Measuring coverage in MNCH: indicators for global tracking of newborn care

PLoS Med. 2013;10(5):e1001415. doi: 10.1371/journal.pmed.1001415. Epub 2013 May 7.

Abstract

Neonatal mortality accounts for 43% of under-five mortality. Consequently, improving newborn survival is a global priority. However, although there is increasing consensus on the packages and specific interventions that need to be scaled up to reduce neonatal mortality, there is a lack of clarity on the indicators needed to measure progress. In 2008, in an effort to improve newborn survival, the Newborn Indicators Technical Working Group (TWG) was convened by the Saving Newborn Lives program at Save the Children to provide a forum to develop the indicators and standard measurement tools that are needed to measure coverage of key newborn interventions. The TWG, which included evaluation and measurement experts, researchers, individuals from United Nations agencies and non-governmental organizations, and donors, prioritized improved consistency of measurement of postnatal care for women and newborns and of immediate care behaviors and practices for newborns. In addition, the TWG promoted increased data availability through inclusion of additional questions in nationally representative surveys, such as the United States Agency for International Development-supported Demographic and Health Surveys and the United Nations Children's Fund-supported Multiple Indicator Cluster Surveys. Several studies have been undertaken that have informed revisions of indicators and survey tools, and global postnatal care coverage indicators have been finalized. Consensus has been achieved on three additional indicators for care of the newborn after birth (drying, delayed bathing, and cutting the cord with a clean instrument), and on testing two further indicators (immediate skin-to-skin care and applications to the umbilical cord). Finally, important measurement gaps have been identified regarding coverage data for evidence-based interventions, such as Kangaroo Mother Care and care seeking for newborn infection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Child Health Services / trends*
  • Consensus
  • Developing Countries*
  • Family Characteristics
  • Female
  • Global Health
  • Guideline Adherence
  • Health Care Surveys / trends*
  • Health Services Accessibility / trends
  • Health Services Research / methods
  • Health Services Research / trends*
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Male
  • Maternal Behavior
  • Patient Acceptance of Health Care
  • Practice Guidelines as Topic
  • Program Evaluation
  • Quality Indicators, Health Care / trends*
  • Research Design
  • Surveys and Questionnaires
  • Time Factors

Grant support

Funding for the Newborn Indicators TWG was provided through Save the Children's Saving Newborn Lives Program, supported by The Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.