Evidence map›Paper›PMID 41999716›Full record

ArticleThe Lancet. Global health2026

Measuring antenatal care timing and content across 131 low-income and middle-income countries, 1995-2023: a systematic analysis of trends.

Anna Gage, Madeleine Conrad, Megan Knight, Aduragbemi Banke-Thomas, Corinne Bintz, Kelly Bienhoff, Rakhi Dandona, M Ashworth Dirac, Thomas Glucksman, Simon I Hay and 9 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Anna GageInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Madeleine ConradDepartment of Epidemology, Emory University, Atlanta, GA, USA.
Megan KnightInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Aduragbemi Banke-ThomasHealth Systems Insight, Ouagadougou, Burkina Faso; London School of Hygiene & Tropical Medicine, London, UK.
Corinne BintzInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Kelly BienhoffInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Rakhi DandonaInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Public Health Foundation of India, Delhi, India.
M Ashworth DiracInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Department of Family Medicine, University of Washington, Seattle, WA, USA.
Thomas GlucksmanInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Simon I HayInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Ali H MokdadInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Bancy NgatiaLondon School of Hygiene & Tropical Medicine, London, UK.
Marie-Jeanne OffosseHealth Systems Insight, Ouagadougou, Burkina Faso.
Bridget StollfusInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA.
Asnake WorkuThe National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Christopher J L MurrayInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Enis BarışInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Nicholas J KassebaumInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Anaesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Annie HaakenstadInstitute for Health Metrics and Evaluation, Hans Rosling Center for Population Health, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA. Electronic address: ahaak@uw.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely and comprehensive antenatal care can improve maternal and perinatal health by enabling early detection and treatment of pregnancy complications. We estimated the content and timing of antenatal care visits for 131 low-income and middle-income countries (LMICs) from 1995 to 2023.

methodsWe systematically identified population-representative data sources capturing antenatal care timing and content. We selected five widely measured indicators of antenatal care screening and prevention services: iron supplementation, measurement of weight and blood pressure, and provision of blood and urine samples. We modelled the proportion of women with a livebirth reporting all five items (antenatal care content proportion), mean number of items reported (antenatal care content mean), proportion with first trimester antenatal care attendance, and mean number of antenatal care visits using spatiotemporal Gaussian process regression.

findingsAcross LMICs, the proportion of women with a livebirth who initiated antenatal care in the first trimester increased from 46·2% (95% uncertainty interval 42·2-49·9) in 1995 to 63·7% (62·8-64·5) in 2023, and the average number of antenatal care visits during pregnancy rose from 3·7 (3·4-4·0) to 6·0 (5·9-6·1). In 2023, 69·3% (68·4-70·1) of women with a livebirth received all five antenatal care items, a major increase from 1995 (25·9% [24·1-27·8]). In 2023, the proportion of women who attended antenatal care but did not receive all five items (26·2% [25·5-27·0]) exceeded those who did not attend antenatal care at all (7·1% [6·5-8·1]). The receipt of all five items also varied by geography: 79·2% (77·6-80·5) in Latin America and the Caribbean received all five items, compared with 59·8% (58·4-60·9) of women in sub-Saharan Africa.

interpretationDespite improvements in the receipt of basic elements of antenatal care from 1995 to 2023, health systems continue to miss opportunities to deliver important care to women who attend antenatal care. The identified gaps in coverage should be targeted for improvement to support receipt of timely and effective health care that improves maternal and neonatal health.

fundingThe Gates Foundation.

Indexed as

Developing CountriesPrenatal CareAdultFemaleHumansPregnancyTime Factors

Identifiers

PMID41999716
PMCPMC13106046

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.