CRING data compilation process Examples from MICS reports

1. Maternal and Reproductive Health indicators CRING data compilation process Examples from MICS reports Statistics and Monitoring Section UNICEF HQ March 2013

2. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

3. MDG 5 – Improve maternal health MICS4 Survey Design Workshop

4. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

5. Contraceptive prevalence rate • Contraceptive use has contributed to improvements in maternal and infant health by serving to prevent unintended or closely spaced pregnancies. MDG report 2012

6. Contraceptive prevalence rate

7. Contraceptive prevalence rate Traditional Modern Modern and traditional Any method is an MDG indicator

8. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

9. Antenatal care • Antenatal care is also among the interventions that can reduce maternal mortality and morbidity. • The antenatal period is critically important for reaching women with interventions and information that promote health, wellbeing and survival of mothers as well as their babies. MDG report 2012

10. Antenatal care: At least one visit with skilled provider (ANC1)

11. Antenatal care: At least one visit with skilled provider (ANC1) • MDG 5 indicator: Antenatal care, at least one visit • Personnel categories • Should have been modified in country • MICS4 standard -- Skilled health personnel includes doctors, nurses, midwives (auxiliary midwives in some countries).

12. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

13. Antenatal care: Four or more visits with any provider (ANC4) • The World Health Organization (WHO) recommends a minimum of four visits for antenatal care, including, at a minimum, screening and treatment for infections and identification of warning signs during pregnancy. (MDG report 2012) • Given measurement challenges, it is not possible to measure that all 4 visits were done with skilled providers, although it might be ideal. • The ANC4 indicator does not look at the content of the visits but rather at the number of visits.

14. Antenatal care: Four or more visits with any provider (ANC4)

15. Antenatal care: Four or more visits with any provider (ANC4) • MDG 5 indicator: Antenatal care, 4 or more visits • Watch out for… • Indicator definition (any provider)

16. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery Care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

17. Delivery CareSkilled attendant at birth • Having a skilled health professional (doctor, nurse or midwife) is a life saving intervention, both for mothers and babies. • Skilled birth attendants can administer interventions to prevent and manage life-threatening complications such as heavy bleeding, or refer the patient to a higher level of care when needed. MDG report 2012

18. Delivery CareSkilled attendant at birth • Beyond doctor, nurse and midwife, skilled categories may vary by country. • The reporting needs to be customized according to the health cadre in the country. • This can be confirmed with MoHs at the country level and customized accordingly for data collection and reporting.

19. Delivery Care: Skilled attendant at birth MDG 5 indicator: Skilled attendant at delivery MICS 4 standard -- Skilled health personnel includes doctors, nurses, midwives (auxiliary midwives in some countries)

20. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery Care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

21. Delivery CareCaesarean section (C-section) • Caesarean sections are one component of comprehensive emergency obstetric care, which also includes blood transfusions and other interventions to manage life-threatening complications of pregnancy and childbirth. • Rates below 5% signal a lack of access to emergency obstetric care, and rates above 15% suggest overuse, which may increase poor maternal and neonatal health outcomes(WHO) Countdown to 2015 – The 2012 report

22. Delivery CareC-Section

23. Delivery Care: Skilled attendant at birth and C-Section

24. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

25. Delivery CareInstitutional deliveries • In addition to professional attention during birth by a skilled birth attendant, it is important that mothers deliver their babies in an appropriate setting, where life saving equipment and hygienic conditions can also help reduce the risk of complications that may cause death or illness to mother and child.

26. Delivery CareInstitutional deliveries

27. Delivery Care: Institutional deliveries • Place of delivery categories varies per country • Public and private, as long as it refers to health facilities • Common - administrative reports on this indicator

28. Maternal health indicators in CRING • Contraceptive prevalence rate • Antenatal care • At least one visit (skilled provider) • At least 4 visits (any provider) • Delivery care • Skilled attendant at birth • C-Section • Institutional deliveries • Early child bearing • Births by age 18

29. Early childbearingBirths by age 18 • One measure of early childbearing is the percentage of young women aged 20–24 • Early childbearing often results from child marriage. • Negative consequences of child marriage abound, particularly for girls. They may be cut off from their families, their formal education left behind. Their development – and the fulfillment of their human rights – may be compromised. There are also health concerns associated with child marriage, which often leads to adolescent childbearing.

30. Early childbearingBirths by age 18

31. Early childbearingBirths by age 18 Sum of the first two columns

32. Childinfo – Delivery care • http://www.childinfo.org/delivery_care.html

33. Childinfo – Antenatal care • http://www.childinfo.org/antenatal_care.html