Antenatal care data sources and their policy and planning implications: A Palestinian example using the Lives Saved Tool
Background
Policy making in healthcare requires reliable and local data. Different sources of coverage data for health interventions can be utilized to populate the Lives Saved Tool (LiST), a commonly used policy-planning tool for women and children’s health. PNIPH evaluated four existing sources of antenatal care data in Palestine to discuss the implications of their use in LiST.
Methods
All intervention coverage and health status indicators around the antenatal period that could be used to populate LiST were identified. These indicators were calculated from 1) routine reported data, 2) a Multiple Indicator Cluster Survey (MICS), 3) paper-based antenatal records, and 4) the eRegistry (an electronic health information system) for public clinics in the West Bank, Palestine, for the most recent year available. Coverage of each indicator was scaled to 90% in public clinics only, and was compared to a no-change scenario for a seven-year period.
Results
Eight intervention coverage and health status indicators needed to populate the antenatal section of LiST could be calculated from both paper-based antenatal records and the e-Registry. Only two could be calculated from routine reports and three from a national survey. Maternal lives saved over seven years ranged from 5 to 39, with percent reduction in the maternal mortality ratio (MMR) ranging from 1-6%. Pre-eclampsia management accounted for 25-100% of the lives saved.
Conclusions
The choice of data source for antenatal indicators will affect policy-based decisions when used to populate LiST. Although all data sources have their purpose, clinical data collected directly in an electronic registry during antenatal contacts may provide the most reliable and complete data to populate currently unavailable but needed indicators around specific antenatal care interventions.
Ingrid K. Friberg1* (ID) , Mahima Venkateswaran1,2, Buthaina Ghanem3 and J. Frederik Frøen1,2
1 Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, P.O.Box 222 Skøyen, N-0213 Oslo, Norway.
2 Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
3 World Health Organization, Palestinian National Institute of Public Health, Al Bireh P.O.Box 4284, Ramallah, Palestinian Territory.
Friberg, I.K., Venkateswaran, M., Ghanem, B. et al. Antenatal care data sources and their policy and planning implications: a Palestinian example using the Lives Saved Tool. BMC Public Health 19, 124 (2019). https://doi.org/10.1186/s12889-019-6427-8
