Improving Maternal and Infant Nutrition: A Framework for Action

Listen

Appendix 5: Indicators for Short, Medium and Long term Outcomes

Short term outcome

Potential Indicator

Data source

1

All those working with women prior to conception, during pregnancy & after birth have the knowledge & skills to give practical information & support on optimal nutrition effectively and/or signpost appropriately

Quality standards for education programmes are established

Under graduate and postgraduate education programmes deliver on agreed learning outcomes to required quality standards in relation to maternal and infant nutrition

National occupational standards for maternal and infant nutrition are established

Training programmes deliver on agreed learning outcomes based on maternal and infant nutrition core standards

% of relevant workforce who have completed training in maternal and infant nutrition

Undetermined, would need to be collected by each Higher & Further Education Institution

2

All those working with pregnant women & parents have the knowledge, skills, confidence & attitude to give practical information & support around breastfeeding and/or signpost appropriately

Quality standards for education programmes are established

Under graduate and postgraduate education programmes deliver on agreed learning outcomes to required quality standards in relation to breastfeeding

% of relevant staff who have completed 'Breastfeeding Management' course

% maternity units with Baby Friendly accreditation

% CHPs with Baby Friendly accreditation

% Universities with Baby Friendly accreditation

Underdetermined

Baby Friendly audits

UNICEF Baby Friendly Initiative

3

All those working with families with young children have the knowledge & skills to give practical information & support on infant milk feeding, complementary feeding & establishing good eating patterns and/or signpost appropriately

Quality standards for education programmes are established

Under graduate and postgraduate education programmes deliver on agreed learning outcomes to required quality standards in relation to maternal and infant nutrition

National occupational standards for maternal and infant nutrition are established

Training programmes deliver on agreed learning outcomes based on maternal and infant nutrition core standards

% of relevant workforce who have completed training in maternal and infant nutrition

Undetermined, would need to be collected by each Higher & Further Education Institution

Audit of training provision

4

Services and all those working with children and families are more responsive to individual nutritional needs of children and families

Inclusion of maternal and infant nutrition in Pathways for Maternity Care and GIRFEC pathways

% of referred nutritionally vulnerable individuals accessing services

Evidence that service development is influenced by feedback from vulnerable groups - link to quality outcome measure around patient experience, patient reported outcomes, patient experience of access

Local directory of support services for maternal and infant nutrition

5

Increased identification & engagement of nutritionally vulnerable families

% of eligible beneficiaries who register for Healthy Start

% of Healthy Start beneficiaries that obtain women's vitamins

% of Healthy Start beneficiaries that obtain children's vitamins

Establish a core data set for maternal and infant nutrition to be included within the local Health Plan Indicator tool

% of local Health Plan Indicator tools that incorporate the core data set for maternal and infant nutrition

Department of Work & Pensions/ SG

Undetermined

6

All relevant national & local policies support healthy maternal & child nutrition

Existence of maternal and infant nutrition local delivery plans

Inclusion of maternal and infant nutrition in other relevant local policies/strategies e.g. in Single Outcome Agreements, Children's Services Plans and/or Joint Health Improvements Plans

Inclusion of maternal and infant nutrition in other relevant national policies

Audit of Board plans

Audit of local joint plans

Audit of national plans

7

Healthy food & drink is more affordable & more available to vulnerable families

Price rise of a healthy food basket is less or more than a standard or unhealthy food basket

% of eligible retailers registered with Healthy Start

% of eligible retailers registered with Healthy Start within the 15% most deprived datazones based on SIMD

Other indicators could be developed via Obesity Route Map

FSA Scotland

Healthy Start administrative data

8

More parents & carers understand the impact of optimal nutrition prior to conception & during pregnancy on maternal health, and consequently on foetal & child development & health

Maternal and infant nutrition is a core component of antenatal education which is based on principles of adult learning

% of parents/carers achieving learning outcomes

% of parents/carers from the six equality groups and deprived communities accessing antenatal education

Relevant resources are updated taking account of equality impact assessment findings

% of female respondents aged 18 - 49 yrs taking folic acid supplements because they hope to become pregnant

% of pregnant respondents who started taking folic acid supplements before becoming pregnant

% of pregnant respondents who have taken folic acid supplements during the first 12 weeks of pregnancy

% of women who took vitamin supplements during pregnancy

Audit of antenatal education curriculum

Monitoring of local service delivery

Audit of resources

Scottish Health Survey - Nurse interview

Infant Feeding Survey

9

More parents and carers understand the short & long term benefits of breastfeeding on maternal health, & child development & health

% of women who meet the required Baby Friendly standard i.e. the % of women who able to identify the health benefits of breastfeeding

Baby Friendly audits

10

More parents & carers understand the impact of infant milk feeding, complementary food & drinks on infant & child development & health

% of parents/carers who prepare infant formula according to guidelines

% of parents/carers who report accessing information on complementary feeding

% of participants from the six equality groups and deprived communities accessing support for complementary feeding

Relevant resources are updated taking account of equality impact assessment findings

% of infants weaned at around six months

Infant Feeding Survey

Evaluation of weaning sessions

Audit of resources

Infant Feeding Survey

11

More parents & carers have the confidence & skills to implement good feeding and eating patterns

% of parents/carers who prepare infant formula according to guidelines

% of parents/carers who report they have increased confidence after accessing support for complementary feeding

% of children who receive vitamin supplements

Other indicators could be developed from the National Diet & Nutrition Survey ( NDNS) of Infants & Young Children (to be published 2012)

Infant Feeding Survey

Evaluation of local service

Infant Feeding Survey

NDNS of Infants & Young Children (2012)

12

More parents & carers understand the impact of under/overweight prior to pregnancy & returning to a healthy weight after birth on the mother's future health

% of women whose height and weight is recorded at booking to allow calculation of Body Mass Index

% of women who report being given information on impact of weight on health

Inclusion of an intervention within the Pathways for Maternity Care for women whose BMI is outwith the normal range

ISD Scotland data

Undetermined

Review of Pathways

Medium Term Outcome

Potential Indicator

Data Source

13

More children are breastfed and for longer

% of infants breastfed at birth, 10 days, 6-8 weeks and 6 months

ISD Scotland

Infant Feeding Survey

14

More parents & carers choose healthy food & drinks for themselves & their children

% of infants who receive an "ideal" first food at weaning (fruits, vegetables, baby rice)

% of eligible beneficiaries who register for Healthy Start

% of respondents who have tried to eat more healthily in the last year to improve their health

% of respondents who have maintained a healthier eating pattern in the last year

% of women taking vitamin supplements while breastfeeding

Other indicators could be developed from NDNS survey on infants and young children (to be published 2012)

Infant Feeding Survey

Healthy Start Management Information

Scottish Health Survey - Knowledge, attitudes and motivation module

Undetermined

NDNS survey on infants and young children (2012)

15

Increased acceptability of breastfeeding in Scottish society in general & in disadvantaged groups

% of women who have been stopped from or made to feel uncomfortable about breastfeeding in a public place

% of respondents in the general population who tend to agree or strongly agree that women should only breastfed their babies at home or in private

% of respondents in lower socioeconomic groups who tend to agree or strongly agree that women should only breastfed their babies at home or in private

Infant Feeding Survey

Scottish Health Survey -

Knowledge, attitudes and motivation module

16

Increased awareness in the general population of the short & long term benefits of breastfeeding on maternal & child development & health

% of respondents who are able to identify at least one health benefit of breastfeeding for infants

% of respondents who are able to identify at least one health benefit of breastfeeding for mothers

% of respondents who state that bottle fed babies are less healthy and less immune to infection than breast fed babies

Undetermined

17

Increased awareness in the general population of the impact of nutrition on foetal & child development & health

% of general population who identify folic acid supplementation as important for pregnant women

% of general population who are able to identify the recommended daily intake of fruit and vegetables for children

Undetermined

Medium/Long term Outcome

Potential Indicator

Data Source

18

society values & prioritises maternal & child nutrition

% household expenditure on fruit and vegetables

% household expenditure on soft drinks

% household expenditure on confectionery

% of respondents in the general population who tend to agree or strongly agree that women should only breastfeed their babies at home or in private

Family Food Survey

Scottish Health Survey - Knowledge, attitudes and motivation module

19

breastfeeding is increasingly seen as the norm

% of respondents who if a close friend or relative was having a baby would encourage them to breastfeed

Undetermined

20

the social & physical environment supports healthy nutrition for young children

% of early years establishments assessed who provide fruit, milk and water daily

% of early years establishments assessed who have a healthy eating policy

Care Commission inspections

Long term Outcome

Potential Indicator

Data Source

21

reduced childhood obesity

% of children with a BMI on or above 85 th centile and on or above 95 th centile at the Primary 1 assessment

ISD Scotland

22

improved child nutrition-related health & wellbeing

% of infants breastfed at birth, 10 days, 6-8 weeks and 6 months

% of infants weaned at around 6 months

% of children with a BMI on or above 85 th centile and on or above 95 th centile at the Primary 1 assessment

% of Primary 1 children with decayed, missing or filled teeth

ISD Scotland

Infant Feeding Survey

ISD Scotland

Scottish Dental Inspection Programme

23

reduced inequalities in child nutrition-related health & wellbeing

Reduction in gap across all quintiles of rates of 21 & 22 above

As 21 & 22 above

24

reduced maternal obesity

% of overweight and obese women aged 16 - 44 yrs

% of overweight and obesity in pregnant women at first booking appointment

% overweight and obese women following birth (at a point in time yet to be determined)

Scottish Health Survey

ISD Scotland

Undetermined

25

improved maternal nutrition-related health & wellbeing

% of women taking folic acid supplements prior to and during pregnancy

% of women taking vitamin D supplements during pregnancy and while breastfeeding

% of pregnant women with a BMI < 18.5 at first booking appointment

Scottish Health Survey - Nurse interview

Undetermined

ISD Scotland

26

reduced inequalities in maternal nutrition-related health & wellbeing

Reduction in gap across all quintiles of rates of 24 & 25 above

As 24 & 25 above