Availability of Priority Maternal and Newborn Health Indicators: Cross-sectional Analysis of Pregnancy, Childbirth and Postnatal Care Registers from 21 Countries

AbstractBackgroundData from national health management information systems (HMIS) are essential for routinely tracking progress toward national and subnational objectives, programmatic decision-making, planning and review, and ultimately to improve quality of care. It is through an in-depth understanding of the data elements captured in patient registers, as building blocks of national HMIS indicators, that it is possible to improve standardization in data collection and measurement of key indicators to help track progress towards achieving maternal and newborn health goals.Methods and findingsThis analysis was done through a review of antenatal (ANC), childbirth and postnatal (PNC) registers from 21 countries across five world regions. Between July and October 2020, various country-based maternal and newborn experts, implementing agencies, program managers, and ministries of health personnel were contacted and requested to share the current versions of the registers. Both paper-based and electronic registers were obtained. Twenty ANC registers, eighteen childbirth and thirteen PNC were analyzed. Both longitudinal and cross-sectional ANC and PNC registers were reviewed, while the childbirth registers included in the review were all cross-sectional. For the ANC registers 11/20 (55%) and for PNC registers 7/13 (54%) were longitudinal. In four countries the registers were electronic (Norway, Sweden, USA, West-Bank - Palestine), while the rest was paper-based. There was great variation in the number of data elements included from each register reviewed ranging from 24 in Nepal’s childbirth register to 188 in Eswatini’s ANC register. These findings are presented in four broad categories (Pregnancy, Childbirth, Postnatal care, and Mortality outcomes), with subheadings in each category.ConclusionThis analysis highlights some areas in where there are data gaps as we work to reduce preventable maternal, newborn deaths and stillbirths and deliver high-quality, equitable care. Programme managers and health workers need this data to monitor the performance of their national health system and to guide the continuous improvement of health care services for women and newborns. The results of this analysis will complement additional work and help to inform the standardization of pregnancy and childbirth registers and provide information for other countries seeking to introduce indicators in their health systems.