Health Economics Unit, School of Public Health and Family Medicine, Health Sciences Faculty, University of Cape Town, Cape Town, South Africa.
PLoS One. 2018 Oct 5;13(10):e0204822. doi: 10.1371/journal.pone.0204822. eCollection 2018.
Antenatal period is an opportunity for reaching pregnant women with vital interventions. In fact, antenatal care (ANC) coverage was an indicator for assessing progress towards the Millennium Development Goals. This paper applies a novel index of service coverage using ANC, which accounts for every ANC visit. An index of service coverage gap is also proposed. These indices are additively decomposable by population groups and they are sensitive to the receipt of more ANC visits below a defined threshold. These indices have also been generalised to account for the quality of services.
Data from recent rounds of the Demographic and Health Survey (DHS) are used to reassess ANC service coverage in 35 sub-Saharan African countries. An index of ANC coverage was estimated. These countries were ranked, and their ranks are compared with those based on attaining at least four ANC visits (ANC4+).
The index of ANC coverage reflected the level of service coverage in countries. Further, disparities exist in country ranking as some countries, e.g. Cameroon, Benin Republic and Nigeria are ranked better using the ANC4+ indicator but poorly using the proposed index. Also, Rwanda and Malawi are ranked better using the proposed index.
The proposed ANC index allows for the assessment of progressive realisation, rooted in the move towards universal health coverage. In fact, the index reflects progress that countries make in increasing service coverage. This is because every ANC visit counts. Beyond ANC coverage, the proposed index is applicable to assessing service coverage generally including quality education.
产前阶段是为孕妇提供重要干预措施的机会。事实上，产前护理（ANC）覆盖率是评估千年发展目标进展的指标。本文应用了一种新的 ANC 服务覆盖指数，该指数考虑了每次 ANC 就诊。还提出了服务覆盖差距指数。这些指数可以按人口群体进行加性分解，并且对低于定义阈值的更多 ANC 就诊的接受情况敏感。这些指数也已经推广到服务质量的考虑。
使用最近几轮人口与健康调查（DHS）的数据，重新评估了 35 个撒哈拉以南非洲国家的 ANC 服务覆盖情况。估计了 ANC 覆盖率指数。对这些国家进行了排名，并将其排名与至少接受四次 ANC 就诊（ANC4+）的国家进行了比较。
ANC 覆盖率指数反映了各国的服务覆盖水平。此外，国家排名存在差异，例如喀麦隆、贝宁共和国和尼日利亚等国家，使用 ANC4+指标排名更好，但使用拟议指数排名较差。此外，卢旺达和马拉维使用拟议指数排名更好。
拟议的 ANC 指数允许评估基于向全民健康覆盖迈进的渐进实现。事实上，该指数反映了各国在提高服务覆盖率方面取得的进展。这是因为每次 ANC 就诊都很重要。除了 ANC 覆盖率之外，该指数还适用于评估一般的服务覆盖率，包括优质教育。
