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Table 4 List of indicators that were recommended to be added to the core list of indicators

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

Percentage of org. collecting this indicator (%)

Resources and training needed for routine collection

Kasaï

Kasaï Central

Kasaï Oriental

Contraception

1.1: Number of clients initiating contraception

# of clients accepting a new modern contraceptive method, by method

Should be couple with indicators covering use, discontinuation and trained staff on provision of modern contraceptive methods

100%

56%

89%

Training for all primary care providers on the different modalities of contraception

1.2: Number of clients receiving emergency contraception

Should be coupled with an indicator tracking the number of resources available in clinic and indicator on number trained staff on provision of modern contraceptive methods

100%

44%

78%

Training on the new IAFM guidelinesd

Train primary care providers on the different contraceptive modalities that can be used for EC

1.3: Percentage of clients adopting modern contraceptive method after delivery

N/A

100%

56%

89%

N/A

Maternal Health

Abortion

2.4: Number of clients presenting for post-abortion care

N/A

88%

0%

89%

Training on the new IAFM guidelines

DHIS2 create anonymity for this indicatora (code)

Service mappingb of abortion providers who provide abortion services to the fullest extent of the law

2.5: Number of clients receiving post-abortion care

N/A

100%

22%

78%

Training on the new IAFM guidelines

DHIS2 create anonymity for this indicatorc (code)

Service mapping of abortion providers who provide abortion services to the fullest extent of the law

3.1: Number of maternal deaths

# of maternal deaths in the facility, by cause of death

Should be disaggregated by cause and coupled with indicators that capture maternal death in the community

100%

44%

78%

Increased transparency in auditing practices surrounding maternal death

Resources will need to be developed and implemented at the community level to capture the indicators for the maternal deaths in the community

3.2: Number of maternal deaths, disaggregated

# of maternal deaths1, disaggregated by age (less than 15 years; between 15 and 19 and equal or greater than 19 years)

38%

44%

44%

Training for data collectors on the different causes of maternal death and how to encode for each

Develop detailed manuals for frontline workers and data collectors

Training and capacity building for community health workers

Increased transparency in auditing practices surrounding maternal deaths

3.3: Percentage of maternal death reviews

# of maternal deaths in the facility that were audited and reviewed

French wording should be changed to “revue” as this is how it is reported in DHIS2

75%

11%

89%

Training and capacity building for staff to review on maternal death cases

Training and capacity building for community health workers

Increased transparency in auditing practices surrounding maternal deaths

3.4: Number of clients receiving antenatal care

N/A

100%

44%

67%

Accessibility to commodities and supplies

3.5: Number of deliveries

# of clients delivering in facility, including both live and stillbirths

Should be coupled with indicators to capture births occurring in the community

100%

44%

89%

Frontline workers will need training on reporting on stillbirths

Leveraging systems to capture stillbirths for community births (UNICEF)

Training and capacity building for community health workers

3.6: Number of deliveries, disaggregated

# of clients delivering in facility, including both live and stillbirths, disaggregated by age (less than 15 years; between 15 and 19 and equal or greater than 19 years)

63%

22%

78%

Frontline workers will need training on reporting on stillbirths

Leveraging systems to capture stillbirths for community births (UNICEF)

Training and capacity building for community health workers

3.7: Number of clients receiving post-natal care

N/A

88%

22%

78%

N/A

3.8: Number of caesarean section deliveries

Coupled with an indicator on the number of referrals for cesarians

88%

11%

67%

Might not be useful outside of hospital setting

3.13: Number of antenatal care clients with tetanus vaccination

N/A

100%

33%

89%

N/A

3.14: Number of antenatal care clients receiving preventive therapy for malaria

N/A

88%

44%

89%

N/A

3.15: Number of antenatal care clients receiving syphilis screening

N/A

50%

22%

33%

N/A

3.16: Number of antenatal care clients receiving urinary tract infection screening or treatment

N/A

88%

33%

67%

N/A

3.17: Number of clients with identified maternal morbidities during post-natal care

N/A

75%

33%

78%

N/A

Newborn Health

4.1: Number of neonatal deaths

# of neonatal deaths (0–28) at the facility level

Should be coupled with an indicator tracking neonatal death within the community

75%

44%

67%

Increased transparency in auditing practices surrounding neonatal death audits

Training and capacity building for community health workers

4.2: Number of stillbirths

N/A

75%

44%

67%

N/A

4.3: Number of babies born low birth weight

Should be coupled with an indicator tracking malnutrition among pregnant women

75%

44%

78%

N/A

4.4: Number of small and sick newborns receiving care

N/A

50%

22%

78%

N/A

4.5: Number of newborns receiving post-natal care

# of newborns receiving post-natal care within 7–10 days

63%

22%

67%

N/A

4.8: Number of neonatal deaths, disaggregated

N/A

63%

11%

67%

When reviewing data and making recommendations for health programs, consider the disaggregated indicator

Leverage systems that capture newborn death and review these cases for cause of death

Training and capacity building for of primary care providers

4.9: Percentage of perinatal death reviews

French wording should be changed to “revue” as this is how it is reported in DHIS2

25%

22%

67%

In urban settings, national systems would need to be established to capture newborn death and review these cases for cause of death

Training and capacity building of primary care providers

Will need to be added to the DHIS2

4.10: Number of newborns receiving Hepatitis B

N/A

0%

0%

22%

Will need to be added to the DHIS2

Extensive training and capacity building will need to be implementing for scale-up at the national level

4.11: Number of newborns initiating breastfeeding early

 

75%

33%

56%

N/A

4.12: Number of infants weighed at birth

# of newborns weighed at delivery

75%

11%

56%

N/A

4.13: Number of babies registered

Distinguish between registration at the facility level and at the state level

63%

22%

67%

Civil registries to be integrated into hospitals and clinics

Significant training and resources will need be implemented

4.14: Number of newborns receiving treatment for possible severe bacterial infection (PSBI)

N/A

63%

0%

56%

N/A

4.15: Number of newborns admitted

N/A

25%

11%

44%

N/A

4.16: Number of newborns with morbidities identified during post-natal care

N/A

38%

0%

44%

Resources for primary care providers on the definitions for morbidity type

Will need to be added to the DHIS2

Extensive training and capacity building of primary care providers

Child Health

5.1: Number of deaths of children under 5

N/A

88%

0%

44%

Training and outreach programs will need to be implemented at the health facility and community level

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

5.4: Coverage of diarrhea treatment

N/A

50%

14%

44%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

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

25%

0%

56%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

Significant resources and training will need to occur for this to be captured

5.7: Number of children presenting with fever tested for malaria in endemic settings

# of children under 5 who have been administered outpatient malaria tests, by age

50%

14%

56%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

5.8: Number of confirmed cases of malaria in endemic settings

N/A

50%

14%

56%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

5.9: Percentage of confirmed malaria cases treated

N/A

50%

14%

56%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

5.10: Coverage of DPT3

N/A

50%

14%

56%

Child health indicators to be integrated into routine service delivery as a specific area of its own, including for data collection

Adolescent health

6.4: Percentage of adolescents living with HIV who are currently receiving antiretroviral therapy, disaggregated

# of adolescents living with HIV who are currently receiving antiretroviral therapy, disaggregated by age (less than 15 years; between 15–19 and equal or greater than 19 years)

Removal of the denominator

38%

38%

22%

Significant training and capacity development for frontline staff on adolescent health indicator reporting

Will need to be added to the DHIS2

6.5: Immunization coverage rate

# of adolescents receiving the nationally mandated immunization, disaggregated by age (less than 15 years; between 15–19 and equal or greater than 19 years)

Removal of the denominator

50%

38%

44%

Significant training and capacity development for frontline staff on adolescent health indicator reporting

Will need to be added to the DHIS2

SGBV

7.1: Number of rape survivors

N/A

88%

50%

78%

An anonymous code should be assigned to each survivor to avoid duplication of data

7.3: Percentage of rape survivors receiving HIV post-exposure prophylaxis

Should be coupled with indicators capturing referrals and availability of supplies

63%

29%

67%

Significant training for the entire health care team

Training on the new IAFM

Inclusion of community leaders

Inclusion of judicial system

Training and outreach for community leaders

Changes in the DHIS2 will need to be made to avoid duplicity in the data reporting

Training in clinical management of HIV

Increased availability/supply of PEP kits

Coordination with the Justice System

7.4: Percentage of rape survivors receiving emergency contraception

Should be coupled with indicators capturing referrals and availability of supplies

88%

38%

67%

Significant training for the entire health care team

Training on the new IAFM

Training and outreach for community leaders

Inclusion of judicial system

Changes in the DHIS2 will need to be made to avoid duplicity in the data reporting

Coordination with the Justice System

HIV

8.1: Antiretroviral therapy coverage among people living with HIV, disaggregated

N/A

38%

38%

56%

Training in clinical management of HIV

8.2: Percentage of exposed individuals receiving post-exposure prophylaxis

N/A

38%

38%

56%

Training in clinical management of HIV

8.3: Percentage of donated blood units screened for HIV in quality assured manner

N/A

38%

13%

56%

Training in clinical management of HIV

Might not be useful outside of hospital setting

Prevention of mother-to-child transmission

9.1: Percentage of antenatal care clients receiving syphilis screening and treatment

N/A

50%

25%

44%

Scale-up of these programs at the national level

Training and capacity building of staff for service delivery and data capturing

9.2: Percentage of antenatal care clients offered testing for HIV

# of first-time antennal care clients who received pre-testing counselling for HIV

50%

25%

56%

Training in clinical management of HIV

9.3: Percentage of HIV-positive pregnant people receiving antiretroviral therapy

N/A

63%

25%

44%

Training in clinical management of HIV

9.4: Percentage of all deliveries to HIV-positive mothers receiving antiretrovirals

#of HIV-positive mothers who receive ART according to national protocol

Should be coupled with an indicator for the infant also receiving ART

50%

25%

44%

Training in clinical management of HIV

STI & RTI

10.1: Percentage of STI/RTI cases managed

# of patients with STI/RTI accessing services who are diagnosed symptomatically, and counselled according to protocol

Distinguish between the number of cases and the number of cases “managed”

STI and RTI cases need to be formulated as separate indicators

75%

15%

78%

Training on how to identify and report on STI/RTIs

Training on the clinical management of STI/RTI cases

  1. Italicized text refers to current description of indicator
  2. aAs mentioned in the body of the report, our stakeholders noted that data and trends of the different provinces across DRC is available and accessible on DHIS2 by all provincial members. Given that this information is accessible, coding the abortion indicators on DHIS2’s interface is crucial to protect, patients, health care providers, agencies and the provinces
  3. bService mapping: Mapping of service providers who provide safe abortion care—in their respective governorates—to the fullest extent of the law to enable the feasibility of collecting the abortion indicators
  4. cAs mentioned within the body of the report, the data and trends of the different health zones and provinces that are submitted on DHIS2 are universally accessible to anyone who has access to the HIS in the DRC
  5. dIAFM guidelines: The Inter-Agency Field Manual on Reproductive Health in Humanitarian settings is a set of guidelines issued by normative bodies, particularly those of the World Health Organization, and incorporates specific evidence from, or examples about, the application and adaptation of global SRH or human rights standards in humanitarian settings