Validating Indicators of the Quality of Maternal Health Care in Kenya

Ann K. Blanc, Population Council
Charlotte Warren, Population Council
Katharine McCarthy, Population Council
James Kimani, Population Council
Jackline Kivunaga, Population Council
Brian Mdawida, Population Council
Charity Ndwiga, Population Council
Saumya Ramarao, Population Council

Objective: To validate a set of maternal and newborn health indicators that can be measured in facility and population-based surveys. Methods: We compared women’s self-reports of care received during labor and delivery against direct observation by a third party in two Kenyan hospitals (n=666). Self-reported data was collected via interviews prior to hospital discharge. The area under the receiver operating curve (AUC) and inflation factor (IF) was calculated for each indicator. Results: Four of 47 indicators met both validation criteria (AUC>0.60 and 0.75<IF<1.25): main provider was a nurse/midwife, support companion present at birth, cesarean operation, and low birthweight infant. Twenty-five indicators met one criterion only, including skilled birth attendance. Conclusions: Few indicators met the validation criteria, partly due to close to perfect reporting of routine practices. Validity results are influenced by context and question wording; low validity is associated with indicators related to the timing or sequence of events.

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 Presented in Session P2. Data and Methods/Applied Demography/ Spatial Demography/ Demography of Crime