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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