Measuring coverage in MNCH: new findings, new strategies, and recommendations for action

PLoS Med. 2013;10(5):e1001423. doi: 10.1371/journal.pmed.1001423. Epub 2013 May 7.


Considerable progress has been made in reducing maternal, newborn, and child mortality worldwide, but many more deaths could be prevented if effective interventions were available to all who could benefit from them. Timely, high-quality measurements of intervention coverage--the proportion of a population in need of a health intervention that actually receives it--are essential to support sound decisions about progress and investments in women's and children's health. The PLOS Medicine "Measuring Coverage in MNCH" Collection of research studies and reviews presents systematic assessments of the validity of health intervention coverage measurement based on household surveys, the primary method for estimating population-level intervention coverage in low- and middle-income countries. In this overview of the Collection, we discuss how and why some of the indicators now being used to track intervention coverage may not provide fully reliable coverage measurements, and how a better understanding of the systematic and random error inherent in these coverage indicators can help in their interpretation and use. We draw together strategies proposed across the Collection for improving coverage measurement, and recommend continued support for high-quality household surveys at national and sub-national levels, supplemented by surveys with lighter tools that can be implemented every 1-2 years and by complementary health-facility-based assessments of service quality. Finally, we stress the importance of learning more about coverage measurement to strengthen the foundation for assessing and improving the progress of maternal, newborn, and child health programs.

Publication types

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

MeSH terms

  • Adult
  • Child
  • Child Health Services* / standards
  • Child Health Services* / statistics & numerical data
  • Child Mortality
  • Child, Preschool
  • Data Interpretation, Statistical
  • Developing Countries* / statistics & numerical data
  • Family Characteristics
  • Female
  • Global Health
  • Health Care Surveys* / standards
  • Health Care Surveys* / statistics & numerical data
  • Health Services Accessibility / standards
  • Health Services Research / methods*
  • Health Services Research / standards
  • Health Services Research / statistics & numerical data
  • Healthcare Disparities
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Male
  • Maternal Health Services* / standards
  • Maternal Health Services* / statistics & numerical data
  • Maternal Mortality
  • Program Evaluation
  • Quality Improvement
  • Quality Indicators, Health Care* / standards
  • Quality Indicators, Health Care* / statistics & numerical data
  • Reproducibility of Results
  • Research Design
  • Surveys and Questionnaires

Grants and funding

This work was conducted under the auspices of the Child Health Epidemiology Reference Group (CHERG) for WHO and UNICEF, with financial support from The Bill & Melinda Gates Foundation through their grant to the US Fund for UNICEF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.