Assessing the validity of indicators of the quality of maternal and newborn health care in Kenya.

摘要: Nearly 275 000 maternal deaths occurred globally in 2011, nearly all of which took place low– and middle–income countries (LMIC) [1]. Most these did not reduce mortality to levels targeted the Millennium Development Goals (MDG5) Progress has been hindered, part, by a lack reliable health data, especially on [2]. Measurement challenges are particularly significant LMIC with irregular incomplete system reporting. To measure progress health, monitoring agencies have relied tracking indicators proposed as measures quality care, such proportion births attended skilled birth attendant, that assumed be strongly correlated [3]. Such routinely assessed population––based household survey programs, Demographic Health Surveys (DHS) Multiple Indicator Cluster (MICS), female respondents report events surrounding recent [4]. Despite their widespread use, majority care indicators, including attendance, validated [1,5,6]. In fact, numerous researchers noted correlation between [5,7–9]. These argue information category provider at is deficient it relies assumptions about training competence well access essential supplies equipment. It important therefore identify alternate describe actual content can reported accuracy, potential included routine data collection programs. A growing, but still limited, body research examined validity intrapartum early postpartum period. To our knowledge, however, no study yet how accurately women recall skill level birth, although there some attempts look issues [10]. Furthermore, few validation studies taken generally compared self–reports hospital records, may or inaccurate, conducted high–income settings, where rates low [11–15]. To address this gap, women’s ability set newborn either currently use survey–based collection. spite its limitations, seems likely “skilled attendance” indicator will continue used so we assess during delivery. We compare received against third party observations labor Finally, provide suggestions for modifications procedures could improve measurement care.