Pregnancy

•Definition: Percent of women who attend one or more antenatal care visits delivered by skilled provider during their pregnancy (ANC 1+).

•Default data source: Coverage data for this indicator are drawn from DHS, MICS, and other nationally representative household surveys.

•Notes: This has no direct impact and is not currently displayed in the LiST editor. It is used as a component in the formulas used to determine the coverage of certain interventions delivered as a part of ANC. For details on the calculation of coverage of antenatal care interventions in LiST, please see LiST Technical Note

•Definition: Percent of women who attend four or more antenatal care visits delivered by any provider during their pregnancy (ANC 4+).

•Default data source: Coverage data for this indicator are drawn from DHS, MICS, and other nationally representative household surveys.

•Definition: Percent of neonates who are protected at birth (PAB) from tetanus infection. PAB is defined as the percent of women who received two doses of tetanus toxoid during this pregnancy or ever: Received at least 2 doses, the last within 3 years; received at least three doses, the last within 5 years; received at least 4 doses, the last within 10 years; or received at least five doses during lifetime. Also known as TT2+.

•Notes: Default data can be replaced with data from DHS/MICS or other sources as appropriate.

•Effect size reference: Blencowe H, Lawn J, Vandelaer J, et al. Tetanus toxoid immunization to reduce mortality from neonatal tetanus. International Journal of Epidemiology 2010; 39(Suppl 1): i102-i109. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845866/.

•Definition: Percent of pregnant women receiving 2+ doses of Sp/Fansidar or sleeping under an insecticide treated net during pregnancy.

•Default data source: Coverage data for this indicator are drawn from DHS, MICS, and other nationally representative household surveys. This also includes Malaria Indicator Surveys.

•Notes: By default, this indicator can only be modified if the national government recommends IPTp. This can be changed on the "Baseline child health status" tab of the "Health status, mortality, and economic status" menu.

The effect is only applied to the first and second pregnancies among women who are exposed to malaria.

Coverage is calculated as the greater of either a) IPTp coverage or b) coverage of ITN-use among pregnant women based on household survey data.

•Effect size reference: Eisele TP, Larsen D, Steketee RW. Protective efficacy of interventions for preventing malaria mortality in children in Plasmodium falciparum endemic areas. International Journal of Epidemiology 2010; 39(Suppl 1): i88-i10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845865/. (The pooled effect size for IPTp or ITN usage is applied for IPTp and/or ITN use due to similar causal pathways for preventing maternal anemia and lack of evidence of a synergistic effect.)

Pollard SL, Mathai M, Walker N. Estimating the impact of interventions on cause-specific maternal mortality: A Delphi approach. BMC Public Health 2013; 13(Suppl 3): S12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847442/. (The effect size for either IPTp or ITN usage is applied for IPTp and/or ITN use due to similar causal pathways for preventing maternal anemia and lack of evidence of a synergistic effect.)

Gamble CL, Ekwaru JP, ter Kuile FO. Insecticide-treated nets for preventing malaria in pregnancy. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD003755. DOI: 10.1002/14651858.CD003755.pub2. (The effect size for ITN usage is applied as a proxy for IPTp and/or ITN use due to similar causal pathways for preventing stillbirth and lack of evidence of a synergistic effect.)

Radeva-Petrova D, Kayentao K, Ter Kuile FO, et al. Drugs for preventing malaria in pregnant women in endemic areas: Any drug regimen versus placebo or no treatment. Cochrane Database Syst Rev 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498495/. (The effect size for either IPTp or ITN usage is applied for IPTp and/or ITN use due to similar causal pathways for preventing maternal anemia and lack of evidence of a synergistic effect.)

•Definition: Percent of pregnant women tested for syphilis and given treatment if needed.

•Default data source: Coverage data for this indicator are not typically available. As a proxy, coverage is calculated from utilization data from household survey and readiness data from healthy facility survey. For details on this calculation, please see the LiST Technical Note

•Notes: The default coverage=antenatal care (at least 1 visit) * quality. You can either change utilization (ANC1) or quality to alter coverage. Or you can select coverage at the top box and then change coverage directly

•Effect size reference: Blencowe H, Cousens S, Kamb M, et al. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality. BMC Public Health 2011; 11(Suppl 3): S9. http://www.ncbi.nlm.nih.gov/pubmed/21501460.

•Wan Z, Zhang H, Xu H, Hu Y, Tan C, Tao Y. Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China. BMC Pregnancy Childbirth. 2020 Oct 27;20(1):648. doi: 10.1186/s12884-020-03314-y. PMID: 33109116; PMCID: PMC7590689. https://pubmed.ncbi.nlm.nih.gov/33109116/

•Default data source: Coverage data for this indicator are not typically available. Currently set at 0 for baseline; user should enter local data if possible and available.

•Notes: The effect size is applied to the percentage of the population who are calcium deficient.This is a country-specific value found in the “Health status, mortality and economic status” tab under “Household status.”

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Effect size reference:

Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2018 Oct 1;10(10):CD001059. doi: 10.1002/14651858.CD001059.pub5. PMID: 30277579; PMCID: PMC6517256. https://pubmed.ncbi.nlm.nih.gov/30277579/

•Definition: Percent of pregnant women at risk of preterm births who receive low-dose aspirin

•Default data source: Coverage data for this indicator are not typically available; it is set to 0 by default

•Effect size reference: Hoffman MK, Goudar SS, Kodkany BS, et al. Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial. Lancet 2020; 395(10220): 285-93.

•Definition: Percent of pregnant women at risk of preterm births who receive progesterone

•Default data source: Coverage data for this indicator are not typically available; it is set to 0 by default

•Effect size reference: Epppic Group. Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomised controlled trials. Lancet 2021; 397(10280): 1183-94.

•Definition: Percent of pregnant women taking a multiple micronutrient supplement daily. A multiple micronutrient supplement is defined as a supplement containing at least iron, folate, and additional vitamins/minerals.

•Default data source: Coverage data for this indicator are not typically available. Currently set at 0 for baseline; user should enter local data if possible and available.

•Notes: The sum of multiple micronutrient supplementation and iron supplementation cannot be greater than 100%.

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Effect size reference: Smith ER, Shankar AH, Wu LSF, et al. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries. Lancet Global Health 2017; 5(11): e1090-e1100. http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30371-6/fulltext

Oh C, Keats EC, Bhutta ZA. Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients. 2020 Feb 14;12(2):491. doi: 10.3390/nu12020491. PMID: 32075071; PMCID: PMC7071347. https://pubmed.ncbi.nlm.nih.gov/32075071/

•Definition: Percent of pregnant women taking an iron supplement daily, for at least 90 days.

•Default data source: Coverage data for this indicator are drawn from DHS, MICS, and other nationally representative household surveys.

•Notes: The sum of iron supplementation and multiple micronutrient supplementation cannot be greater than 100%.

•Effect size reference: Pena-Rosas JP, De-Regil LM, Garcia-Casal MN, et al. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev 2015. http://www.ncbi.nlm.nih.gov/pubmed/26198451

•Definition: Percent of pregnant women who are food insecure who receive balanced energy-protein (BEP) supplementation.

•Default data source: Coverage data for this indicator are not typically available. Currently set at 0 for baseline; user should enter local data if possible and available.

•Notes: The effect size is applied to the prevalence of body mass index (BMI) <18.5 among women of reproductive age (15-49 years), used as a proxy for food insecurity (the "Baseline Maternal Health Status" tab of the "Health status, mortality, and economic status" menu).

•Effect size reference: Lassi ZS, Padhani ZA, Rabbani A, Rind F, Salam RA, Das JK, Bhutta ZA. Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries. Nutrients. 2020; 12(2):531. https://doi.org/10.3390/nu12020531

•Affected fraction reference: Jackson BD, Walker N, Heidkamp R. Metrics for Identifying Food Security Status and the Population with Potential to Benefit from Nutrition Interventions in the Lives Saved Tool (LiST). J Nutrition 2017, 147(11S): 2147S-2155S. https://doi.org/10.3945/jn.116.243808

•Definition: Percent of women receiving detection and appropriate management of moderate to severe hypertension during pregnancy.

•Notes: The default coverage=antenatal care (at least 4 visit) * quality. You can either change utilization (ANC4) or quality to alter coverage. Or you can select coverage at the top box and then change coverage directly

•Effect size reference: Pollard SL, Mathai M, Walker N. Estimating the impact of interventions on cause-specific maternal mortality: A Delphi approach. BMC Public Health 2013; 13(Suppl 3): S12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847442/.

Jabeen M, Yakoob MY, Imdad A, et al. Impact of interventions to prevent and manage preeclampsia and eclampsia on stillbirths. BMC Public Health 2011; 11(Suppl 3): S6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231912/

•Definition: Percent of pregnant women screened for diabetes and managed appropriately, if needed.

•Notes: This currently only impacts stillbirths. The default coverage=antenatal care (at least 4 visit) * quality. You can either change utilization (ANC4) or quality to alter coverage. Or you can select coverage at the top box and then change coverage directly

•Effect size reference: Syed M, Javed H, Yakoob MY, et al. Effect of screening and management of diabetes during pregnancy on stillbirths. BMC Public Health 2011; 11(Suppl 3): S2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231893/.

•Definition: Percent of pregnant women experiencing malaria that are appropriately managed.

•Notes: The intervention covers the entire period between conception and six weeks after delivery. The default coverage=antenatal care (at least 4 visit) * quality. You can either change utilization (ANC4) or quality to alter coverage. Or you can select coverage at the top box and then change coverage directly

•Definition: Percent of pregnancies screened for fetal growth restriction (including BMI, fundal height, ultrasound, and/or Doppler) and managed with appropriate obstetric intervention, including early delivery, if needed.

•Default data source: Coverage data for this indicator are not typically available. Currently set at 0 for baseline; user should enter local data if possible and available.

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Notes: Based on a review by Imdad and colleagues, the impact of detection and management of fetal growth restriction was added to LiST. (Imdad A, Yakoob MY, Siddiqui S, et al. Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths. BMC Public Health 2011, 11(Suppl 3): S1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231882/.) The review found that proper detection and management of IUGR (fetal growth restriction) could reduce stillbirths by 20%. However, this analysis depends on proper management, often including induced labor and Cesarean sections, that may not be available in low-resource settings. In addition, by producing earlier births, management does reduce the stillbirths, but the child of the resulting birth may be premature and appropriate management of premature babies, especially those very premature, may not be available. The users who choose to scale up FGR should be aware of these difficulties and will need to specify the effectiveness of the intervention.

•Effect size reference: The effect size is currently set to 0 (see above); use the "Effectiveness" menu to modify if necessary.

•Definition: Coverage and effectiveness of PMTCT interventions are specified in the AIM module.