Presented during a webinar on "Measuring the Content of Postnatal Care for Women: What Do We Know and Where Do We Need to Go?" in September 2017. See the second presentation at https://www.slideshare.net/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care/measureevaluation/validating-intervention-coverage-indicators-for-maternal-postnatal-care
Overview Presentation: Measuring the Content of Postnatal Care for Women
Measuring the Content of Postnatal
Care for Women
Kavita Singh, PhD, MPH
Allisyn Moran, PhD MHS
28 September 2017
• Proposed content
• Research Studies
• Presentation of Findings from Key Validation
• Next steps
Outline of the Webinar
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
• PNC for women is Prioritized by Ending
Preventable Maternal Mortality (EPMM)
Need to balance medically essential interventions
and those that women can accurately recall and
• Relevant for all women
• Applicable to women at any time during the
• Apply to facility and home-based postnatal
• Based on WHO PNC Guidelines (2013)
• No more than five measures – tracer for overall
content of care
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
Questions/Counseling: pain, emotional well-being;
maternal danger signs and where to go, nutrition,
hygiene, safe sex, family planning
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)
Ghana (Hill et al, 2015)
Bangladesh and Malawi (Yoder et al, 2013)
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?
VALIDATING INTERVENTION COVERAGE
MATERNAL POSTNATAL CARE
Ann K. Blanc and Katharine McCarthy
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
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: firstname.lastname@example.org
• Data on content of PNC for newborns has been
• DHS is developing an optional module on
• PNC guidelines will be revised in 2018
• What types of questions could be included?
What additional research is needed?
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.