Metrics & Measurement for Improved Care

Weak health information systems continue to hinder the provision of quality maternal, newborn and child health (MNCH) care in many low-resource settings. Country and global consensus on priority maternal health indicators and reliable capture and use of such measures to improve health care utilization, quality and equity is a pressing need in maternal health.

MCSP worked to strengthen health information systems — both facility- and community-based — and use of data for decision-making and learning. Quality improvement at the facility level focused on simplified models to measure and track progress in quality of care and to link improvements to health outcomes. The Program promoted improved metrics and measurement for MNH through three primary mechanisms of support:

• Global efforts to refine and advocate for robust MNH indicators, tailored to system level, to promote better management and quality of services. MCSP worked closely with the World Health Organization (WHO), UNFPA, Ending Preventable Maternal Mortality Working Group, Every Newborn Action Plan, and other stakeholders to define priority quality MNH measures. As co-chair of the WHO Quality of Care Network for MNCH, MSCP supported the design, revisions and implementation of a monitoring framework for the  network, including prioritization of a small number of common quality of care measures for monitoring across all network countries.
• Country national governments to prioritize robust MNH indicators and maternal mortality rate targets for incorporation into national MNH strategies and indicator dashboards.
• Sub-national managers and frontline health care workers to strengthen health worker measurement capacity and collection and use of prioritized MNH indicators to routinely measure/assess essential system functions and utilization and quality of clinical care services. We promoted the regular calculation, visualization and analysis of a core set of priority indicators for key phases of routine MNH care, and for maternal and newborn complications care. MCSP promoted the regular calculation, visualization and analysis of priority indicators for key phases of both routine and complications MNH care .

The Program also supported countries to strengthen Maternal Death Surveillance & Response and Maternal and Perinatal Deaths Surveillance and Response (MPDSR) systems, including surveillance of maternal and newborn deaths and causes of death. MCSP promoted stronger alignment of MPDSR efforts with broader MNH metrics and quality improvement efforts. We worked with country counterparts to strengthen local information systems, including capture of primary data in registers and patient records. The Program built manager and health worker capacity to calculate and use priority data to monitor, and strengthen essential system functions and quality of MNCH/postpartum family planning health care services.

As part of respectful maternity care (RMC) and quality of care work, MCSP also tested methods to incorporate routine assessment and measurement of client experience of care, RMC, and mistreatment in childbirth into comprehensive MNH programs in program-supported regions.