Count every newborn; a measurement improvement roadmap for coverage data

BMC Pregnancy and Childbirth

Research

Shams El Arifeen¹  Suzanne Fournier²  Agbessi Amouzou³  Christabel Enweronu-Laryea⁴  Matthews Mathai⁵  Shamim A Qazi⁵  Ashok Deorari⁶  Anne CC Lee⁷  Patricia S Coffey⁸  Penny Dawson⁹  Barbara Rawlins^1,10  Peter Waiswa^1,11  Tanya Marchant^1,12  Harriet Ruysen^1,13  Joy E Lawn^1,14  Sarah G Moxon^1,14  Hannah Blencowe^1,14  Niall Conroy^1,15  John Grove^1,16  Allisyn C Moran^1,17  Rubayet Sayed^1,18  Kate J Kerber^1,19  Lara ME Vaz^1,19  Steve Wall^1,19  Deborah Sitrin^1,19  Tanya Guenther^1,19  Juan Gabriel Ruiz Peláez^2,20  A Metin Gülmezoglu^2,21  Joshua P Vogel^2,21  Kathleen Hill^2,22  Troy Jacobs^2,23  Donna Vivio^2,23  Anna C Seale^2,24 

[1] Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), 68, Shaheed Tajuddin Sharani, 1212, Mohakhali, Dhaka, Bangladesh;Children's Investment Fund Foundation (CIFF), Health Team, 7 Clifford Street, W1S 2FT, London, UK;Data, Research and Policy, UNICEF, 3 UN Plaza, 10017, New York City, NY, USA;Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, PO Box 4236, Accra, Ghana;Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland;Department of Paediatrics, WHO Collaborating Centre for Education & Research in Newborn Care, All India Institute of Medical Sciences, 110029, Ansari Nagar, New Delhi, India;Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 75 Francis Street, 02115, Boston, MA, USA;Devices/Tools Global Program, Health Technologies for Women and Children, PATH, 2201 Westlake Avenue, Suite 200, 98121, Seattle, USA;International Division, John Snow Inc. (JSI), 44 Farnsworth St, 02210-1211, Boston, MA, USA;Maternal and Child Survival Program/Jhpiego, 1776 Massachusetts Avenue, Suite 300, 20036, Washington, DC, USA;Maternal and Newborn Working Group, INDEPTH Network, P.O. Box KD213, 38 & 40 Mensah Wood Street, East Legon, Kanda, Accra, Ghana;Makerere University College of Health Sciences, School of Public Health, Plot 1 New Mulago Hospital, P.O Box 25809, Kampala, Uganda;Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Department of Disease Control, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Saving Newborn Lives, Save the Children, 2000 L Street NW, Suite 500, 20036, Washington, DC, USA;Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK;Mohamed Aden Sheikh Children's Teaching Hospital, Hargeisa, Somaliland;Maternal, Newborn and Child Health, Global Development Program, Bill & Melinda Gates Foundation, 98109, Seattle, WA, USA;Office of Health, Infectious Disease and Nutrition, Bureau for Global Health, United States Agency for International Development, 20523-1000, Washington, DC, USA;Saving Newborn Lives, Save the Children in Bangladesh, House 35, Road 43, Gulshan 2, 1212, Dhaka, Bangladesh;Saving Newborn Lives, Save the Children, 2000 L Street NW, Suite 500, 20036, Washington, DC, USA;School of Medicine, Pontificia Universidad Javeriana, Carrera 7 No 40-62, Bogotá, Colombia;Fundación Canguro, Calle 56A No 50-36 - Bloque A13, Apto 416, Pablo VI Azul, Bogotá, Colombia;Hospital Universitario San Ignacio, Carrera 7 No 40-62, Bogotá, Colombia;UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, CH-1211, Geneva, Switzerland;USAID Applying Science to Strengthen and Improve Health Systems (ASSIST) project, University Research Co. LLC (URC), 7200 Wisconsin Avenue, Suite # 500, 20814, Bethesda, MD, USA;United States Agency for International Development, Bureau for Global Health, Office of Health, Infectious Disease and Nutrition, Maternal and Child Health Division, 1300 Pennsylvania Avenue, NW, 20523, Washington, DC, USA;University College London Department of Infectious Diseases Informatics, UCL Institute for Health Informatics, Farr Institute, 222 Euston Road, NW1 2DA, London, UK;

关键词: Newborn;    maternal;    coverage;    indicators;    monitoring;    evaluation;    quality;    equity;    impact;    mortality;    stillbirth;    health systems;    accountability;   

DOI  :  10.1186/1471-2393-15-S2-S8

来源: Springer

【 摘 要 】

BackgroundThe Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularly to track coverage, quality and equity.MethodsIn a multistage process, a matrix of 70 indicators were assessed by the Every Newborn steering group. Indicators were graded based on their availability and importance to ENAP, resulting in 10 core and 10 additional indicators. A consultation process was undertaken to assess the status of each ENAP core indicator definition, data availability and measurement feasibility. Coverage indicators for the specific ENAP treatment interventions were assigned task teams and given priority as they were identified as requiring the most technical work. Consultations were held throughout.ResultsENAP published 10 core indicators plus 10 additional indicators. Three core impact indicators (neonatal mortality rate, maternal mortality ratio, stillbirth rate) are well defined, with future efforts needed to focus on improving data quantity and quality. Three core indicators on coverage of care for all mothers and newborns (intrapartum/skilled birth attendance, early postnatal care, essential newborn care) have defined contact points, but gaps exist in measuring content and quality of the interventions. Four core (antenatal corticosteroids, neonatal resuscitation, treatment of serious neonatal infections, kangaroo mother care) and one additional coverage indicator for newborns at risk or with complications (chlorhexidine cord cleansing) lack indicator definitions or data, especially for denominators (population in need). To address these gaps, feasible coverage indicator definitions are presented for validity testing. Measurable process indicators to help monitor health service readiness are also presented. A major measurement gap exists to monitor care of small and sick babies, yet signal functions could be tracked similarly to emergency obstetric care.ConclusionsThe ENAP Measurement Improvement Roadmap (2015-2020) outlines tools to be developed (e.g., improved birth and death registration, audit, and minimum perinatal dataset) and actions to test, validate and institutionalise proposed coverage indicators. The roadmap presents a unique opportunity to strengthen routine health information systems, crosslinking these data with civil registration and vital statistics and population-based surveys. Real measurement change requires intentional transfer of leadership to countries with the greatest disease burden and will be achieved by working with centres of excellence and existing networks.

【 授权许可】

Unknown   
© Moxon et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.