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State of Alaska

Complete Health Indicator Report of Health Care - No Prenatal Care (HA2020 Leading Health Indicator: 21)

Definition

Percentage of infants born to pregnant women who did not receive prenatal care in the first trimester as a percentage of the total number of live births.

Numerator

Number of infants born to pregnant women who did not receive prenatal care in the first trimester.

Denominator

Number of live births.

Why Is This Important?

Access to quality healthcare is influenced by a number of factors, including: having a usual source of care, having health insurance, and being able to afford care. Inadequate prenatal care--including late initiation of care, infrequent prenatal visits, or no care at all--is associated with poor infant and maternal outcomes, including low birth weight or preterm infants and for the mothers an increased risk for pregnancy-related mortality and complications of childbirth.

Healthy People Objective: Prenatal care beginning in first trimester

U.S. Target: 77.9 percent (or 22.1 percent not beginning prenatal care in the first trimester)
State Target: Healthy Alaskans 2020 Target: 19.0% with no prenatal care in first trimester

Other Objectives

Healthy Alaskans 2020 Indicator 21: Reduce the percentage of women delivering live births who have not received prenatal care beginning in the first trimester of pregnancy to 19% by 2020.

How Are We Doing?

The percentage of Alaska mothers not receiving prenatal care in the first trimester had been on a decline.

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. '''Strategy 1:''' [[br]]Increase the number of women of childbearing age who report having access to health care providers who support them to plan their pregnancies. '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Health care access is measured in several ways, including: # Structural measures of the presence or absence of specific resources that facilitate health care, such as having health insurance or a usual source of care. # Assessments by patients of how easily they are able to gain access to health care. # Utilization measures of the ultimate outcome of good access to care (i.e., the successful receipt of needed services). '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3). '''Strategy 2:''' [[br]]Increase the number of women who have their pregnancies confirmed by a health care provider in the first trimester. '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Attaining good access to care requires three discrete steps: # Gaining entry into the health care system. # Getting access to sites of care where patients can receive needed services. # Finding providers who meet the needs of individual patients and with whom patients can develop a relationship based on mutual communication and trust. '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3). '''Strategy 3:''' [[br]]Improve systems and services that care for women with addictions (alcohol, drugs, tobacco). '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Health care access is measured in several ways, including: # Structural measures of the presence or absence of specific resources that facilitate health care, such as having health insurance or a usual source of care. # Assessments by patients of how easily they are able to gain access to health care. # Utilization measures of the ultimate outcome of good access to care (i.e., the successful receipt of needed services). '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3).

Health Program Information

A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_21_Prenatal.pdf].


Related Indicators

Relevant Population Characteristics

Pregnant teens 15-19 years of age, mothers with low level of education, race other than White, Hispanic ethnicity, being unmarried, lower socio-economic status, and women who lack health insurance are less likely to get early prenatal care.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Having health insurance improves availability of prenatal care services. Lack of health insurance affects both the timing and frequency of prenatal care visits, resulting in poor pregnancy outcomes such as premature birth, low birth weight, and complicated delivery. Availability of family planning services is another system factor that reduces the risk of unintended pregnancy. If a pregnancy is planned, a woman is more likely to seek early and adequate prenatal care.

Related Health Care System Factors Indicators:


Risk Factors

The risk factors for late entry are (2006 Alaska PRAMS data): - women less than 20 years of age - women with less than 12 years of education - non-White women - Hispanic women - unmarried women - women with an annual household income less than $15,000/year - unintended pregnancy - women who had no private insurance prior to conception

Related Risk Factors Indicators:


Health Status Outcomes

Prenatal care can improve birth outcomes and prevent medical complications and their costs associated with premature births, low birth weight births, and maternal and infant mortality and morbidity.



Graphical Data Views

Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, all Alaskan, Alaska Natives, and U.S., 2001-2020

::chart - missing::

Alaska ComparisonsYearPercentage of women not receiving prenatal care
Record Count: 46
All Alaskans200119.1%
All Alaskans200219.5%
All Alaskans200319.9%
All Alaskans200418.9%
All Alaskans200519.5%
All Alaskans200618.7%
All Alaskans200719.7%
All Alaskans200820.2%
All Alaskans200919.7%
All Alaskans201021.3%
All Alaskans201122.0%
All Alaskans201223.1%
All Alaskans201320.6%
Alaska Natives200127.9%
Alaska Natives200229.8%
Alaska Natives200329.2%
Alaska Natives200429.0%
Alaska Natives200528.2%
Alaska Natives200627.3%
Alaska Natives200730.1%
Alaska Natives200832.3%
Alaska Natives200927.0%
Alaska Natives201027.3%
Alaska Natives201125.4%
Alaska Natives201227.0%
Alaska Natives201323.7%
U.S.200116.6%
U.S.200216.3%
U.S.200315.9%
U.S.200416.1%
U.S.200516.1%
U.S.200616.8%
U.S.200729.2%
U.S.200829.0%
U.S.200927.9%
U.S.201026.9%
U.S.2011**
U.S.2012**
Healthy Alaskans Goal201319.0%
Healthy Alaskans Goal201419.0%
Healthy Alaskans Goal201519.0%
Healthy Alaskans Goal201619.0%
Healthy Alaskans Goal201719.0%
Healthy Alaskans Goal201819.0%
Healthy Alaskans Goal201919.0%
Healthy Alaskans Goal202019.0%

Data Notes

** Data Not Available U.S. data for 2005 includes only the 37 states that had not implemented the 2003 birth certificate revision. U.S. data for 2006 includes only the 32 states that had not implemented the 2003 birth certificate revision. There is no U.S. Comparable data for 2007 or 2008 as the National Center for Health Statistics only reported on those states that were using the 2003 birth certificate revision. Alaska had not implemented this version in 2007 or 2008, therefore the data are not comparable.

Data Sources

  • Alaska Bureau of Vital Statistics, Division of Public Health, Department of Health and Social Services
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention

More Resources and Links

Alaska and national goals may be found at the following sites:

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.
Page Content Updated On 01/23/2016, Published on 01/23/2016
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 14 February 2016 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Sat, 23 Jan 2016 15:53:38 AKST
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 14 February 2016 0:55:47 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Sat, 23 Jan 2016 15:53:38 AKST