Reproductive Health Indicators Research Articles

Physiological endocrinology and causes of disorders of the menstrual cycle

The menstrual cycle is the result of a complex interaction between the hormonal system and the body's organs, namely the hypothalamus, pituitary, ovaries and uterus. Regular menstrual cycle is an indicator of women's reproductive health, changes in the menstrual cycle can be associated with ovarian-thyroid dysfunction and pituitary axis. This article aimsto understand the role of endocrinology in the process of the menstrual cycle as well as review the currently available literature on the causes of disorders of the menstrual cycle.The method used is Systematic Literature Review using the Preferred Reporting Items for Systematic Reviews (PRISMA) flow by collecting articles, according to those obtained from the PubMed database, Wiley Online Library, Science Direct and Cochrane, with the keywords "Menstrual cycle, hormone disruption, gynecological disease , and endocrinology” from the results of the analysis, 6 articles were selected that met the criteria. The conclusion ismany factors influence the occurrence of disturbances in the menstrual cycle that can affect reproductive health, including diabetes, night shift work schedules, nutritional intake, smoking habits, as well as psychological stress and anxiety during the pandemic due to the Covid-19 disease and vaccine administration.

РАБОТА СЛУЖБЫ РОДОВСПОМОЖЕНИЯ В РЕСПУБЛИКЕ ДАГЕСТАН С УЧЕТОМ ДИНАМИКИ ДЕМОГРАФИЧЕСКИХ ПРОЦЕССОВ

The article presents the results of the analysisof the dynamics of the demographic situation and the reproductive potential of residents byDerbent and Derbent district of Dagestan. It was revealed that the differentiation between the districts in terms of demographic findings and women reproductive health indicators increases, which affects the performance of birth care services.

Exploring the feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in Jordan

BackgroundReliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and variable in quality across different humanitarian settings. To address this gap in data quality, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes in humanitarian settings, and assessed their feasibility in the field in Jordan, in addition to three other countries; with the goal of aggregating information from global consultations and field-level assessments to reach consensus on a set of core SRMNCAH indicators for services and outcome evaluation in humanitarian settings among WHO global partners.MethodsThe feasibility assessment in Jordan focused on the following constructs: relevance/usefulness, feasibility of measurement, systems and resources, and ethical issues. The multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, facility assessments, and observational sessions.ResultsFindings suggest that there is widespread support among regional, national, as well as global stakeholders for developing a core list of SRMNCAH indicators for monitoring and evaluation of services and outcomes in humanitarian settings in Jordan. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome.ConclusionsDespite stakeholder support in developing a core set of indicators, this would only be useful if it has the buy-in from the international community. Greater harmonization and coordination, alongside increased resource allocation, would improve data collection efforts and allow stakeholders to meet indicators’ reporting requirements.

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

The participation of males in joint spousal decisions is urgently needed in achieving the fundamental indicators of reproductive health. The low involvement of males in family planning (FP) decision-making is a major determining factor in low FP usage in Malawi and Tanzania. Despite this, there are inconsistent findings regarding the extent of male involvement and the determinants that aid male participation in FP decisions in these two countries. The objective of this study was to assess the prevalence of male involvement in FP decisions and its associated determinants within the household context in Malawi and Tanzania. We used data from the 2015-2016 Malawi and Tanzania Demographic and Health Surveys (DHSs) to examine the prevalence and the determinants inhibiting male involvement in FP decisions. The total sample size of 7478 from Malawi and 3514 males from Tanzania aged 15-54 years was employed in the analysis by STATA version 17. Descriptive (graphs, tables and means), bi-variate (chi-square) and logistic regression analyses (unadjusted (U) and adjusted odds ratio (AOR)) were performed to identify the determinants associated with male involvement in FP decisions. The mean age of respondents in Malawi was 32 years (±8 SD) and in Tanzania, 36 years (±6 SD), with the prevalence of male involvement in FP decisions being 53.0% in Malawi and 26.6% in Tanzania. Being aged 35-44 years [AOR = 1.81; 95% CI: 1.59-2.05] and 45-54 years [AOR = 1.43; 95% CI: 1.22-1.67], educated (secondary/higher) [AOR = 1.62; 95% CI: 1.31-1.99], having access to media information [AOR = 1.35; 95% CI: 1.21-1.51] and having a female head of household [AOR = 1.79; 95% CI: 1.70-1.90] were determinant factors of male involvement in FP decisions in Malawi. Primary education [AOR = 1.94; 95% CI: 1.39-2.72], having a middle wealth index ranking [AOR = 1.46; 95% CI: 1.17-1.81], being married [AOR = 1.62; 95% CI: 1.38-1.90] and working [AOR = 2.86; 95% CI: 2.10-3.88] were higher predictors of male involvement in FP decisions in Tanzania. Increasing the role of males in FP decisions and involvement in FP utilization may improve uptake and continuity of FP usage. Therefore, the findings from this cross-sectional study will support redesigning the ineffective strategic FP programs that accommodate socio-demographic determinants that may increase the likelihood of male involvement in FP decisions, especially in the grassroots settings in Malawi and Tanzania.

A subnational reproductive, maternal, newborn, child, and adolescent health and development atlas of India

Understanding the fine scale and subnational spatial distribution of reproductive, maternal, newborn, child, and adolescent health and development indicators is crucial for targeting and increasing the efficiency of resources for public health and development planning. National governments are committed to improve the lives of their people, lift the population out of poverty and to achieve the Sustainable Development Goals. We created an open access collection of high resolution gridded and district level health and development datasets of India using mainly the 2015–16 National Family Health Survey (NFHS-4) data, and provide estimates at higher granularity than what is available in NFHS-4, to support policies with spatially detailed data. Bayesian methods for the construction of 5 km × 5 km high resolution maps were applied for a set of indicators where the data allowed (36 datasets), while for some other indicators, only district level data were produced. All data were summarised using the India district administrative boundaries. In total, 138 high resolution and district level datasets for 28 indicators were produced and made openly available.

The role of gender inequality and health expenditure on the coverage of demand for family planning satisfied by modern contraceptives: a multilevel analysis of cross-sectional studies in 14 LAC countries

Despite international efforts to improve reproductive health indicators, little attention is paid to the contributions of contextual factors to modern contraceptive coverage, especially in the Latin America and the Caribbean (LAC) region. This study aimed to identify the association between country-level Gender Inequality and Health Expenditure with demand for family planning satisfied by modern contraceptive methods (DFPSm) in Latin American sexually active women. Our analyses included data from the most recent (post-2010) Demographic and Health Survey or Multiple Indicator Cluster Survey from 14 LAC countries. Descriptive analyses and multilevel logistic regressions were performed. Six individual-level factors were included. The effect of the country-level factors Gender Inequality Index (GII) and Current Health Expenditure on DFPSm was investigated. DFPSm ranged from 41.8% (95% CI: 40.2-43.5) in Haiti to 85.6% (95% CI: 84.9-86.3) in Colombia, with an overall median coverage of 77.8%. A direct association between the odds of DFPSm and woman's education, wealth index, and the number of children was identified. Women from countries in the highest GII tertile were less likely (OR: 0.32, 95% CI: 0.13-0.76) to have DFPSm than those living in countries in the lowest tertile. Understanding the contribution of country-level factors to modern contraception may allow macro-level actions focused on the population's reproductive needs. In this sense, country-level gender inequalities play an important role, as well as individual factors such as wealth and education. Bill and Melinda Gates Foundation and Associação Brasileira de Saúde Coletiva (ABRASCO).

Urogenital schistosomiasis (UGS) and female genital schistosomiasis (FGS) in Cameroon: an observational assessment of key reproductive health determinants of girls and women in the Matta Health Area

Objectives and settingAcross sub-Saharan Africa, urogenital schistosomiasis (UGS), in particular female genital schistosomiasis (FGS), is a significant waterborne parasitic disease, with its direct burden on the sexual and reproductive health...

Effect of the COVID-19 on the reproductive health indicators of cadets

The study investigated the influence of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 on the reproductive health indicators of cadets of military educational organizations. In the Department of Assisted Reproductive Technologies at the Clinic of Obstetrics and Gynecology of the Kirov Military Medical Academy, 183 male cadets aged 2127 years were divided into two groups and examined. The first group consisted of 132 cadets who had mild and moderate COVID-19, and the second group included 51 cadets without COVID-19 in the anamnesis. COVID-19 was found negatively affect the reproductive health of cadets. Individuals who previously had COVID-19 were found to have a significant decrease in the level of total testosterone and decreased concentration and mobility of sperm in the ejaculate. Moreover, in cadets without COVID-19 who were vaccinated with the combined vector vaccine Gam-COVID-Vac, the indicators of the hormonal profile and spermograms were within the reference values. The results indicate the need for further investigation of the effect of various negative factors, including severe acute respiratory syndrome coronavirus 2, on the reproductive health of cadets of military educational organizations. Moreover, the development of preventive, therapeutic, and rehabilitation measures will reduce the risk of infertility and reproductive losses, which is consistent with the interests of national projects on healthcare and demography.

Clinicoetiological study on vaginal discharge among sexually active women attending a tertiary center in North Kerala, India.

Vaginal discharge is a common complaint among women attending the sexually transmissible infections (STIs) clinic and is a cause for concern and mental distress. It can be attributed to physiological or pathological causes. This study aims to understand the prevalence of various etiologies of vaginal discharge, which would help frame health policies based on local needs. (1) To estimate the prevalence of discharge per vaginum among sexually active women attending the STI clinic at a tertiary care center during a 1-year period, (2) To identify the organisms causing vaginal discharge, (3) To have a clinicoetiological correlation of the cases, and (4) To identify the subspecies of Candida causing vaginal candidiasis. A total of 126 patients with vaginal discharge attending the STI clinic at a tertiary care center were included in the study. A detailed clinical history, physical examination of the external genitalia, and vaginal examination were done on each patient. Five swabs were taken from the posterior fornix and lateral vaginal wall for evaluation of the organisms. The mean age of the study population was 31.51 ± 7.9 years. Vulvovaginal candidiasis (VVC) was found to be the most common cause of vaginal discharge, followed by bacterial vaginosis, mucopurulent cervicitis, herpes genitalis, and trichomoniasis. The most common species of Candida was found to be Candida albicans. Even though VVC still remains the major cause, other viral infections like herpes significantly contribute. Vaginal discharge is an important indicator of women's reproductive health and its detailed evaluation helps identify the prevalence of various STIs in the community.

Non-invasive assessment of ovarian activity in free-ranging eastern black rhinoceros (Diceros bicornis michaeli) in Kenya

Eastern black rhinos (Diceros bicornis michaeli) are a critically endangered species living in diverse habitats across Africa. In Kenya, once threatened with extinction due to massive poaching pressures, increased protection has resulted in losses being less than 1% annually today. Still, some populations have failed to achieve desired population growth targets. At Ol Jogi Wildlife Conservancy, some individuals are experiencing sub-optimal reproduction based on historical calving records and long inter-calving intervals (>3years). Hormones drive the reproductive process, so non-invasive assessments of endocrine patterns can be useful indicators of individual reproductive health. In this study, we analysed longitudinal fecal progestagen metabolite (fPM) concentrations in all breeding female eastern black rhinos at Ol Jogi (n = 17) and compared the prevalence of irregular estrous cycles (longer or shorter than 20-40days) and anestrous periods (interluteal period more than twice the length of a normal follicular phase, i.e. > 10days) between optimal (inter-calving interval < 3years) and sub-optimal (>3years) reproducing individuals. Ten rhinos were pregnant during at least part of the study period. A total of 12 complete cycles were observed in seven females with an average length of 36 ± 3days and equal numbers of regular and irregular cycles. Single anestrous periods averaging 67 ± 13days were observed in five females. Surprisingly, a majority of cycles in optimal reproducing individuals were categorized as irregular based on fPM profiles. Overall, results suggest that irregular ovarian activity and isolated bouts of anestrus do not have negative impacts on reproductive performance in this subpopulation at Ol Jogi. A high priority is to continue using noninvasive hormone monitoring to evaluate how ecological or other variables influence reproductive success in this and other eastern black rhino subpopulations in Kenya.

Оцінка стану репродуктивного здоров'я жіночого населення Закарпатської області в сучасних умовах

Introduction. The demographic crisis in Ukraine is a socio-medical problem caused by: socio-economic factors; the consequences of the COVID-19 pandemic, which continues in conditions of war; a decrease in the total fertility rate against the background of somatic and gynecological pathology; the increase in the specific weight of reproductive losses; high level of maternal and infant mortality. Goal. To analyze the dynamics of reproductive health indicators of the female population of the Transcarpathian region for 5 years. Determine the priority directions for improving the situation in the region. Materials and methods. Analysis and statistical processing of data by region for 2018-2022. Conclusions of the commission of the health care department on the analysis of cases of maternal and perinatal mortality. The results of a sample survey of the female population. Research results and their discussion. The reasons for the deterioration of reproductive health and the structure of morbidity among women of reproductive age and adolescent girls are determined. The most urgent problems are the increase in miscarriages, high rates of oncogynecological morbidity, the increase in the level of maternal mortality against the background of the consequences of the COVID-19 pandemic, chronic extragenital pathology. When analyzing cases of maternal and perinatal losses, deficiencies in the provision of assistance were revealed. The results of the survey indicate a low level of sanitary education. Two international projects aimed at improving the quality of medical services and perinatal care were launched in the region. Conclusions. Analysis of reproductive health indicators of the female population shows negative trends and requires further development and implementation of effective measures to improve the situation. The implemented medical reform is imperfect in terms of: monitoring; coordinated work of the primary and secondary links of assistance; quality of training of specialists and improvement of their qualifications.

Assessment of indicators of reproductive health of the population of the Trans-Ural Republic of Bashkortostan in 2000–2020

BACKGROUND: The reproductive health of a population depends on many factors one of which is chemical pollution of the environment caused by both natural conditions and man-made impacts. The population living in geochemical provinces is often subject to pathological conditions caused by a lack, excess or imbalance of macro- and microelements. This study was carried out in the Republic of Bashkortostan in areas of natural and man-made anomalies with excessive content of heavy metals in the environment.&#x0D; AIM: To analyze the demographic profile and assess the reproductive health of the population of the Trans-Ural zone of the Republic of Bashkortostan.&#x0D; MATERIALS AND METHODS: A descriptive ecological study of the trend of reproductive health of the population of the Trans-Ural zone of the Republic of Bashkortostan was carried out using average population indicators. Statistical data presented in the open press by the Ministry of Health of the Republic of Bashkortostan for the 20002020 period were used. These data included demographic indicators, infant mortality, frequency of congenital malformations, and morbidity of children within the first year of life.&#x0D; RESULTS: In all the areas studied, there was a tendency for a decrease in the birth rate and an increase in the mortality rate. The highest average birth rate of 19.8 was recorded in the Burzyansky District and the lowest of 13.1 in the Zilairsky District, which was higher than the republican average of 12.4. During the study period, there was a significant decrease in infant mortality both in the republic and in the Trans-Urals regions. Average infant mortality rates relative to congenital malformations among newborns in the Sibay, Baymaksky, and Zianchurinsky Districts as well as the relative risk of blood diseases in children of the first year of life in most of the studied areas was higher than the average republican level.&#x0D; CONCLUSION: Reproductive health of the population of Sibay for the period 20002020 is exposed to a higher risk of congenital malformations and infant mortality than the average republican level. In the Baymaksky, Zianchurinsky, Uchalinsky and Khaibullinsky Districts, the risk of developing blood diseases in children within the first year of life was higher than the average republican level. The results further indicate the need to take measures to reduce risks and improve the safety of reproductive health of the population of the mining region.

Adolescent pregnancy outcomes in Jos, North Central Nigeria: The roles of disclosure and social support systems

ABSTRACT Adolescent pregnancy is mostly unintended and an indicator of unmet sexual and reproductive health (SRH) needs. In most African cultures, sociocultural and religious expectations of chastity make unintended adolescent pregnancy a traumatic experience. This study examined the roles of disclosure and social support networks in determining adolescent pregnancy outcomes in Jos, Nigeria. Using a qualitative design, we conducted in-depth interviews with 17 young persons aged 16–24 years, recruited through purposive and snowballing sampling methods. Data were analysed using an inductive approach. Informal social support networks, mainly mothers and close friends, played prominent roles in pregnancy disclosure. The fear of unsafe abortion complications and lack of other options forced most participants into early motherhood. Parenting issues also contributed to unintended adolescent pregnancies. Participants noted that adolescent males had better access to contraceptive devices like condoms. Additionally, the absence of formal opportunities for institutional support through education and youth-friendly SRH services constituted barriers to preventing unintended adolescent pregnancies. Considering the important role family plays, preventing unintended adolescent pregnancies requires empowering parents on SRH communication. A gender-based approach to adolescent-friendly SRH services is recommended. The Nigerian government needs to reconsider how to provide contextually-acceptable comprehensive sexuality education to young people.

Comparison of Menstrual Distress in Adolescent Girls Across Residential Area

Menstruation is an important indicator of reproductive health and development. In spite of a biological fact, menstrual distress is rooted in psychological and socio-cultural realities of the life of adolescent girls and women. The purpose of this study was to better understand the challenges girls face due to menstruation in the form of menstrual distress adolescent girls in Haryana State. The study was conducted on 240 adolescent girls in the age group of 10-14years and 15-19 years belonging to rural and urban areas of Hisar district. The study found that more than one fourth adolescent girls irrespective of area of residence reported higher physical distress and socially imposed impurity and restriction distress. Rural girls were more distressed than urban counterparts. Regarding facilities at school in terms of MHM, girls reported lack of proper disposal system for sanitary materials and lack of availability of changing rooms. Nearly half of respondents reported lack of open discussion from family on MHM issues. Results indicated that menstrual experiences were very painful and made adolescent girls distressed both at physiological and psychological levels. Rural adolescents had higher distress in all the aspects as compared to urban adolescents except positivity on womanhood.

Associations Between State-Level Changes in Reproductive Health Services and Indicators of Severe Maternal Morbidity

This cross-sectional study examines the legislative, state, economic, and racial factors in increased severe maternal morbidity risk in pregnant individuals.

VALIDATION OF A GEORGIAN LANGUAGE QUESTIONNAIRE IN A REPRODUCTIVE HEALTH INDICATORS EVOLUATION (PILOT) STUDY

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reproductive health is a priority for the world. The goal of our research was the validation of a Georgian language questionnaire in a Reproductive Health Indicators Evaluation (Pilot) Study. The study group consisted of 100 people. The research has shown that the questionnaire specially prepared by us is adequate for conducting research as a research tool and creates a necessary and sufficient condition for obtaining information.

Differential Effects of Household Characteristics on Uptake of Skilled Birth Attendance among Women of Reproductive Age in Western Kenya

Maternal health remains a challenge in developing countries. The number of women dying every year from maternal-related causes has remained high in developing countries despite various efforts to bring them down. Such deaths occur due to complications during pregnancy, childbirth and the postpartum period. Approximately 16–33% of maternal deaths can be averted if supervised by skilled professionals. WHO describes skilled birth attendance (SBA) as skilled care at birth. Great Lakes University of Kisumu (GLUK) supported the strengthening of Community Health Strategy implementation (CHS) in the Western region of Kenya for a period of five years aiming at reducing poor reproductive health indicators among young people and women. The overall aim of this study was to determine the contribution of CHS implementation to maternal and child health, specifically on uptake of SBA. This was an embedded study in a larger study. It was an analytical study utilizing secondary quantitative data drawn from a descriptive cross-sectional study done during the period of GLUK’s intervention. The main objective of this study therefore, was to establish the differential effects of household characteristics on the uptake of SBA among women of reproductive age in the Western region of Kenya. Descriptive statistics were used to determine the uptake level of SBA. Cross-tabulations were done to determine the association between household characteristics and uptake of SBA, where Chi-square was used to test for significance of association at a 5% confidence level. Logistic regression analysis was done to test the strength of association between the variables of interest. Analysis was done using STATA version 14. Findings showed that uptake of SBA was 70%. Trend analysis across ages of the U5-year-old children showed a steady annual increase of 3% in the uptake of SBA over the five-year period from 69% to 77%. Results from Chi-square tests showed that four out of seven Socio-demographic and economic household characteristics had a significant influence on the uptake of SBA (Housing type-P-value=0.000); Age of the Household head-P-value=0.002); Disability-P-value 0.004) and Availability of staple food -P-value=0.000). Gender, education level of the Household head and presence of a latrine had no association. Logistic regression analysis showed that out of the 4 variables with association, only 2 (housing type-P-value= 0.000 and availability of staple food-P-value=0.000) showed significant strength of association

Effect of integrating maternal and child health services, nutrition and family planning services on postpartum family planning uptake at 6 months post-partum in Burkina Faso, Cote d’Ivoire and Niger: a quasi-experimental study protocol

BackgroundAlthough several interventions integrating maternal, neonatal, child health and nutrition with family planning have been implemented and tested, there is still limited evidence on their effectiveness to guide program efforts and policy action on health services integration. This study aims to assess the effectiveness of a service delivery model integrating maternal and child health services, nutrition and family planning services, compared with the general standard of care in Burkina Faso, Cote d'Ivoire, and Niger.MethodsThis is a quasi experimental study with one intervention group and one control group of 3 to 4 health facilities in each country. Each facility was matched to a control facility of the same level of care that had similar coverage on selected reproductive health indicators such as family planning and post-partum family planning. The study participants are pregnant women (up to 28 weeks of gestational age) coming for their first antenatal care visit. They will be followed up to 6 months after childbirth, and will be interviewed at each antenatal visit and also during visits for infant vaccines. The analyzes will be carried out by intention to treat, using generalized linear models (binomial log or log Poisson) to assess the effect of the intervention on the ratio of contraceptive use prevalence between the two groups of the study at a significance level of 5%, while taking into account the cluster effect and adjusting for potential confounding factors (socio-demographic characteristics of women unevenly distributed at inclusion).DiscussionThis longitudinal study, with the provision of family planning services integrated into the whole maternal care continuum, a sufficiently long observation time and repeated measurements, will make it possible to better understand the timeline and the factors influencing women’s decision-making on the use of post-partum family planning services. The results will help to increase the body of knowledge regarding the impact of maternal and child health services integration on the utilization of post-partum family planning taking into account the specific context of sub-Saharan Africa French speaking countries where such information is very needed.

PSYCHOLOGICAL ANALYSIS OF THE ADOPTION OF RISKY SEXUAL BEHAVIOR BY ADOLESCENTS IN TOGO

Adolescent sexual and reproductive health indicators are very worrying in sub-Saharan Africa. In Togo, for the 2020-2021 school year, 1,244 girls dropped out of school due to early pregnancy (Republic of Togo, 2022). This article aims to make a psychological analysis of the adoption of risky sexual behaviors of adolescents in Togo. To do this, we have conducted an exploratory study with five (05) adolescents received in psychological interview using the all-comers method. The results reveal that romantic attachment and sexual curiosity promote early sexuality. But sex education from parents delays the age of first sexual intercourse. With regard to multiple sexual partners, it is favored by low partner abandonment anxiety. For the non-systematic use of condoms, the reasons are diversified according to gender. Thus, for boys, strong sexual arousal contributes to non-systematic condom use, while girls explain it by strong abandonment anxiety. Furthermore, our results also reveal that the adoption of risky sexual behaviors has consequences on the psychological state of adolescents. Given the small size of our sample, it is necessary to conduct a study on a large population in order to identify the relevant psychological factors. This will enable an adolescent-centred approach to improve adolescent sexual health in sub-Saharan Africa.

The RADAR coverage tool: developing a toolkit for rigorous household surveys for reproductive, maternal, newborn, and child health & nutrition indicators

ABSTRACT Population-based intervention coverage data are used to inform the design of projects, programs, and policies and to evaluate their impact. In low- and middle-income countries (LMICs), household surveys are the primary source of coverage data. Many coverage surveys are implemented by organizations with limited experience or resources in population-based data collection. We developed a streamlined survey and set of supporting materials to facilitate rigorous survey design and implementation. The RADAR coverage survey tool aimed to 1) rigorously measure priority reproductive, maternal, newborn, child health & nutrition coverage indicators, and allow for equity and gender analyses; 2) use standard, valid questions, to the extent possible; 3) be as light as possible; 4) be flexible to address users’ needs; and 5) be compatible with the Lives Saved Tool for analysis of program impact. Early interactions with stakeholders also highlighted survey planning, implementation, and analysis as challenging areas. We therefore developed a suite of resources to support implementers in these areas. The toolkit was piloted by implementers in Tanzania and in Burkina Faso. Although the toolkit was successfully implemented in these settings and facilitated survey planning and implementation, we found that implementers must still have access to sufficient resources, time, and technical expertise in order to use the tool appropriately. This potentially limits the use of the tool to situations where high-quality surveys or evaluations have been prioritized and adequately resourced.