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.

Data Source(s):

Population-based surveys, such as DHS, RHS, and MICS; facility records and health services data.

Purpose:

This indicator measures whether ANC facilities are consistently measuring women’s weight as early as possible in women’s pregnancies, and can serve as a proxy for the quality of ANC care. Recording women’s weight early in pregnancy (ideally in the first trimester) can approximate pre-pregnancy weight and allow tracking of women’s weight gain during pregnancy. Pregnancy weight gain is one of the most critical factors in determining both birth outcomes and maternal nutritional outcomes of pregnancy. Weight gain is particularly important for women who are underweight prior to pregnancy and for women who are pregnant during times of acute nutritional stress, such as famines or seasons of food scarcity.  Conversely, the prevalence of overweight has been increasing worldwide during the past two decades resulting in a “double burden” of health concerns and making excess pregnancy weight gain for overweight women a serious health problem.  Additional information on weight gain during pregnancy and implications for maternal and infant health outcomes can be found in the section on Women’s Nutrition in this database and from IOM (2009). This indicator relates to Millennium Development Goals: #5. improve maternal health and #4. reduce child mortality.

Issue(s):

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 she was weighed at her first ANC visit. Data on women’s weight 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.

References:

Institute of Medicine and National Research Council, 2009, Weight Gain during Pregnancy: Reexamining the Guidelines, Eds: Kathleen Rasmussen and Ann Yaktine, Washington, D.C.: The National Academy Press. https://www.ncbi.nlm.nih.gov/books/NBK32813/