Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators
Introduction 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 stren...
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2024-06-01
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| author | Leopold Ouedraogo Katy Footman Fahdi Dkhimi Bela Ganatra Mohamed Ali Antonella Lavelanet Souleymane Zan Shikha Bansal Karima Gholbzouri Eman Aly Nilmini Hemachandra Laurence Läser Ulrika Rehnstrom Loi Dina Gbenou Yelmali Hien Asmani Chilanga Hayfa Elamin Priya Karna Laurence Codjia Heidi Bart Johnston Ghislaine Glitho Alinsato Sithembile Dlamini-Nqeketo Lisa Hedman Md Khurshid Alam Hyder Theopista John Amrita Kansal Belete Mihretu Pamela Amaka Onyiah Sikander Qais Ellen Thom Meera Upadhyay Qudsia Uzma |
| author_facet | Leopold Ouedraogo Katy Footman Fahdi Dkhimi Bela Ganatra Mohamed Ali Antonella Lavelanet Souleymane Zan Shikha Bansal Karima Gholbzouri Eman Aly Nilmini Hemachandra Laurence Läser Ulrika Rehnstrom Loi Dina Gbenou Yelmali Hien Asmani Chilanga Hayfa Elamin Priya Karna Laurence Codjia Heidi Bart Johnston Ghislaine Glitho Alinsato Sithembile Dlamini-Nqeketo Lisa Hedman Md Khurshid Alam Hyder Theopista John Amrita Kansal Belete Mihretu Pamela Amaka Onyiah Sikander Qais Ellen Thom Meera Upadhyay Qudsia Uzma |
| author_sort | Leopold Ouedraogo |
| collection | DOAJ |
| description | Introduction 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. |
| format | Article |
| id | doaj-art-30530e48eeb747d4b2c8d63482bc0a8a |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Public Health |
| spelling | doaj-art-30530e48eeb747d4b2c8d63482bc0a8a2025-01-28T15:10:12ZengBMJ Publishing GroupBMJ Public Health2753-42942024-06-012110.1136/bmjph-2023-000401Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicatorsLeopold Ouedraogo0Katy Footman1Fahdi Dkhimi2Bela Ganatra3Mohamed Ali4Antonella Lavelanet5Souleymane Zan6Shikha Bansal7Karima Gholbzouri8Eman Aly9Nilmini Hemachandra10Laurence Läser11Ulrika Rehnstrom Loi12Dina Gbenou13Yelmali Hien14Asmani Chilanga15Hayfa Elamin16Priya Karna17Laurence Codjia18Heidi Bart Johnston19Ghislaine Glitho Alinsato20Sithembile Dlamini-Nqeketo21Lisa Hedman22Md Khurshid Alam Hyder23Theopista John24Amrita Kansal25Belete Mihretu26Pamela Amaka Onyiah27Sikander Qais28Ellen Thom29Meera Upadhyay30Qudsia Uzma31WHO Regional Office for Africa, Brazzaville, CongoUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandDepartment of Health Systems Governance and Financing, World Health Organization, Geneva, SwitzerlandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandWorld Health Organization Country Office for Benin, Cotonou, BeninWorld Health Organisation Country Office for India, New Delhi, Delhi, IndiaWorld Health Organisation Regional Office for the Eastern Mediterranean, Cairo, EgyptWorld Health Organisation Regional Office for the Eastern Mediterranean, Cairo, EgyptMyanmar, World Health Organization, Yangon, MyanmarUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandFormerly with World Health Organization Country Office for Burkina Faso, Ouagadougou, Burkina FasoWorld Health Organization Country Office for Burkina Faso, Ouagadougou, Burkina FasoFormerly with World Health Organization Africa Regional Office, Ouagadougou, Burkina FasoWorld Health Organization Regional Office for Africa, Brazzaville, CongoWorld Health Organisation Country Office for India, New Delhi, Delhi, IndiaDepartment of Health Workforce, World Health Organization, Geneva, SwitzerlandUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandWorld Health Organization Country Office for Benin, Cotonou, BeninWorld Health Organization Country Office for South Africa, Pretoria, South AfricaSpecial initiatives, Access to Medicines and Health Products, World Health Organization, Geneva, SwitzerlandWorld Health Organization Country Office for Nepal, Kathmandu, NepalWorld Health Organization Country Office for Rwanda, Kigali, RwandaFormerly with World Health Organization Country Office for Nepal, Kathmandu, NepalWorld Health Organization Country Office for South Africa, Pretoria, South AfricaWorld Health Organization Regional Office for Africa, Brazzaville, CongoFormerly with World Health Organization Eastern Mediterranean Regional Office, Cairo, EgyptPakistan, World Health Organization, Islamabad, PakistanWorld Health Organization South East Asia Regional Office, New Delhi, IndiaPakistan, World Health Organization, Islamabad, PakistanIntroduction 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.https://bmjpublichealth.bmj.com/content/2/1/e000401.full |
| spellingShingle | Leopold Ouedraogo Katy Footman Fahdi Dkhimi Bela Ganatra Mohamed Ali Antonella Lavelanet Souleymane Zan Shikha Bansal Karima Gholbzouri Eman Aly Nilmini Hemachandra Laurence Läser Ulrika Rehnstrom Loi Dina Gbenou Yelmali Hien Asmani Chilanga Hayfa Elamin Priya Karna Laurence Codjia Heidi Bart Johnston Ghislaine Glitho Alinsato Sithembile Dlamini-Nqeketo Lisa Hedman Md Khurshid Alam Hyder Theopista John Amrita Kansal Belete Mihretu Pamela Amaka Onyiah Sikander Qais Ellen Thom Meera Upadhyay Qudsia Uzma 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 |
| title | Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators |
| title_full | Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators |
| title_fullStr | Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators |
| title_full_unstemmed | Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators |
| title_short | Development of indicators to measure health system capacity for quality abortion care in 10 countries: a rapid assessment of a measurement framework and indicators |
| title_sort | development of indicators to measure health system capacity for quality abortion care in 10 countries a rapid assessment of a measurement framework and indicators |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000401.full |
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