th=7824#msg_16901
We recommend prioritizing indicator #3 since it gives a better understanding on the "quality" of the service. We believe that indicator #2 (assessing weight) is not as useful.
We currently have no source of data on dietary interventions during pregnancy that is comparable across the 60 SUN countries. We are currently restricted to monitoring proportion of population benefiting from social protection programmes; the addition of a question on receipt of food or cash assistance during pregnancy would enable us to track these nutrition-specific actions for our specific target group of interest (women during pregnancy).
]]>SUN Movement MEAL Team2019-03-14T01:34:10-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16910&th=7824#msg_16910
We propose to maintain both indicators 2 and 3, because this will provide clearer information on where is the bottleneck in ANC services, i.e. on measuring weight, or providing counselling based on measurements.
We propose to remove indicator 4, because it is very programme specific and is not relevant for Tanzania which is mostly a food secure country where there is no need of food assistance for pregnant women.
UNICEF Nutrition Team Tanzania.]]>Mauro Brero2019-03-14T05:50:53-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16933&th=7824#msg_16933
4. Received food or cash assistance during pregnancy from government, religious institution or NGO program
(a) What kind of food assistance
(i) Take home rations at regular intervals e.g. monthly
(ii) Daily hot cooked meal near home
(iii) Specific food e.g protein rich foods pulses, fortified foods
(b) Total Cash assistance received
Cash assistance through government programs is often in the form of large scale conditional cash transfers. Getting this additional information regarding food / cash assistance will be valuable for programmatic purpose . ]]>Geeta Verma2019-03-14T09:48:08-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=16975&th=7824#msg_16975
jruelbergeron2019-03-14T19:29:28-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17003&th=7824#msg_17003
kdearden2019-03-15T10:04:14-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
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Nsia2019-03-15T10:55:04-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
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Paula Kawiche2019-03-15T11:02:24-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17070&th=7824#msg_17070
aperry2019-03-15T14:32:46-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17121&th=7824#msg_17121
salayon2019-03-15T18:24:20-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17145&th=7824#msg_17145
Indicator #4 We too agree with some of the above comments, specifically that cash and food assistance should be separated, if included at all.
Additionally, please consider during the updating of your tabulation plan, the IPTP guidelines for ANC, in line with "positive pregnancy experience" guidelines/recommendation particularly number of visits, dose of folate, and IPTP. See: https://apps.who.int/iris/bitstream/handle/10665/250796/9789 241549912-eng.pdf;jsessionid=5217E7F88EA53BD2D86DADED04A4EFDA?sequence=1
]]>PATH2019-03-15T19:04:42-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17169&th=7824#msg_17169
We support the four indicators and the associated additions to the respective DHS-7 question. If it is possible to add more about what the health care provider's dietary recommendations were, as opposed to just a "yes" or "no" answer, that may also provide insight into the quality of care and counseling.
]]>1000 Days2019-03-15T19:26:32-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17328&th=7824#msg_17328
Erin Milner2019-03-15T21:44:15-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
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ktripp2019-03-15T22:04:27-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17353&th=7824#msg_17353
We have had field experience testing question 1 during survey work in Bangladesh, with a two-year recall period as is now the recommendation, and we found the question was easily understood and correlated well with better growth outcomes. We also believe that indicator 2 on taking maternal weight during ANC would be easy to add to the questionnaire module.
HKI, JPGSPH, "State of Food Security and Nutrition in Bangladesh: 2014" (Dhaka, BD, 2016).
We are less certain of the use of questions 3 and 4. For question 3, we are not certain if the respondent will be able to judge that the weight information was used in the discussion. A separate composite indicator could be produced form question 1 and 2 with much the same meaning.
For question 4, it is unclear if the respondent will know if the program was linked to the pregnancy or just given at the same time. Even if not linked to the pregnancy, access to such support is useful information but the use of the information is unclear.
]]>Rolf Klemm2019-03-15T22:17:47-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17403&th=7824#msg_17403
Data on coverage of nutrition-specific interventions that aim to improve pregnancy and neonatal outcomes are virtually unavailable (except for delivery and intake of iron and folic acid supplements during pregnancy). Thus, including all the proposed questions would be useful for designing and evaluating maternal health and nutrition programs. This has been my observation as a current doctoral candidate at Cornell and a nutritionist working closely with public health programs on maternal and child nutrition in S. Asia.
On #2 and #3: Since the DHS "Supplemental Module on Maternal Health Care" already asks about weight measured during (at least once) ANC visit, retaining this question with the proposed modification of "at least two ANC visits" does not seem burdensome. In fact, when we know little about coverage of nutrition-specific interventions that target pregnant women, it would be useful to assess prevalence of weight monitoring during pregnancy with question 2, and then assess promotion of weight gain during pregnancy with question 3.
On #4: To assess whether cash/food assistance was received in relation to pregnancy, I propose a small change: 'Received food or cash assistance during pregnancy from government, religious institution or NGO program "after ANC registration"'
OR 'Received food or cash assistance during pregnancy from government, religious institution or NGO program"upon identification of pregnancy"' ]]>gwg2019-03-16T02:29:17-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17413&th=7824#msg_17413
Judy Canahuati2019-03-16T03:21:01-00:00Re: Coverage of Nutritional Interventions during Antenatal Care (ANC)
https://userforum.dhsprogram.com/index.phpindex.php?t=rview&goto=17417&th=7824#msg_17417
Olutayo2019-03-16T03:28:15-00:00