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ANC [message #22625] Mon, 12 April 2021 08:07 Go to next message
DHS user is currently offline  DHS user
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Registered: February 2013
Senior Member
'SECTION 4. PREGNANCY AND POSTNATAL CARE' of the DHS-8 women questionnaire includes only women with a history of 'ONE OR MORE PREGNANCY OUTCOMES 0-35 MONTHS BEFORE THE SURVEY'. On the other hand, the ANC indicator definition states 'Percentage of women with a birth in the last 5 years..." (page 335 of the guide).

Here are my queries:

1. By 'ONE OR MORE PREGNANCY OUTCOMES', does it mean that women who are pregnant at the time of the survey but of no previous birth/pregnancy history won't be included in the 'SECTION 4. PREGNANCY AND POSTNATAL CARE'

2. How could the 2 ANC periods (0-35 months in the questionnaire and 0-59 months/last 5 years in the guide) be reconciled?

3. What is the appropriate time to be covered by the ANC indicator?

4. Could both dejure and defacto women be included in the ANC indicator?

Re: ANC [message #22626 is a reply to message #22625] Mon, 12 April 2021 08:16 Go to previous message
Bridgette-DHS is currently offline  Bridgette-DHS
Messages: 3017
Registered: February 2013
Senior Member
Please see the responses below your questions, answered by Senior Demographic and Health Researcher, Sara Riese:

1. By 'ONE OR MORE PREGNANCY OUTCOMES', does it mean that women who are pregnant at the time of the survey but of no previous birth/pregnancy history won't be included in the 'SECTION 4. PREGNANCY AND POSTNATAL CARE'

Yes. Women have to have had a "pregnancy outcome", meaning a live birth, a stillbirth, a miscarriage, or an abortion, in order to answer questions in Section 4.

2. How could the 2 ANC periods (0-35 months in the questionnaire and 0-59 months/last 5 years in the guide) be reconciled?

In the discussions for the revision of the women's questionnaire for DHS-8, it was decided to reduce the recall period for the pregnancy and postnatal care section to 3-years (0-35 months). The Guide to DHS Statistics you are referring to is for DHS-7, and so still includes the 5-year recall period. In order to reconcile DHS-8 data with data from earlier surveys, I would recommend using a 3-year, or shorter, recall period for any of the ANC/Delivery/PNC indicators of interest. The Github DHS Stata files show how to calculate any of the Reproductive Health indicators for a reference period of 2 or 5 years, and can easily be modified for any reference period.

3. What is the appropriate time to be covered by the ANC indicator?

There is no specific time that is deemed "appropriate" for the ANC indicator. The time period would depend on the data and the research question of interest. Since numerator of the ANC indicator, the number of births in the last X years, is frequently used as a denominator for other indicators, the issue is the recall period for those other indicators. While women are unlikely to forget having a birth in the last 2, 3, or 5 years, they may forget other events that occurred during the pregnancy, birth, or post-partum period, such as services provided during ANC. A shorter recall period may improve women's ability to accurately report these events.

4. Could both dejure and defacto women be included in the ANC indicator?

Women who are both de jure AND de facto can be included in the ANC indicator. However, to be included in the IR file, a woman has to be de facto, therefore if she is de jure but not de facto, she is not included in the dataset and could not be included in the ANC indicator.

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