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Table 5 Maternal Health Indicators considered for global monitoring and reporting, by indicator selection criteria

From: A common monitoring framework for ending preventable maternal mortality, 2015–2030: phase I of a multi-step process

Indicator Criteria (√ = YES, ~ = Some, X = No) Notes
Relevance Validity Feasibility Availability Complements MH Monitoring FWa
Impact
 Maternal mortality ratio ~ ~  
 Maternal cause of death ~ ~ ~ - Global Strategy indicator – need to strengthen information systems to routinely collect
Case fatality rate ~ ~ ~ X - More feasible to collect at sub-national or service delivery levels
 Adolescent birth rate  
COVERAGE: care for all women and girls
 4 or more antenatal care visits  
 Blood pressure screening during antenatal care X - May focus ANC on only BP screening
 Full course of iron/folate during pregnancy X X - May focus ANC on only iron folate
 Skilled attendant at birth ~ - SDG indicator
 Institutional delivery X - Complements skilled attendant at birth
 Oxytocin within 1 minute of birth (facility births) ~ ~ ~ X - Indicates quality of delivery care
- Feasible to strengthen routine health information systems to collect
- Timing is challenging
- Change wording to “uterotonic immediately after birth”
 Companion at birth ~ X X X - Respectful maternity care important, but this is only one element
- May focus respectful maternity care only on companion at birth
- Not feasible for many high-volume facilities
- Not included in large-scale household surveys
 Early postpartum care for woman ~ - Postnatal/postpartum care within 2 days of birth, regardless of place of delivery
 Met Need for family planning  
COVERAGE: Care for women and girls with complications
 Caesarean section rate among poor (bottom two quintiles) ~ ~ X  
 Caesarean section rate  
 Met need for EmOC X X X X  
 UnMet need for EmOC X X X X  
INPUT: counting
 Birth registration X ~ ~ ~ - Not relevant for maternal mortality – included in ENAP core metrics
 Death registration, including cause of death ~ ~ ~  
INPUT: Availability of care
 Availability of EmOC per 500,000 population ~ ~ ~ X - Essential to include an indicator on emergency obstetric care – indicator to be refined and updated
  1. Indicators in italics NOT included in final core list
  2. NOTE: √ = YES; ~ = Some; X = No
  3. aSDGs, WHO 100 Core indicators, WHO Quality of Care metrics, Every Newborn Action Plan (ENAP)