Developing global indicators for quality of maternal and newborn care

News article 2 Jun 2017
Mother and baby in Nigeria

CMNH assess feasibility of WHO maternal & newborn quality of care indicators, and suggest further revision or development in the WHO Bulletin.

In response to the Sustainable Development Goals there has been renewed interest in assessing the quality and coverage of interventions to improve maternal and newborn health. Indicators are measures that describe standards of care that should be in place, and can be used to collect data to evaluate whether care is consistent with standards. The World Health Organization proposed 15 maternal and newborn health quality of care indicators for use at health facility level; six for maternal health, five for newborn health and four general cross-cutting indicators.

The indicators, developed by consensus, were not formally piloted or assessed to determine whether they could be used alongside routine data collection processes in place in low and middle income countries. Using data collected in health facility registers and as part of health facility assessments from 963 healthcare facilities across 10 countries in Africa and Asia, we assessed if the proposed indicators could be applied in these settings.

Our assessment found that ten indicators were clearly defined, of which four could be applied directly in the field, while the other six require revisions to operationalise them. The other five indicators require further development, with one of them being ready for implementation using information available in registers and the other four requiring further information before being deployed. Collecting additional information which is not already captured at facilities is often challenging, but can be done with key indicators that are clearly defined and reflect all components of care provision including input, process and outcome measures.