“Every Newborn-BIRTH” protocol: observational study validating indicators for coverage and quality of maternal and newborn health care in Bangladesh, Nepal, and Tanzania

To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritized by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone to content of care.

EN-BIRTH is an observational study including >20000 facility births in three countries (Tanzania, Bangladesh, and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including uterotonic administration, immediate newborn care, neonatal resuscitation, and Kangaroo mother care. 

This is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform the selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths.

Authors: Louise T Day, Harriet Ruysen, Vladimir S Gordeev, Georgia R Gore-Langton, Dorothy Boggs, Simon Cousens, Sarah G Moxon, Hannah Blencowe, Angela Baschieri, Ahmed Ehsanur Rahman, Tazeen Tahsina, Sojib Bin Zaman, Tanvir Hossain, Qazi Sadeq-ur Rahman, Shafiqul Ameen, Shams El Arifeen, Ashish KC, Shree Krishna Shrestha, Naresh P KC, Dela Singh, Anjani Kumar Jha, Bijay Jha, Nisha Rana, Omkar Basnet, Elisha Joshi, Asmita Paudel, Parashu Ram Shrestha, Deepak Jha, Ram Chandra Bastola, Jagat Jeevan Ghimire, Rajendra Paudel, Nahya Salim, Donat Shamba, Karim Manji, Josephine Shabani, Kizito Shirima, Namala Mkopi, Mwifadhi Mrisho, Fatuma Manzi, Jennie Jaribu, Edward Kija, Evelyne Assenga, Rodrick Kisenge, Andrea Pembe, Claudia Hanson, Godfrey Mbaruku, Honorati Masanja, Agbessi Amouzou, Tariq Azim, Debra Jackson, Theopista John Kabuteni, Matthews Mathai, Jean-Pierre Monet, Allisyn Moran, Pavani Ram, Barbara Rawlins, Johan Ivar Sæbø, Florina Serbanescu, Lara Vaz, Nabila Zaka, Joy E Lawn