Abstract
BackgroundSince 2014, iterative technical work has captured stakeholder demand and channeled it toward improving maternal health measurement, to support SDG 3.1. Strategies toward Ending Preventable Maternal Mortality (EPMM) (2015) turned a broad lens on upstream systemic determinants of maternal health and survival highlighted in 11 Key Themes. A monitoring framework was developed to help countries track progress across these domains. This process yielded requests for additional indicators where stakeholders identified gaps for tracking EPMM Key Themes. In response, two technical consultations aimed at affirming the measurement gaps, specifying the constructs for measurement, and fully elaborating the metadata to allow them to be monitored.MethodsMeasures for development were prioritized based on multi-stakeholder dialogues in five countries, and data collected from government officials and UN partners in twenty countries on perceived need for proposed additional indicators. Sixty-one participants representing expertise in measure development and the topical areas covered took part across both consultations. Measures were developed through two simultaneous participatory online consultations stratified by focus area, comprising videos, discussion forums, polls, and live Zoom meetings.ResultsEight candidate indicators relevant to priority recommendations in the EPMM Strategies are presented. Each includes a definition, numerator and denominator (if applicable), method of estimation, disaggregation factors, preferred data source(s), and expected periodicity. Four address gaps in measures of fundamental rights-related determinants of maternal health at national and subnational level, including women’s reproductive autonomy; participative accountability for maternal health outcomes; and Respectful Maternity Care. Four strengthen the ability to count, track, and link births and maternal deaths and causes of death.ConclusionsThe proposed indicators correspond to specific EPMM Key Themes, filling gaps identified by multiple stakeholders, and respond to calls for a broadened approach to measurement and for indicators that track the social and health-systems determinants of maternal health. They reflect inputs and aspirations of numerous stakeholders, gathered over time and across various platforms. The iterative, discursive exploration of the concepts for measurement and the need for metrics to track them responds to recent calls for measure development to be carried out in more inclusive ways, and to be primarily concept- and user-driven.
Highlights
MethodsMeasures for development were prioritized based on multi-stakeholder dialogues in five countries, and data collected from government officials and UN partners in twenty countries on perceived need for proposed additional indicators
The proposed indicators correspond to specific Ending Preventable Maternal Mortality (EPMM) Key Themes, filling gaps identified by multiple stakeholders, and respond to calls for a broadened approach to measurement and for indicators that track the social and health-systems determinants of maternal health
The iterative, discursive exploration of the concepts for measurement and the need for metrics to track them responds to recent calls for measure development to be carried out in more inclusive ways, and to be primarily concept- and user-driven
Summary
Measures for development were prioritized based on multi-stakeholder dialogues in five countries, and data collected from government officials and UN partners in twenty countries on perceived need for proposed additional indicators. The selection of constructs to be developed into fully articulated indicators was based on inputs collected during national multi-stakeholder dialogues in five countries, along with information from a landscape analysis based on online surveys and key informant interviews with government officials and in-country UN agency staff in twenty countries on their perceived need for the proposed additional indicators. The constructs that a majority of stakeholders across all participating countries rated “Very Important” were considered for inclusion in these consultations These results provided additional inputs into national demand for development of the proposed additional indicators
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