Data can be used from facility records, health information systems (HIS), and specialized surveys that include community-based facility deliveries.  The data can be disaggregated by the type of facility (public, private, non-governmental, community based) and by other relevant factors such as districts and urban/rural location.

Data Source(s):

Facility records; HIS; and specialized surveys

Purpose:

This indicator reflects the percent of women who are placed at increased risk for postpartum mortality and morbidity due to early discharge after delivery, and can serve as a proxy for quality of postpartum care services.  The initial 24 hours after delivery is a high risk time frame for complications and 45 percent of maternal deaths occur within this period (WHO, 2005). At the same time, nearly half of all newborn deaths occur within 24 hours of delivery (UNICEF, 2011). The recommended best practice for health care facilities is to monitor all mothers and newborns for at least 24 hours (USAID/Core Group 2004; CARE/CDC, 2001; WHO/UNFPA/UNICEF/World Bank, 2006; WHO/UNICEF/UNFPA, 2010). This indicator relates directly to achieving Millennium Development Goals #5. improve maternal health and #4. reduce child mortality.

Issue(s):

This indicator measures monitoring of women for 24 hours following delivery as one component of quality postpartum care.  However, it does not address other aspects of quality care, such as the level of monitoring (e.g., is the facility too overcrowded for adequate monitoring), if skilled attendants are available at all times, and if there are necessary drugs, equipment, and supplies to effectively manage complications.

References:

CARE/CDC, 2001, The Healthy Newborn: A reference Manual for Program Managers, Part 4, Atlanta, GA: CDC.  http://www.k4health.org/toolkits/pc-mnh/healthy-newborn-reference-manual-program-managers