Part I Defining the issues to be monitored UPDATE FROM AHN Ahn reviews relevant public health literature in order to identify indicators that can help her to answer the research questions she developed. For example, she looks at: • Sustainable Development Goals, specifically reducing the maternal mortality ratio to less than 70 per 100,000 live births (Target 3.1) and achieving universal access to sexual and reproductive health-care services (Target 3.7) – and the global indicators selected to measure these. • 16 key progress indicators on maternal and child health released as part of the United Nations Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030). • UNFPA’s Handbook on Monitoring Emergency Obstetric Care (2009). On the basis of this, she comes up with the following list of preliminary indicators: • Outcomes: Maternal mortality ratio and neonatal mortality ratio (disaggregated and over time). • Policy efforts: Constitutional provision on the right to health; prioritization of maternal health in the health policy; strategy on maternal health; demand for modern contraception met (%); women receiving prenatal care (%); number of emergency obstetric care facilities per 500,000 of the population; births attended by skilled personnel (%); mothers and babies who receive postnatal care (%); costs of care (all disaggregated and over time). • Resources: Total health expenditure by financing source, per capita; total reproductive, maternal, newborn, and child health expenditure by financing source, per capita. • Assessment: Reasons given for not seeking care; autonomy in making health decisions. EXERCISES 1. Review the following indicators. What could they be used to measure? Do they relate to outcomes, policy efforts or resources? How do they compare to the criteria described on pages 48-49? • School completion rates • Number of schools per municipality • Access to improved sanitation • Number of men-headed and women-headed households evicted from their dwellings during the past five years. 2. Review the benchmarks described below. How do these different types of benchmarks compare to the SMART criteria? What are some of the strengths and weaknesses of each? • Reduce poverty from 25% to 23% in the next five years • Improve living standards • Increase the proportion of the population with health insurance from 30% to 60% in the next seven years. • End all forms of discrimination against women. Chapter 4: Working with indicators and benchmarks | 51