Abstract
Global monitoring of intervention coverage is a cornerstone of international efforts to improve reproductive, maternal, newborn, and child health. In this review, we examine the process and implications of selecting a core set of coverage indicators for global monitoring, using as examples the processes used by the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Accountability for Women's and Children's Health. We describe how the generation of data for global monitoring involves five iterative steps: development of standard indicator definitions and measurement approaches to ensure comparability across countries; collection of high-quality data at the country level; compilation of country data at the global level; organization of global databases; and rounds of data quality checking. Regular and rigorous technical review processes that involve high-level decision makers and experts familiar with indicator measurement are needed to maximize uptake and to ensure that indicators used for global monitoring are selected on the basis of available evidence of intervention effectiveness, feasibility of measurement, and data availability as well as programmatic relevance. Experience from recent initiatives illustrates the challenges of striking this balance as well as strategies for reducing the tensions inherent in the indicator selection process. We conclude that more attention and continued investment need to be directed to global monitoring, to support both the process of global database development and the selection of sets of coverage indicators to promote accountability. The stakes are high, because these indicators can drive policy and program development at the country and global level, and ultimately impact the health of women and children and the communities where they live.
Highlights
Global monitoring of coverage for maternal and child health interventions involves the collection and analysis of a limited set of quantitative indicators to assess progress, and is central to international efforts to improve reproductive, maternal, newborn, and child health (RMNCH)
In this article, which is part of the PLOS Medicine ‘‘Measuring Coverage in MNCH’’ Collection, we review the steps involved in producing data of adequate quality for use in global monitoring
We provide a critical analysis of the sets of coverage indicators included in the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Information and Accountability for Women’s and Children’s Health initiatives (Table 1), which are referred to as ‘‘Countdown’’ and ‘‘the Commission,’’ respectively, throughout the rest of this review
Summary
Global monitoring of coverage for maternal and child health interventions involves the collection and analysis of a limited set of quantitative indicators to assess progress, and is central to international efforts to improve reproductive, maternal, newborn, and child health (RMNCH). Each indicator must be measured at the country level using standard methods that produce complete, comparable, highquality data that are nationally representative Producing such data requires specialized technical inputs in sampling and survey design, thorough training and supervision of those who collect the data, and close attention to quality in data entry, cleaning, weighting, and tabulation. This step requires agreement on which countries will be included, which indicators will be highlighted, what additional information is needed to interpret the results, and the identification of key messages for target audiences These analyses must take into account any limitations of the data that are identified in earlier steps to ensure that correct interpretations are made for public health programming.
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