Antenatal care, delivery attended by skilled health professionals and access to health facilities for delivery are important for the health of both mothers and their babies as they reduce the risk of birth complications and infections (see indicators on “Infant feeding” in Chapter 4). WHO currently recommends a minimum of eight antenatal contacts (WHO, 2016[1]), and antenatal care coverage has been monitored to ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes by 2030 (Sustainable Development Goal 3.7).
In Asia-Pacific, seven in ten pregnant women – on average – received the recommended four visits in lower-middle- and low-income countries and territories, but access to antenatal care varies across countries and territories (Figure 5.9, left panel). Brunei Darussalam, Malaysia and Korea have nearly complete coverage of four antenatal visits. At the other end, in Bangladesh and Papua New Guinea the coverage of four antenatal care visits is less than 50%.
Only four women in five had births attended by a skilled health professional – a doctor, nurse or midwife – in lower-middle- and low-income Asia-Pacific countries and territories, whereas almost all births were attended by a skilled health professional in high- and upper-middle-income countries and territories (Figure 5.9, right panel). Most deliveries in Papua New Guinea, Myanmar and Lao PDR were attended by a skilled health professional, with one birth in three assisted by dais or untrained birth attendants. Traditional birth attendants are important in several other countries and territories including Cambodia, India, Indonesia, Myanmar, Pakistan and the Philippines, especially in rural settings.
In Asia-Pacific, delivery in health facilities varies across countries and territories (Figure 5.10, left panel). In Thailand, Mongolia, Viet Nam and DPRK, almost all deliveries take place at a health facility. On the other hand, in Bangladesh, less than 55% of births takes place in a health facility. Across countries and territories, deliveries in health facilities are more common among mothers giving birth for the first time, or those who have had at least four antenatal visits, as well as among mothers living in urban regions and those with higher education and wealth.
Access to skilled birth attendants varies by socio‑economic factors (Figure 5.10, right panel). Mongolia, Thailand and DPRK have a high coverage of births attended by skilled health professionals among mothers with different education and income levels, as well as living in different geographical locations. However, in other countries and territories, the coverage of births attended by skilled health professionals is highly unequal among women of different income and education levels. For example, in Lao PDR and Bangladesh, access differs almost three‑fold between mothers of the lowest education level and mothers of the highest education levels. Disparity by household income is largest in Lao PDR and Bangladesh, again with almost three‑fold difference between mothers living in household at the highest and at the lowest income quintiles. Differences in access to skilled care at birth between urban and rural areas are relatively smaller across countries and territories, though they remain significant in Lao PDR and Myanmar.
