eRegistries: indicators for the WHO Essential Interventions for reproductive, maternal, newborn and child health

Flenady V 1 , Wojcieszek AM 2 , Fjeldheim I 3 , Friberg IK 3 , Nankabirwa V 4 , Jani JV 3 Show all authors , Myhre S 3 , Middleton P 5 , Crowther C 6 , Ellwood D 5 , Tudehope D 2 , Pattinson R 7 , Ho J 8 , Matthews J 9 , Bermudez Ortega A 10 , Venkateswaran M 3 , Chou D 11 , Say L 11 , Mehl G 11 , Frøen JF 5

Affiliations 

  • 1 Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, Australia. vicki.flenady@mater.uq.edu.au
  • 2 Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, Australia
  • 3 Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
  • 4 Department of Epidemiology and Biostatics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
  • 5 International Stillbirth Alliance, Bristol, UK
  • 6 South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
  • 7 Medical Research Council, University of Pretoria, Pretoria, South Africa
  • 8 Penang Medical College and Penang Hospital, Penang, Malaysia
  • 9 Christian Medical College, Vellore, Tamil Nadu, India
  • 10 The Australian Nurse Family Partnership Program National Program Centre, Abt Australia, Brisbane, Australia
  • 11 Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
BMC Pregnancy Childbirth, 2016 Sep 30;16(1):293.
PMID: 27716088

Abstract

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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