Why is this National Indicator important?
Birth weight is an important indicator of foetal and neonatal health at both individual and population levels. There is a significant evidence of the correlation between maternal health and social circumstances and birth weights which are outwith the normal birth weight range. Birth weight that is not within normal ranges also has a strong association with poor health outcomes in infancy, childhood and across the whole life course, including long term conditions such as diabetes and coronary heart disease.
Increasing the proportion of babies with an appropriate for gestational age (AGA) birth weight should provide an indicator of improvements in reducing the incidence of small for gestational age (SGA) and large for gestational age (LGA). SGA and LGA are closely associated with maternal health behaviours and poor health and social circumstances and should provide a robust proxy measure in relation to the following improvement areas:
- Progress in reducing the health impact of socio-economic inequalities
- Progress in linking effectively with wider services improving the social circumstances of mothers, e.g. housing, social work
- Progress in prevention of maternal obesity and clinical management of obese women preconceptually and antenatally
- Progress in increasing smoking cessation rates and exposure to second hand and the clinical management of women and babies where cessation/exposure attempts fail and
- Progress in improving maternal nutrition, including uptake of vitamins and improved maternal nutrition amongst women eligible for healthy start
Progress in increasing alcohol abstention pre-conceptually and during pregnancy. Progress in managing the care of women who misuse alcohol and/or drugs.
What will influence this National Indicator?
As a universal public service for pregnant women, NHS antenatal healthcare has a critical role to play in ensuring all children get the best start in life. This role encompasses a wide spectrum of NHS activity from promotion of health, screening and prevention, to clinical treatment and care. To strengthen the role of the NHS, evidence indicates that there needs to be a greater focus on women from socially complex, high risk groups accessing and experiencing high quality antenatal health care. We have evidence that those women who most need antenatal care are currently less likely to have timely access and or benefit from high quality antenatal health care.
An antenatal access HEAT target has therefore been developed to be achieved by 2015. This target seeks to increase the number of women accessing high quality antenatal care by the 12th week gestation - especially women in high risk groups such as women under 20 and those living in the least affluent SIMD quintiles. Alongside the HEAT target a set of level three quality outcome indicators are being developed by the Refreshed Framework for Maternity Care's Implementation Group. Included within these indicators is a specific quality measure in relation to continuity of carer. Continuity of carer is critical to the formation of trusted relationships with women, thereby enabling maternity care staff to work with women using strengths based approaches. The quality indicators include specific health improvement measures including measures relating to maternal and infant nutrition, smoking cessation and alcohol and drugs use.
What is the Government's role?
The Scottish Government has launched a number of focussed frameworks and programmes which aim to strengthen the contribution the NHS makes to outcomes for children in their early years. These include an Action Framework for Maternal and Infant Nutrition, a Refreshed Framework for Maternity Care, Reducing Antenatal Inequalities Guidance, Refreshed Hall 4 guidance, and the Family Nurse Partnership. These initiatives share the primary aim of improving maternal and child health outcomes and reducing inequalities in health outcomes between and across groups. Their implementation is crucial to realising the ambitions in the Healthcare Quality Strategy in relation to the early years, and the three social policy frameworks: Equally Well; Early Years Framework; and Achieving our Potential.
How is Scotland performing?
Information is not yet available on this indicator. Figures for 1st April 2011 to 31st March 2012 will be published by the NHS Information Service Division (ISD) as part of Births in Scottish Hospitals in August 2012, along with newly calculated data for previous years
Criteria for recent change
The criteria for the arrow assessment will be decided once the data for the indicator become available.
A time series from 2001-2010 has been calculated based on existing data by ISD, but is not due to be published until August 2012 as part of the Births in Scottish Hospitals statistics. Historic data will then be published alongside new data for the year ending 31st March 2012, meaning that an arrow can be calculated at that point.
Further Information
For information on general methodological approach, please click here.
Scotland Performs Technical Note
Who are our partners?
NHS Scotland
Local Authorities
Voluntary Organisations
Related Strategic Objectives
Healthier
Smarter
Wealthier and Fairer