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