Quality of care indicators for maternal and newborn health: A study in eight health zones in the Democratic Republic of Congo
Strengthening information systems to support health data use is a critical component of quality improvement. In the past, research on quality of care has focused on the availability of resources and implementation of clinical guidelines, while often ignoring the regular metrics and monitoring systems used to inform decision making and manage improvement initiatives. Recognizing the lack of standardized global indicators, in 2013, the World Health Organization (WHO) and the Partnership for Maternal, Newborn, and Child Health (PMNCH), with the participation of numerous stakeholders, identified 13 indicators for assessing the quality of health care provided to mothers, newborns, and children in health facilities. These global core indicators, however, required further testing to determine the feasibility of collection and measurement. As part of IHPplus, MSH focused on improving the quality of maternal and newborn health services in DRC and contributing to the growing body of work on data quality and use at the health facility level. IHPplus supported competency-based training in maternal and newborn health practices in 362 facilities as well as provision of registers and tools for data collection. The Ministry of Health’s (MOH) revised approach to capacity building, which consisted of a 15-day training facilitated by gynecologists, obstetricians, and pediatricians, was used. The training included theoretical components, practice on mannequins, and clinical placements. IHPplus wanted to understand what more was needed to support routine use of data for quality improvement. Thus, IHPplus, with the DRC’s MOH and the University of Kinshasa’s School of Public Health (UK-SPH), embarked on a study to evaluate the availability, quality, and utility of selected WHO-proposed indicators for assessing the quality of maternal and newborn health care in health facilities.