Improving Coverage Measurement for MNCH

Special Issue of the Journal of Global Health

A new collection of research and reviews on measuring intervention coverage for MNCH through household surveys

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Watch the special issue launch event 

IIP-JHU is continuing to work on increasing the quality and volume of evidence on trends in coverage for MNCH interventions that is available to Governments in low- and middle-income countries and their development partners, for use in guiding their investments and programs.

With support from the Bill & Melinda Gates Foundation, and guided by a Core Group of experts, IIP-JHU is supporting new studies in three areas.

GENERATING NEW EVIDENCE ON THE VALIDITY OF MNCH COVERAGE DATA

ICM-supported studies have been completed in three areas: (1) a replication in Nigeria of the studies assessing treatment indicators for childhood pneumonia (implemented by University of Edinburgh); (2) two studies assessing the validity of caregivers’ reports of careseeking for sick children, in Zambia (Johns Hopkins University, Tulane University, and Chainama College) and India (University of Edinburgh and Vadu HDSS); (3) a study in Kenya of the validity of reports of the services received for the mother and her newborn one year after delivery (Population Council); (4) a study in Kenya and Swaziland assessing the validity of mothers’ reports of the content of postnatal care visits (Population Council); and (5) a study in Nepal validating birthweight, preterm, and careseeking indicators (Johns Hopkins University).

LINKING CARESEEKING DATA OBTAINED IN HOUSEHOLD SURVEYS WITH HEALTH SERVICE ASSESSMENTS

Several of the validation studies conducted in phase one of this work, and reported on in the PLOS Medicine Collection, showed that there are some indicators that cannot be measured well through household surveys. Examples include the treatment of childhood pneumonia and many of the interventions delivered to the mother and newborn around the time of birth. Work has therefore been conducted to find ways to link measurements of careseeking collected through household surveys with assessments of the care provided by health services providers. A technical consultation in April 2014 brought together those with relevant experience, as a basis for planning the research program. A systematic review of efforts to link household survey with provider assessments laid out the state of the data and identified technical issues in conducting this work.

ICM has supported two implementations of this linking approach: a pilot study in four catchment areas of Zambia, and a study in one region of Côte d’Ivoire in conjunction with the 2016 Côte d’Ivoire MICS. Both studies were designed to answer methodological questions related to the implementation of linking methods at scale, including comparing approaches to linking household and provider data, and the implications of different sampling approaches.

IMPROVING HOW COVERAGE DATA ARE REPORTED ON, INTERPRETED AND USED

Coverage data are sometimes presented in ways that can lead to incorrect interpretation, or that are difficult for non-technical users to understand. One objective of the improving measurement of coverage work is to explore options for improving the dissemination of coverage results that will increase their correct interpretation and use to improve programs.