1. Overview Presentation:
Measuring the Content of Postnatal
Care for Women
Kavita Singh, PhD, MPH
Allisyn Moran, PhD MHS
28 September 2017
PNC Webinar

2. • Background
• Proposed content
• Research Studies
• Presentation of Findings from Key Validation
Studies
• Questions
• Next steps
Outline of the Webinar

3. Background: Importance of Topic
• Postnatal care (PNC) for women is a critical
intervention for maternal health
• PNC within 2 days is a standard indicator
• PNC “Checks” but not content of care are
currently captured in household surveys
• DHS 2014 in Bangladesh
• DHS recently included questions in the core
questionnaire on PNC signal functions for
newborns
• PNC for women is Prioritized by Ending
Preventable Maternal Mortality (EPMM)

4. Background: Measurement
Need to balance medically essential interventions
and those that women can accurately recall and
report
• Relevant for all women
• Applicable to women at any time during the
postpartum period
• Apply to facility and home-based postnatal
care
• Based on WHO PNC Guidelines (2013)
• No more than five measures – tracer for overall
content of care

5. Proposed content
In 2014, a list of signal functions was drafted based
on review of the WHO PNC Guidelines and input
from maternal health experts, including:
Assessments and checks: blood pressure,
temperature, vaginal bleeding, abdominal
palpation, perineum; healing of perineum wounds
and trauma (e.g. fistula); micturition, urinary
incontinence, leading urine or stool and bowel
function; engorgement
Questions/Counseling: pain, emotional well-being;
maternal danger signs and where to go, nutrition,
hygiene, safe sex, family planning

6. Research
Several large-scale validation studies including testing
of proposed PNC signal functions for women
China (Li et al, 2013)
Mozambique (Stanton et al, 2013)
Kenya (Blanc et al, 2016a)
Mexico (Blanc et al, 2016b)
Qualitative studies
Ghana (Hill et al, 2015)
Bangladesh and Malawi (Yoder et al, 2013)

7. Webinar Objectives
Share findings from key validation studies
Generate discussion on the topic.
Think through the way forward.
• What are the next steps?
• Is more research needed?
• Can we propose key measures now?

8. VALIDATING INTERVENTION COVERAGE
INDICATORS FOR
MATERNAL POSTNATAL CARE
Ann K. Blanc and Katharine McCarthy

9. Questions from the Audience

10. Questions for the audience
1. There are only a handful of validation studies; almost all conducted in
hospitals or high-volume clinics. Do we need to examine accuracy of
reporting among women who gave birth in other types of facilities (or
at home)?
2. Do we need to test longer recall periods? Do we need to examine
validity in other settings?
3. What are alternatives to population-based surveys for collecting data
on intervention coverage for PNC?
4. Can we identify a (small) set of critical and valid indicators that can be
recommended for inclusion in household surveys (e.g., DHS, MICS)?
Please use the Q&A box or email responses to: kavita_singh@unc.edu

11. Next steps
• Data on content of PNC for newborns has been
prioritized
• DHS is developing an optional module on
maternal health/care
• PNC guidelines will be revised in 2018
• What types of questions could be included?
What additional research is needed?

12. This presentation was produced with the support of the United States Agency for
International Development (USAID) under the terms of MEASURE Evaluation
cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is
implemented by the Carolina Population Center, University of North Carolina at
Chapel Hill in partnership with ICF International; John Snow, Inc.; Management
Sciences for Health; Palladium; and Tulane University. Views expressed are not
necessarily those of USAID or the United States government.
www.measureevaluation.org