Percent of pregnant women whose blood pressure was checked at first ANC visit
The percent of women ages 15 to 49 with a live birth within a given time period who had their blood pressure checked at their first visit for antenatal care (ANC). WHO guidelines include blood pressure checks as a basic component of ANC (WHO, 2002).
This indicator is calculated as:
(Number of women ages 15 to 49 with a live birth whose blood pressure was checked at their first ANC visit / Total number of women ages 15 – 49 with live births within reference period) x 100
This indicator can be calculated from the Demographic Health Survey (DHS), the Reproductive Health Survey (RHS), UNICEF Multiple Indicator Cluster Survey (MICS), or other national surveys that collect detailed pregnancy histories. Specialized survey data and health facility records can also be used. Data can be disaggregated by the type of facility (public, private, non-governmental, community-based), by district and urban rural location.
Population-based surveys, such as DHS, RHS, and MICS; facility records and health services data
This indicator measures whether ANC facilities are consistently measuring women’s blood pressure as early as possible in their pregnancies, and can serve as a proxy for the quality of ANC care. Women’s blood pressure should be monitored at each ANC visit and during delivery. A blood pressure measure early in pregnancy (ideally in the first trimester) can help distinguish whether women have chronic high blood pressure (or hypertension), which was present before pregnancy, or a pregnancy-induced hypertension which occurs after 20 weeks gestation, during labor, or within 48 hours of delivery (WHO, 2008). Women with chronic hypertension can benefit from treatment and continued monitoring during pregnancy. For women with pregnancy-induced hypertension after 20 weeks, their condition may progress from a mild hypertension to pre-eclampsia, then to the life-threatening condition of eclampsia. If pre-eclampsia is detected and appropriately managed before the onset of convulsions and other
life-threatening complications, women’s risk of developing eclampsia can be
reduced. Eclampsia accounts for about 12 percent of maternal deaths (WHO, 2008). This indicator relates to achieving Millennium Development Goals #5. improve maternal health and #4. reduce child mortality.
With population-based surveys, recall error is a potential source of bias given that surveys ask the respondent about each live birth for a period up to five years before the interview. The respondent may or may not remember if her blood pressure was taken at her first ANC visit. Data on women’s blood pressure measured at their first ANC visit from routine health records will not include information for pregnancies occurring outside the public health sector, including home and private facility deliveries.
quality, safe motherhood (SM)
WHO, 2002, Antenatal Care Randomized Trial: Manual for the Implementation of the New Model, Geneva: WHO. http://whqlibdoc.who.int/hq/2001/WHO_RHR_01.30.pdf
WHO, 2008, Managing Eclampsia: Education material for teachers of midwifery, Midwifery education modules – second edition, Geneva: WHO. http://whqlibdoc.who.int/publications/2008/9789241546669_2_eng.pdf