| Coverage of Nutritional Interventions during Antenatal Care (ANC) [message #16770] |
Fri, 01 March 2019 13:44  |
DataDENT
Messages: 11
Registered: January 2019
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Nutrition-specific interventions during pregnancy are a key component of the WHO 2016 Antenatal Care for a Positive Pregnancy Experience guidelines. We propose four indicators that will allow countries to monitor implementation of WHO-recommended dietary counseling and cash/food support interventions.
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.
[Updated on: Fri, 01 March 2019 13:56] Report message to a moderator |
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| Re: Coverage of Nutritional Interventions during Antenatal Care (ANC) [message #16901 is a reply to message #16770] |
Wed, 13 March 2019 21:34  |
SUN Movement MEAL Team
Messages: 9
Registered: March 2019
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The SUN MEAL Results Framework seeks to track the coverage of nutrition interventions targeted to women during pregnancy. The data from these additional questions would be very useful in this regard.
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).
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| Re: Coverage of Nutritional Interventions during Antenatal Care (ANC) [message #17353 is a reply to message #16770] |
Fri, 15 March 2019 18:17 |
Rolf Klemm
Messages: 7
Registered: March 2019
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HKI wishes to endorse the first two Nutritional Interventions during Antenatal Care (ANC) recommendations for inclusion in DHS-8 (2018-2023).
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.
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| Re: Coverage of Nutritional Interventions during Antenatal Care (ANC) [message #17403 is a reply to message #17353] |
Fri, 15 March 2019 22:29 |
gwg
Messages: 2
Registered: March 2019
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I support the recommendation for including the 4 questions proposed by DataDENT, and using the recall period of 2 years to minimize respondent burden.
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"'
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| Re: Coverage of Nutritional Interventions during Antenatal Care (ANC) [message #17417 is a reply to message #16770] |
Fri, 15 March 2019 23:28 |
Olutayo
Messages: 12
Registered: March 2019
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I support the inclusion of the indicator and the associated questions. Understanding determinants of poor nutrition outcomes, including inadequate program coverage, is necessary to effectively address the issue. The fact that most countries are not on track to meet WHA 2025 nutrition goals show that we need to do things differently or better, and there can be no meaningful action without the right data to guide such action.
[Updated on: Fri, 15 March 2019 23:28] Report message to a moderator |
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