Table 2

Identified measurement areas for ANC guideline monitoring and evaluation by topic areas

Topic areaWhat to be measured?Measures identified by the scoping reviewScoping review sources
Health systems
 Service delivery modelsANC contacts (eight or more).x16
Pregnant women carrying their own case notes.x40
Service-specific availability and readiness: midwife-led continuity of care.*
Timing of first ANC visit.x16 19–26 41–44
 Health workforce organisationHealth worker density and distribution.*x45
Health units with at least one service provider trained to care for and refer sexual and gender-based violence survivors.*x17 46 47
Policy on task shifting for ANC (counselling and provision of selected interventions).
 Community engagementCommunities offering facilitated participatory learning and action cycles with women’s groups to improve maternal and newborn health.*
Content of care
 Maternal and fetal assessment and managementAssessment for tobacco use and secondhand smoke exposure.x4 44
Assessment for use of alcohol and other substances.
Ultrasound scan before 24 weeks.
On-site haemoglobin testing for anaemia.*
On-site testing for asymptomatic bacteriuria.*
Treatment for asymptomatic bacteriuria.
Symphysis-fundal height measurement.*
Monitoring of fetal heart rate.†
Monitoring of blood pressure.†x43 48–54
 Nutritional interventionsIron and folic acid supplementation.*x4 16–18 34 49 53 55–58
Availability of balanced energy and protein dietary supplementation.
Calcium supplementation.*
Vitamin A supplementation coverage.*
Caffeine intake information.
 Infectious disease testing and managementPregnant women counselled and tested for HIV and know their results.x4 17 40 49 56 59–65
Testing for syphilis.x17 33 49 61 66
Treatment for helminths.*x17 18 49
Newborns protected at birth from tetanus.x15 17 18 34 40 49 53 55–57 67
Intermittent preventive therapy for malaria.*x45 53 56 68 69
Testing for tuberculosis.*
Antiretroviral pre-exposure prophylaxis to prevent HIV infection.*x70
 Counselling and information sharingCounselling on diet and exercise in pregnancy.*
Counselling on birth preparedness.†x49 50 71
Counselling on family planning.†x49 56
Experience of care
 Management of physiological symptomsInformation and treatment for common physiological symptoms (eg, leg cramps, constipation, nausea).
  • This table condenses measures by intervention type. For example, ‘iron and folic acid supplementation’ includes all measures for recommendations A.2.1 (daily oral iron and folic acid supplementation) and A.2.2 (intermittent oral iron and folic acid supplementation).

  • *Measurement area is for an ANC recommendation that is unique to specific contexts (eg, undernourished populations, high-prevalence settings, malaria-endemic areas).

  • †Measurement area is for a good clinical practice within ANC.

  • ANC, antenatal care.