UN Process Indicators Data Collection and Calculation of Indicators

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UN Process Indicators Data Collection and Calculation of Indicators Powered By Docstoc
					UN Process Indicators: Data Collection and Use
Sourou Gbangbade Anne Paxton

“In God we trust” All others must show data…

Why are we collecting data for the UN Process Indicators?

Needs Assessments

Monitoring Progress

UN Process Indicators #1 and 2

Indicators of Coverage
The number of facilities that provides emergency obstetric signal functions per 500,000 population The geographical distribution of EmOC facilities For every 500,00 population there should be At least 4 basic EMoC facilities At least 1 comprehensive EmOC facility Minimum level for amount of EmOC services is met in sub-national areas


UN Process Indicators #3-5

Indicators of Utilization
The proportion of all births in EmOC facilities

At least 15% of all births in the population take place in either B/EmOC or C/EmOC facilities
At last 100% of women estimated to have obstetric complications are treated in EmOC facilities

4 5

Met need for emergency obstetric care: The proportion of all women with major obstetric complications who are treated in EmOC facilities
Caesarian section rate as a proportion of all live births: The proportion of pregnant women who have a cesarean section in a specific geographical area and time period

As a proportion of births in the population, caesarian sections account for not less than 5% nor more than 15%

UN Process Indicator #6:

Indicator of Quality
The Case Fatality rate: The proportion of women with major obstetric complications who die in a facility. The case fatality rate is less than 1%

The c-section rate can also give some indication of quality of care. If it is very high, you may need to review the indications for csections performed.

First steps in collecting the data for UN Process Indicators
• Review your registers and flow of patients through a representative facility. • Revise registers where necessary (add column for complications). • Are registers filled in completely? Legibly?

The “raw data” for the UN process indicators from facilities
• “Easy” variables – Births – C-sections – Direct maternal deaths “Harder” variables – Obstetric complications • Data on functioning – "the Signal Functions"

“Easy” variables
• Data on deliveries, c-sections and maternal deaths are commonly collected in health facilities, although not always in the same register

Births C-sections

Admissions registers Labor and delivery register Maternity ward register Operating theater

Maternal deaths

Discharge register Death register

“Harder” variables
• The UN Guidelines define direct, major obstetric complications as
– – – – – – – hemorrhage (antepartum or post-partum) prolonged/obstructed labor postpartum sepsis complications of abortion pre-eclampsia/eclampsia ectopic pregnancy, and ruptured uterus

• Difficult to judge severity of these conditions • Abortions - not all incomplete abortions are complications!

Data on functioning
• Determine what signal functions a facility is actually doing, not only what it is supposed to do.
• On a quarterly basis – observe the performance of signal functions, or – review records, or – interview staff.

Abstracting data from registers for use
• Many facilities have a system in place to compile their obstetric data on a monthly, quarterly or semiannual basis. • Data reports may be used internally; may also be required by health authorities or donor agencies.

Using the data collected to improve services at facility
After all the work that goes into increasing coverage and improving facilities, you want to see increased use!

Using the data collected to improve services at facility
Quality of care
• Calculate your case fatality rate as a rough indication of quality of care • Interpret with care

Using the data collected to improve services at facility
• Other tools for measuring and improving quality of care
• Improving Emergency Obstetric Care through Audit: How are we doing?
• “Emergency Obstetric Care: A Leadership Manual for Improving the Quality of Services” with accompanying Toolbook

Lingjuan Ma Lingjuan Ma MS
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