Indicators and Analysis Dr Kaninika Mitra UNICEF, West Bengal  Maternal  Death  Review
The need for indicators <ul><li>“ A quantitative or qualitative factor or variable that provides a simple and reliable mea...
Types of MDR Indicators <ul><li>Process indicators </li></ul><ul><li>Program indicators </li></ul><ul><li>HMIS  </li></ul>
CB-MDR Process Indicators <ul><li>Proportion of maternal deaths investigated in the district  </li></ul><ul><li>Reported v...
FBMDR Process Indicators <ul><li>Proportion of eligible institutions that conducted FBMDR </li></ul><ul><li>Number of mate...
District Level process indicators: <ul><li>Proportion of maternal deaths notified vs. estimated. </li></ul><ul><li>Proport...
Program indicators- district & state level <ul><li>Proportion of deaths among adolescents (15-49 yrs) </li></ul><ul><li>Di...
Program indicators  …contd <ul><li>Distribution of deaths, in antenatal, intra-natal and post-partum period </li></ul><ul>...
HMIS Indicators:  HMIS formatsbleeding TN reports. xls ,  HMIS formatsdistrict hospital.xls <ul><li>Number of deaths, by d...
Some examples of  indicators  calculated & graphically represented Based on data from commjunity based maternal death inve...
Maternal deaths investigated against reported
Spatial distribution of maternal deaths 2005 2006 2007 2008 2009 2010 (Jan-Jul) DECREASING NUMBER OF REPORTED MATERNAL DEA...
Strongest association with Female Literacy LITERACY STATUS OF THE DECEASED WOMEN 47.2 48.33 40.2 34.9 31.67 37.4 7.5 12.1 ...
52.8 44.3 2.8 34.17 50.0 11.67 0.83 3.33 22.4 67.3 4.7 5.6 May 2005 – July 2006 July 2006-September 2007 May 2008 - March ...
 
 
0% 20% 40% 60% 80% 100% May 2005 – July 2006 July 2006- Sept 2007 May 2008 - March 2010 PROBABLE CAUSES OF DEATH Others In...
<ul><li>There is a woman behind every number….! </li></ul>
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Maternal Death Review indicators analysis

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Maternal Death Review indicators analysis

  1. 1. Indicators and Analysis Dr Kaninika Mitra UNICEF, West Bengal Maternal Death Review
  2. 2. The need for indicators <ul><li>“ A quantitative or qualitative factor or variable that provides a simple and reliable means to measure achievement, to reflect changes connected to an intervention, or to help assess the performance of a development actor” </li></ul><ul><li>(DAC Glossary of Key Terms in Evaluation, May 2002) </li></ul>
  3. 3. Types of MDR Indicators <ul><li>Process indicators </li></ul><ul><li>Program indicators </li></ul><ul><li>HMIS </li></ul>
  4. 4. CB-MDR Process Indicators <ul><li>Proportion of maternal deaths investigated in the district </li></ul><ul><li>Reported versus expected/estimated </li></ul><ul><li>Investigated versus reported </li></ul><ul><li>How do we calculate? </li></ul>
  5. 5. FBMDR Process Indicators <ul><li>Proportion of eligible institutions that conducted FBMDR </li></ul><ul><li>Number of maternal deaths reported </li></ul><ul><li>Proportion of maternal deaths investigated </li></ul><ul><li>Proportion of eligible institutions that conducted FBMDR meetings </li></ul><ul><li>Proportion of minor gaps resolved </li></ul><ul><li>Proportion of major gaps on which action is initiated (proposals submitted) </li></ul><ul><li>Proportion of major gaps on which action taken (proposals approved and process begun) </li></ul><ul><li>How do we calculate? </li></ul>
  6. 6. District Level process indicators: <ul><li>Proportion of maternal deaths notified vs. estimated. </li></ul><ul><li>Proportion of maternal deaths investigated vs notified. </li></ul><ul><li>Proportion of maternal deaths reviewed versus investigated </li></ul><ul><li>Proportion of MDR meetings conducted by the DM </li></ul><ul><li>Proportion of maternal deaths (among all deaths of RH age group) </li></ul><ul><li>How do we calculate? </li></ul>
  7. 7. Program indicators- district & state level <ul><li>Proportion of deaths among adolescents (15-49 yrs) </li></ul><ul><li>Distribution of maternal deaths, by district, block </li></ul><ul><li>Distribution of maternal deaths, by education status, age at marriage, age of death </li></ul><ul><li>Distribution of maternal deaths, by caste, religion </li></ul><ul><li>How do we calculate? </li></ul>
  8. 8. Program indicators …contd <ul><li>Distribution of deaths, in antenatal, intra-natal and post-partum period </li></ul><ul><li>Proportion of deaths during or after abortion-spontaneous & induced </li></ul><ul><li>Distribution of deaths, by place of death-home, institution, transit </li></ul><ul><li>Distribution of deaths, by ANC & PNC received </li></ul><ul><li>Distribution of deaths, by delays (first, second and third) </li></ul><ul><li>Distribution of deaths by causes </li></ul><ul><li>How do we calculate? </li></ul>
  9. 9. HMIS Indicators: HMIS formatsbleeding TN reports. xls , HMIS formatsdistrict hospital.xls <ul><li>Number of deaths, by district </li></ul><ul><li>Number of deaths, by month </li></ul><ul><li>Proportion of deaths, by cause </li></ul><ul><ul><li>Bleeding </li></ul></ul><ul><ul><li>Severe hypertension/fits </li></ul></ul><ul><ul><li>Obstructed labor </li></ul></ul><ul><ul><li>Fever related </li></ul></ul><ul><ul><li>Others </li></ul></ul>
  10. 10. Some examples of indicators calculated & graphically represented Based on data from commjunity based maternal death investigation (MAPEDIR) in Purulia
  11. 11. Maternal deaths investigated against reported
  12. 12. Spatial distribution of maternal deaths 2005 2006 2007 2008 2009 2010 (Jan-Jul) DECREASING NUMBER OF REPORTED MATERNAL DEATHS BLOCK-WISE PROGRESS
  13. 13. Strongest association with Female Literacy LITERACY STATUS OF THE DECEASED WOMEN 47.2 48.33 40.2 34.9 31.67 37.4 7.5 12.1 13.2 12.5 10.3 4.7 0% 20% 40% 60% 80% 100% May 2005 – July 2006 July 2006-September 2007 May 2008 - March 2010 Illiterate Upto 8th Standard 9th Standard & above DNK
  14. 14. 52.8 44.3 2.8 34.17 50.0 11.67 0.83 3.33 22.4 67.3 4.7 5.6 May 2005 – July 2006 July 2006-September 2007 May 2008 - March 2010 AGE AT MARRIAGE 11-17 years 18-20 years 21-24 >24 Not Known Data not available 12% 77% 10% 25% 59% 16% 9% 64% 26% 0% 20% 40% 60% 80% 100% May 2005 – July 2006 July 2006-September 2007 May 2008 - March 2010 AGE AT DEATH < 20 20-30 > 30
  15. 17. 0% 20% 40% 60% 80% 100% May 2005 – July 2006 July 2006- Sept 2007 May 2008 - March 2010 PROBABLE CAUSES OF DEATH Others Injury/accident Tuberculosis Malaria anaemia Sepsis Obstructed Labour / Ruptured uterus Eclampsia/ pre-eclamsia Haemorrhage
  16. 18. <ul><li>There is a woman behind every number….! </li></ul>

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