BACKGROUND : Electronic health registries – eRegistries - can systematically collect relevant information at the point of
care for reproductive, maternal, newborn and child health (RMNCH). However, a suite of process and outcome
indicators is needed for RMNCH to monitor care and to ensure comparability between settings. Here we report on
the assessment of current global indicators and the development of a suite of indicators for the WHO Essential
Interventions for use at various levels of health care systems nationally and globally.
METHODS : Currently available indicators from both household and facility surveys were collated through publicly
available global databases and respective survey instruments. We then developed a suite of potential indicators and
associated data points for the 45 WHO Essential Interventions spanning preconception to newborn care. Four types of
performance indicators were identified (where applicable): process (i.e. coverage) and outcome (i.e. impact) indicators
for both screening and treatment/prevention. Indicators were evaluated by an international expert panel against the
eRegistries indicator evaluation criteria and further refined based on feedback by the eRegistries technical team.
RESULTS : Of the 45 WHO Essential Interventions, only 16 were addressed in any of the household survey data available.
A set of 216 potential indicators was developed. These indicators were generally evaluated favourably by the panel, but
difficulties in data ascertainment, including for outcome measures of cause-specific morbidity and mortality, were
frequently reported as barriers to the feasibility of indicators. Indicators were refined based on feedback, culminating in
the final list of 193 total unique indicators: 93 for preconception and antenatal care; 53 for childbirth and postpartum
care; and 47 for newborn and small and ill baby care.
CONCLUSIONS : Large gaps exist in the availability of information currently collected to support the implementation
of the WHO Essential Interventions. The development of this suite of indicators can be used to support the
implementation of eRegistries and other data platforms, to ensure that data are utilised to support evidence-based
practice, facilitate measurement and accountability, and improve maternal and child health outcomes.
Additional file 1: Example score sheet with indicator criteria.
Additional file 2: Evaluation rounds, interventions addressed with
number of indicators and indicator sources.
Additional file 3: Likely indicator values for power comparison
displayed in Fig. 3.
Additional file 4: Response to feedback – examples of indicator
Additional file 5: List of final indicators.
Additional file 6: Glossary of denominator units and definitions.
Ukpe, I.S. (Indongesit Sunday)(Association of Schools of Public Health, 2008-03)
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