Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators

dc.contributor.authorHeidi Bart, Johnston
dc.contributor.authorUlrika Rehnstrom, Loi
dc.contributor.authorMohamed, Ali
dc.contributor.authorKaty, Footman
dc.contributor.authorGhislaine Glitho, Alinsato
dc.contributor.authorEman, Aly
dc.contributor.authorAsmani, Chilanga
dc.contributor.authorShikha, Bansal
dc.contributor.authorLaurence, Codjia
dc.contributor.authorFahdi, Dkhimi
dc.contributor.authorSithembile, Dlamini-Nqeketo
dc.contributor.authorHayfa, Elamin
dc.contributor.authorDina, Gbenou
dc.contributor.authorKarima, Gholbzouri
dc.contributor.authorLisa, Hedman
dc.contributor.authorNilmini, Hemachandra
dc.contributor.authorYelmali, Hien
dc.contributor.authorMd Khurshid Alam, Hyder
dc.contributor.authorTheopista, John
dc.contributor.authorAmrita, Kansal
dc.contributor.authorPriya, Karna
dc.contributor.authorLaurence, Läser
dc.contributor.authorAntonella, Lavelanet
dc.contributor.authorBelete, Mihretu
dc.contributor.authorPamela Amaka, Onyiah
dc.contributor.authorLeopold, Ouedraogo
dc.contributor.authorSikander, Qais
dc.contributor.authorEllen, Thom
dc.contributor.authorMeera, Upadhyay
dc.contributor.authorQudsia, Uzma
dc.contributor.authorSouleymane, Zan
dc.contributor.authorBela, Ganatra
dc.date.accessioned2024-05-14T09:44:42Z
dc.date.available2024-05-14T09:44:42Z
dc.date.issued2024-05-06
dc.description.abstractIntroduction: A significant gap exists in the availability of indicators and tools to monitor health system capacity for quality abortion care at input and process levels. In this paper, we describe the process and results of developing and assessing indicators to monitor health system capacity strengthening for quality abortion care.Methods: As part of a 4-year (2019–2022) multicountry project focused on preventing unsafe abortion using a health system strengthening approach in 10 countries, we developed a monitoring framework with indicators and metadata. Through an internal consultative process, we identified a structured list of operational health system capacity indicators for abortion. After implementing the indicators for baseline and annual project monitoring, project staff from 10 teams assessed each indicator using 4 criteria: validity, feasibility, usefulness and importance.Results: We identified 30 indicators aligning with 5 of the 6 WHO health system building blocks (excluding service delivery): 6 indicators in leadership and governance, 5 in health workforce, 6 in health information, 8 in access to medicines and health products and 5 in health financing. In our assessment of indicators, average scores against the predetermined criteria were lowest for feasibility (7.7 out of 10) compared with importance (8.5), usefulness (8.9) and validity (9.3). Assessors highlighted the need for fewer and less complex indicators, simplified language, clearer benchmarks, for indicators to be abortion-specific, less subjective and for future frameworks to also include service delivery and research and innovation.Conclusion: We used 30 indicators to monitor health system capacity for quality abortion care in 10 countries and gathered critical feedback that can be used to further strengthen the set of indicators in future work. Establishing core input and process indicators will be critical to inform and support evidence-based policy and programme improvements for quality abortion care.
dc.description.sponsorshipThis work was supported by an anonymous donor and from the United Nations Development Programme–United Nations Population Fund–United Nations Children’s Fund–WHO–World Bank Special Programme of Research, Development and Research Training in Human Reproduction, a cosponsored programme executed by the WHO. The views expressed in this article are those of the authors and do not necessarily represent the views of, and should not be attributed to, the WHO.
dc.identifier.citationHeidi Bart, J., Ulrika Rehnstrom, L., Mohamed, A., Katy, F., Ghislaine Glitho, A., Eman, A., . . . Bela, G. (2024). Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators. BMJ Public Health, 2(1), e000401.
dc.identifier.otherDOI: https://doi.org/10.1136/bmjph-2023-000401
dc.identifier.urihttp://hdl.handle.net/20.500.14041/6456
dc.language.isoen_US
dc.publisherBMJ Public Health
dc.subjectResearch Subject Categories::MEDICINE::Surgery::Obstetrics and women's diseases::Reproductive health
dc.titleDevelopment of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators
dc.typeArticle
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