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National Indigenous Reform Agreement: PI 09-Antenatal care, 2014 QS

Identifying and definitional attributes

Metadata item type:Help on this termQuality Statement
Synonymous names:Help on this termData quality statement — Indicator 9 Antenatal care
METeOR identifier:Help on this term567202
Registration status:Help on this termIndigenous, Archived 17/02/2016

Relational attributes

Indicators linked to this Quality statement:Help on this term

National Indigenous Reform Agreement: PI 09-Antenatal care, 2014 Indigenous, Archived 24/11/2014

Data quality

Quality statement summary:Help on this term

The Perinatal national minimum data set (NMDS) includes information on gestational age at first antenatal visit for births from July 2010. For births before July 2010 data collection is not consistent across jurisdictions. Caution should be used when interpreting these results.

In 2011, information about number of antenatal visits was available for New South Wales, Queensland, South Australia, Tasmania, the Australian Capital Territory and the Northern Territory only. Number of antenatal visits were collected using non-standardised definitions and with variable response rates. Comparisons between jurisdictions should therefore be made with caution.

The NPDC includes information on the Indigenous status of the mother only. Since 2005, all jurisdictions have collected information on Indigenous status of the mother in accordance with the Perinatal NMDS.

No formal national assessment has been undertaken to determine completeness of the coverage or identification of Indigenous mothers in the NPDC or to determine variability between states and territories. The current data have not been adjusted for potential under-identification of Indigenous status of the mother and thus jurisdictional comparisons of Indigenous data should not be made.

Remoteness data for 2010 and previous years are not directly comparable to remoteness data for 2011 and subsequent years.

This indicator consists of two parts:

PART A: The number of women who gave birth, where an antenatal visit was reported in the first trimester as a proportion of women who gave birth. First trimester is defined as before 14 weeks of pregnancy.

Numerator — Number of women who gave birth who attended at least one antenatal visit in the first trimester for at least one live or stillborn baby

Denominator — Total number of women who gave birth to at least one live or stillborn baby (where gestation at first antenatal visit is known)

Calculation: 100 × (Numerator ÷ Denominator)

PART B: The number of women who gave birth where 5 or more antenatal visits were reported, as a proportion of women who gave birth.

Numerator — Number of women who gave birth where at least 5 antenatal visits were reported for pregnancy of 32 or more weeks gestation, for at least one live or stillborn baby

Denominator — Total number of women who gave birth at 32 or more weeks gestation, for at least one live or stillborn baby (where number of antenatal visits is known).

Calculation is 100 × (Numerator ÷ Denominator)

Crude and age-standardised rates (directly age-standardised to the total number of women who gave birth in Australia in the reference period using 5 year age groups from 15-19 to 40-44 years) are presented. Rate ratios and rate differences are presented as additional statistics.

Variability band: to be calculated using the standard method for estimating 95% confidence intervals as follows:

Crude rate:

Where n=denominator for PART A or PART B (see denominators above).

Age-standardised rate:

Where wi = the proportion of the standard population in age group i

di = the numerator for either PART A or PART B in age group I (see numerators above)

ni = the denominator for either PART A or PART B respectively in the population in age group i.

 

Institutional environment:Help on this term

The National Perinatal Epidemiology and Statistics Unit (NPESU) calculated this indicator on behalf of the Australian Institute of Health and Welfare (AIHW).

The AIHW is an independent statutory authority within the Health and Ageing portfolio, which is accountable to the Parliament of Australia through the Minister for Health and Ageing. For further information see the AIHW website.

Data collected as part of the National Perinatal Data Collection include a National Minimum Data Set and were supplied by state and territory health authorities to the NPESU, a collaborating unit of the Institute. The state and territory health authorities receive these data from patient administrative and clinical records. This information is usually collected by midwives or other birth attendants. States and territories use these data for service planning, monitoring and internal and public reporting.

Timeliness:Help on this term

The reference period for the data is 2011. Data are collected on an ongoing basis and are compiled by the AIHW annually.

Accessibility:Help on this term

The AIHW provides a variety of products that draw upon the NPDC. Published products available on the AIHW website are:

  • Australia’s mothers and babies annual report
  • METeOR – online metadata repository
  • National health data dictionary.

Ad hoc data are also available on request (charges apply to recover costs). Data for this indicator are published annually in Australia’s mothers and babies; and biennially in the Aboriginal and Torres Strait Islander Health Performance Framework report.

Interpretability:Help on this term

Supporting information on the use and quality of the NPDC are published annually in Australia’s mothers and babies (Chapter 1), available in hard copy or on the AIHW website. Comprehensive information on the quality of Perinatal NMDS elements are published in Perinatal National Minimum Data Set compliance evaluation 2006 to 2009. Readers are advised to read caveat information to ensure appropriate interpretation of the performance indicator. More detailed information on the quality of Indigenous data that might affect interpretation of the indicator was published in Indigenous mothers and their babies, Australia 2001-2004 (Chapter 1 and Chapter 5).

Metadata information for this indicator are published in the AIHW’s online metadata repository, METeOR. Once nationally consistent data items on antenatal care are added to the Perinatal NMDS, metadata information for this indicator will be revised in METeOR, and published in the National Health Data Dictionary as a national standard. In December 2009, a data item on ‘pregnancy duration at the first antenatal care visit’ was added to the Perinatal NMDS and included in METeOR.

Relevance:Help on this term

The National Perinatal Data Collection comprises data items as specified in the Perinatal national minimum data set plus additional items collected by the states and territories. The purpose of the Perinatal NMDS is to collect information at birth for monitoring pregnancy, childbirth and the neonatal period for both the mother and baby(s).

The Perinatal NMDS is a specification for data collected on all births in Australia in hospitals, birth centres and the community. It includes information for all live births and stillbirths of at least 400 grams birthweight or at least 20 weeks gestation, except in Vic and WA, where included if gestational age is 20 weeks or more or if gestation unknown birthweight is at least 400 grams. It includes data items relating to the mother, including demographic characteristics and factors relating to the pregnancy, labour and birth; and data items relating to the baby, including birth status, sex, gestational age at birth, birthweight and neonatal morbidity and fetal deaths.

The Perinatal NMDS includes information on gestational age at first antenatal visit for births from July 2010. In 2011, data reported on number of women who gave birth who attended at least one antenatal visit in the first trimester are available for all states and territories. For births before July 2010 data collection is not consistent across jurisdictions. Caution should be used when interpreting these results.

The Perinatal NMDS did not include number of antenatal visits data items in 2011 and national data are not currently available. Therefore, data are not available for all states and territories. Data reported on number of antenatal visits are for New South Wales, Queensland, South Australia, Tasmania, the Australian Capital Territory and the Northern Territory.  Totals reported for this indicator are not generalisable to Australia. A standard data item to collect the number of antenatal visits data items will be introduced to the Perinatal data set specification (DSS) from July 2012.

Information collected on antenatal care differs among the jurisdictions. Comparisons between states and territories should therefore be interpreted with caution.

While each jurisdiction has a unique perinatal form for collecting data on which the format of the Indigenous status question and recording categories varies slightly, all systems include the NMDS item on Indigenous status of mother.

No formal national assessment has been undertaken to determine completeness of the coverage of Indigenous mothers in the Perinatal NMDS. However, the proportion of Indigenous mothers for the period 2002-2011 has been consistent, at 3.6–3.9 per cent of women who gave birth.  Comparisons between states and territories should be interpreted with caution.

Mothers for whom Indigenous status was not stated have been excluded from analyses for this indicator.

Analysis by state/territory is based on the usual residence of the mother. Excludes Australian non-residents of external territories and where the state/territory of residence was not stated.

Data excludes records with missing data for gestation at first antenatal visit.

Reporting by remoteness is in accordance with the Australian Statistical Geography Standard (ASGS) for 2011 data and in accordance with the Australian Standard Geographical Classification (ASGC) for earlier data.

Accuracy:Help on this term

Inaccurate responses may occur in all data provided to the Institute. The Institute does not have direct access to perinatal records to determine the accuracy of the data provided. However, the NPESU undertakes validation on receipt of data by the Institute. Data received from states and territories are checked for completeness, validity and logical errors. Potential errors are queried with jurisdictions, and corrections and resubmissions are made in response to these edit queries. The NPESU does not adjust data to account for possible data errors.

Errors may occur during the processing of data by the states and territories or at the AIHW. Processing errors prior to data supply may be found through the validation checks applied by the NPESU. This indicator is calculated on data that has been reported to the AIHW. Prior to publication, these data are referred back to jurisdictions for review. The NPESU does not adjust the data to correct for missing values. Note that because of data editing and subsequent updates of state/territory databases, and because data are being reported by place of residence rather than place of birth the numbers reported for this indicator differ from those in reports published by the states and territories. The data are not rounded.

The data supplied for the 2011 NPDC by Victoria to prepare this indicator was not the final data. Further minor changes to the data are unlikely to produce any detectable change to the indicator.

The method for collecting data for the item ‘gestational age at first antenatal visit’ was revised by NT to improve data accuracy. The revised method was applied retrospectively for NT 2007-2010 data. Updated data for this data item were used to produce tables by remoteness.

Data presented by Indigenous status are influenced by the quality and completeness of Indigenous identification of mothers which is likely to differ among jurisdictions. Approximately 0.3 per cent of mothers who gave birth in the reference period had missing Indigenous status information. No adjustments have been made for under-identification or missing Indigenous status information and thus jurisdictional comparisons should not be made.

Data reported for 2011 on number of women who gave birth who attended at least one antenatal visit in the first trimester are available for all states and territories. Data reported for 2010 on number of antenatal visits are for New South Wales, Queensland, South Australia, Tasmania, the Australian Capital Territory and the Northern Territory only. Residents of these jurisdictions who gave birth in a different jurisdiction would not have data on antenatal care.

Proportions of records missing antenatal care information on whether the first visit was in the first trimester are very different for women who resided in New South Wales (3.0 per cent), Victoria (1.2 per cent), Queensland (1.2 per cent), the Australian Capital Territory (0.2 per cent) and the Northern Territory (1.0 per cent) compared with South Australia (7.1 per cent), Western Australia (11.8 per cent), and Tasmania (22.0 per cent). Improvements in data validation in the Northern Territory, including validation against date of first of ultrasound examinations attended, has led to improved data quality and a decrease in the proportion of records missing antenatal care information, since 2007. The timing of the first visits for women missing data may be distributed differently to those whose data have been reported. There are also differences in how the jurisdictions define antenatal visits.

Coherence:Help on this term

An interim measure is presented for this indicator, pending development and implementation of standard data definitions in the Perinatal NMDS. Data presented in future years may not be consistent or comparable with data presented here. Changing levels of Indigenous identification over time and across jurisdictions may affect the accuracy of compiling a consistent time series in future years.

In 2011, the ABS updated the standard geography used in Australia for most data collections from the Australian Standard Geographical Classification (ASGC) to the Australian Statistical Geography Standard (ASGS). Remoteness areas were also updated at this time, based on the 2011 ABS Census of Population and Housing. The new remoteness areas will be referred to as RA 2011, and the previous remoteness areas as RA 2006. Data for 2007 through to 2010 reported by remoteness are reported for RA 2006. Data for 2011 are reported for RA 2011. The AIHW considers the change from RA 2006 to RA 2011 to be a series break when applied to data supplied for this indicator, therefore remoteness data for 2010 and previous years are not comparable to remoteness data for 2011 and subsequent years.

Source and reference attributes

Submitting organisation:Help on this termAustralian Institute of Health and Welfare
Origin:Help on this term

AIHW National Perinatal Data Collection (NPDC)

Relational attributes

Related metadata references:Help on this term

Supersedes National Indigenous Reform Agreement: PI 09-Antenatal care, 2013 QS Indigenous, Archived 25/06/2014

Has been superseded by National Indigenous Reform Agreement: PI 09—Antenatal care, 2015, Quality Statement Indigenous, Archived 07/02/2017

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