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Validation of maternal report of nutrition‐related interventions and counselling during antenatal care in southern Nepal

The delivery of nutrition‐related interventions and counselling during antenatal care is critical for a healthy pregnancy for both mother and child. However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess t...

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Published in:Maternal and child nutrition 2022-04, Vol.18 (2), p.e13303-n/a
Main Authors: Bryce, Emily, Katz, Joanne, Heidkamp, Rebecca, Lama, Tsering Pema, Khatry, Subarna K., LeClerq, Steve, Munos, Melinda
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container_title Maternal and child nutrition
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description The delivery of nutrition‐related interventions and counselling during antenatal care is critical for a healthy pregnancy for both mother and child. However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteristics and accuracy. Maternal report of services received collected during a post‐partum survey was compared to the gold standard, the direct observation of all women's antenatal care visits. Individual‐level validity was assessed by calculating indicator sensitivity, specificity and area under the operating curve (AUC). The inflation factor (IF) measured population‐level bias. For five indicators, the high true coverage limited our ability to assess the validity of the maternal reports. There were no indicators that had both high individual‐level validity (AUC > 0.70) and low population bias (0.75 < IF 89%) for the majority of indicators. Maternal reports resulted in higher coverage estimates than what was observed for all but one indicator. No indicator assessed had high individual level validity (AUC > 0.70) and low population bias (0.75 
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However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteristics and accuracy. Maternal report of services received collected during a post‐partum survey was compared to the gold standard, the direct observation of all women's antenatal care visits. Individual‐level validity was assessed by calculating indicator sensitivity, specificity and area under the operating curve (AUC). The inflation factor (IF) measured population‐level bias. For five indicators, the high true coverage limited our ability to assess the validity of the maternal reports. There were no indicators that had both high individual‐level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25). Indicators with greater true coverage estimates had higher sensitivity and lower specificity estimates compared to those indicators with lower true coverage. There were no maternal characteristics associated with the accuracy of the report. Maternal report of antenatal nutrition‐related interventions and counselling during household surveys was found to have variable validity across indicators. Additional research in settings with varying coverage levels should be considered to best inform antenatal care coverage measurement in household surveys. Key Messages The coverage of nutrition‐related interventions and counselling was high (>89%) for the majority of indicators. Maternal reports resulted in higher coverage estimates than what was observed for all but one indicator. No indicator assessed had high individual level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25). The greater the indicator's true coverage estimate, the greater the sensitivity and lower the specificity values. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteristics and accuracy. There were no indicators that had both high individual‐level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25).]]></description><identifier>ISSN: 1740-8695</identifier><identifier>ISSN: 1740-8709</identifier><identifier>EISSN: 1740-8709</identifier><identifier>DOI: 10.1111/mcn.13303</identifier><identifier>PMID: 34905808</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>area under curve ; Child ; Counseling ; counselling ; Female ; Humans ; mental recall ; Mothers ; Nepal ; Original ; Pregnancy ; Prenatal Care ; sensitivity and specificity ; Surveys and Questionnaires</subject><ispartof>Maternal and child nutrition, 2022-04, Vol.18 (2), p.e13303-n/a</ispartof><rights>2021 The Authors. published by John Wiley &amp; Sons Ltd.</rights><rights>2021 The Authors. 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Indicators with greater true coverage estimates had higher sensitivity and lower specificity estimates compared to those indicators with lower true coverage. There were no maternal characteristics associated with the accuracy of the report. Maternal report of antenatal nutrition‐related interventions and counselling during household surveys was found to have variable validity across indicators. Additional research in settings with varying coverage levels should be considered to best inform antenatal care coverage measurement in household surveys. Key Messages The coverage of nutrition‐related interventions and counselling was high (>89%) for the majority of indicators. Maternal reports resulted in higher coverage estimates than what was observed for all but one indicator. No indicator assessed had high individual level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25). 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However, the accuracy of maternal reports of many of these services during household surveys has not yet been examined. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteristics and accuracy. Maternal report of services received collected during a post‐partum survey was compared to the gold standard, the direct observation of all women's antenatal care visits. Individual‐level validity was assessed by calculating indicator sensitivity, specificity and area under the operating curve (AUC). The inflation factor (IF) measured population‐level bias. For five indicators, the high true coverage limited our ability to assess the validity of the maternal reports. There were no indicators that had both high individual‐level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25). Indicators with greater true coverage estimates had higher sensitivity and lower specificity estimates compared to those indicators with lower true coverage. There were no maternal characteristics associated with the accuracy of the report. Maternal report of antenatal nutrition‐related interventions and counselling during household surveys was found to have variable validity across indicators. Additional research in settings with varying coverage levels should be considered to best inform antenatal care coverage measurement in household surveys. Key Messages The coverage of nutrition‐related interventions and counselling was high (>89%) for the majority of indicators. Maternal reports resulted in higher coverage estimates than what was observed for all but one indicator. No indicator assessed had high individual level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25). The greater the indicator's true coverage estimate, the greater the sensitivity and lower the specificity values. Our objectives were to assess the validity of the maternal reports of 10 antenatal nutrition interventions, including counselling, and examine associates between maternal characteristics and accuracy. There were no indicators that had both high individual‐level validity (AUC > 0.70) and low population bias (0.75 < IF < 1.25).]]></abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>34905808</pmid><doi>10.1111/mcn.13303</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-4823-1647</orcidid><oa>free_for_read</oa></addata></record>
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subjects area under curve
Child
Counseling
counselling
Female
Humans
mental recall
Mothers
Nepal
Original
Pregnancy
Prenatal Care
sensitivity and specificity
Surveys and Questionnaires
title Validation of maternal report of nutrition‐related interventions and counselling during antenatal care in southern Nepal
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