Feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in the Democratic Republic of Congo

Emina, Jacques; Etinkum, Rinelle; Aissaoui, Anya; Gbomosa, Cady Nyombe; Elamurugan, Kaeshan; Rajendra, Kanya Lakshmi; El Mowafi, Ieman Mona; Kobeissi, Loulou

doi:10.1186/s12978-022-01415-9

Reproductive Health

Table 3 List of indicators that should be excluded according to our stakeholders, with primary rationale

From: Feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in the Democratic Republic of Congo

	Indicator number and name	Rationale for exclusion
Contraception	1.4: Percentage of clients adopting modern contraception method after abortion	Service not provided Potential risk for patient and primary care provider^a
Comprehensive abortion care	2.1: Number of clients requesting an abortion	Potential risk for patient and primary care provider Legal status of abortion in DRC Insufficient data encryption
	2.2: Number of clients receiving an abortion referral	Legal status of abortion in DRC Potential risk for patient and primary care provider Insufficient data encryption
	2.3: Number of clients receiving an induced abortion	Potential risk for patient and primary care provider Induced abortions are illegal in the DRC except in limited situations according to the Maputo Protocol; however, this exception has yet to be written into national law. Though care can be provided to clients presenting with having self-induced an abortion, due to its rarity and potential repercussions, this indicator is not collected Insufficient data encryption
Maternal health	3.9: Availability of PAC	Service mapping exercise at the provincial level^b
	3.10: Availability of basic emergency obstetric care (BEmOC)	Service mapping exercise
	3.11: Availability of comprehensive emergency obstetric care (CEmOC)	Service mapping exercise
	3.12: Availability of skilled personal	Service mapping exercise
Newborn health	4.6: Availability of KMC	Service mapping exercise
Newborn health	4.7: Availability of neonatal resuscitation	Service mapping exercise
Child health	5.2: Under 5 mortality rate	Population-level indicator with impractical denominator^c
	5.3: Percentage of children under 5 with suspected pneumonia taken to appropriate health facility	Population-level indicator with impractical denominator
	5.5: Percentage of children under 5 who are wasted	Low burden of disease, population-level indicator with impractical denominator
	5.6: Percentage of children under 5 who are registered	The denominator of this indicator is not feasible since population level metrics are often unreliable in the DRC
Adolescent health	6.1: Adolescent birth date	Population-level indicator with impractical denominator
	6.2: Sexual violence against children	Information not actionable, population-level indicator with impractical denominator
	6.3: Adolescent mortality rate	Population-level indicator with impractical denominator
	6.6: Suicide rate, disaggregated	Population-level indicator with impractical denominator Low burden of disease^d
Sexual and gender-based violence	7.2: Percentage of health facilities with clinical management of rape services	Service mapping exercise
	7.5: Number of rape survivors requesting abortion	Though it is technically legal to receive an abortion due to rape according to the Maputo Protocol, this exception has yet to be written into national law. As such, this indicator is not collected
	7.6: Number of rape survivors receiving induced abortion care or referral	Though it is technically legal to receive an abortion due to rape according to the Maputo Protocol, this exception has yet to be written into national law. Though care will be provided to clients presenting with abortion, due to its rarity and potential repercussions, this indicator is not collected
	7.7: Availability of intimate partner violence front line support (LIVES)	Service not routinely provided
HIV	No indicator indicated for exclusions in this section
Prevention of mother-to-child transmission	No indicator indicated for exclusions in this section
Sexually transmitted infections (STIs) and reproductive tract infections (RTIs)	No indicator indicated for exclusions in this section

^aAccording to the penal code of the Democratic Republic of Congo (DRC), abortion is prohibited without exception. Legal prohibition notwithstanding, it is generally accepted that the procedure can be performed to save a woman’s life; yet, women are rarely able to obtain safe abortion care on this basis. Despite DRC signatory to the Maputo Protocol, the vast majority of abortions occurring in the DRC are clandestine, and many of these are unsafe. The Maputo Protocol was signed by the DRC in March 2018 and was published into the national legal gazette, officially entering the treaty into force
^bService mapping exercise aims to examine what services and programs, and by whom are offered; the services and programs that other agencies within the same communities are offering. It seems to also examine the links between services and programs provided and utilized by the target population. Service mapping also aims to identify any service and/or programming gaps that may exist in the community that might need to be addressed
^cOur stakeholders repeatedly invalidated population level data, due to weak infrastructure and national registries. Given the unreliability of population level data, indicators that include a denominator is impractical and should be reworded as a facility-based indicator
^dPerceived low burden disease reported by the research study participants

Back to article page

ISSN: 1742-4755

Contact us

General enquiries: journalsubmissions@springernature.com