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Overview Presentation: Measuring the Content of Postnatal Care for Women


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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

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Overview Presentation: Measuring the Content of Postnatal Care for Women

  1. 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. 2. • Background • Proposed content • Research Studies • Presentation of Findings from Key Validation Studies • Questions • Next steps Outline of the Webinar
  3. 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. 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. 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. 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. 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?
  9. 9. Questions from the Audience
  10. 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:
  11. 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. 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.