Lessons learnt; a decade of measuring the impact of safe motherhood programmes

Abstract

This booklet concerns the insights that were gained from measurement efforts of Safe Motherhood Programs which involved the development of measurement methods for reducing maternal morbidity and mortality. The change in Safe Motherhood Program can be measured through a study design that depends on the conceptual framework and the ability to measure the preferred outputs and outcomes. Upon an evaluation of the program difficulties were encountered in measuring the effects which include a comprehensive package for interventions and difficulty in measuring the preferred outcomes. The use of descriptive rather than experimental study designs was deemed necessary unless the intervention could be generalized broadly into many settings. The use of indicators in measuring the implementation and use of appropriate services is essential. The health outcome indicators can obtain rough population-based estimates; however there would be a difficulty in measuring change obstetric morbidity through interviews and health examination surveys and perceived morbidity. Process indicators on the other hand measure the use of services and complications although identification of good approaches has yet to be developed.