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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 providera
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 levelb
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
4.7: Availability of neonatal resuscitation Service mapping exercise
Child health 5.2: Under 5 mortality rate Population-level indicator with impractical denominatorc
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 diseased
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
  1. 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
  2. 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
  3. 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
  4. dPerceived low burden disease reported by the research study participants