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This paper assesses the validity of childbirth care indicators as reported in a rural primary health care context. Ensuring these indicators are accurate is vital as they are used to monitor the progress made in improving the quality of care provided to women and newborns in pregnancy, during childbirth and in the post-natal period.

Antoinette Bhattacharya et al assessed twenty-five childbirth care indicators  to validate health worker documentation and women’s self-reports. Women who were interviewed at the time of leaving the health facility were able to recall the care they received with a high degree of validity (AUC≥0.70 and 0.75<IF<1.25) for 9 of 20 indicators assessed; six additional indicators met either AUC or IF criteria for validity. During follow-up interviews, women’s ability to recall their experience had high validity for one of 15 indicators assessed, the placement of their newborn skin-to-skin; two additional indicators met IF criteria only. Health worker documentation had high validity for four of 10 indicators assessed; three additional indicators met AUC or IF criteria.

In conclusion the authors recommend that in addition to standard household surveys, monitoring of facility-based childbirth care should consider drawing from and linking multiple data sources, including routine health facility data and exit interviews with recently delivered women.


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Professor Elizabeth Allen

Professor in Medical Statistics

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Dr Nasir Umar

IDEAS Nigeria Country Coordinator and Assistant Professor

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Professor Joanna Schellenberg

IDEAS Co-Principal Investigator and Professor

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Professor Tanya Marchant

IDEAS Principal Investigator and Professor