Suggested Indicators for Monitoring and Evaluation of
Programs to Detect and Treat Severe Pre-Eclampsia/
Eclampsia during Pregnancy
Below you find a relatively small menu of indicators that can be used to monitor and
evaluate programs that are intended to improve screening and treatment of pre-eclampsia
and eclampsia. One useful M&E resource that provides guidance on how to select and
measure indicators related to antepartum and postpartum hemorrhage in the larger context
of emergency obstetric care is WHO’s “Monitoring Emergency Obstetric Care: A Handbook,”
published in 2009.
OUTPUT INDICATORS
Service Readiness

Number/percentage of antenatal care providers trained in PE/E screening and
management in the last three years , either preservice or inservice training (including
BP and urine protein testing and treatment of severe PE/E with MgSO4)

Number/percentage of health facilities reporting a stock-out of MgSO4 in the past month
or the specified time period

Number/percentage of health facilities reporting a stock-out of urine protein test supplies
in the past month or the specified time period

Number/percentage of health facilities with functional BP equipment available in the
target service delivery area (ANC clinic , maternity, admissions, etc.) in the past month
or the specified time period

Number/percentage of health facilities offering delivery services that report they offer
parenteral administration of anti-convulsants to women with pre-eclampsia or eclampsia
Service Delivery

Percentage of first visit ANC clients with prior pregnancies who were asked if they had
experienced any complications during a prior pregnancy

Percentage of ANC clients who had their blood pressure checked

Percentage of ANC clients who had their urine tested for protein

Percentage of ANC clients who were asked if they had experienced danger signs (severe
headache, blurred vision and/or swelling of the hands or face)

Number of severe pre-eclampsia and eclampsia cases treated

Number/percentage of cases of severe pre-eclampsia and eclampsia that were managed
using MgSO4

Number/percentage of health facilities offering delivery services that administered
parenteral anti-convulsants for pre-eclampsia or eclampsia in the past three months

Number/percentage of health facilities offering delivery services that performed newborn
resuscitation in the past three months (with bag and mask)

Number/percentage of health facilities qualified to provide comprehensive EMOC that
performed C-section in the past three months
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
Number/percentage of health facilities qualified to provide comprehensive EMOC that
performed blood transfusion in the past three months
OUTCOME INDICATORS

Percentage of women with a live birth in the specified time period who received
antenatal care and had their blood pressure checked

Percentage of women with a live birth in the specified time period who received
antenatal care and had a urine sample taken

Percentage of women with a live birth in the specified time period who received
antenatal care and were counseled about danger signs of pregnancy complications
(specifically, severe headache and/or swelling of the hands or face if possible)

Percentage of women with a live birth in the specified time period who received calcium
supplements during pregnancy

Percentage of women with a live birth in the specified time period who were treated for
convulsions during pregnancy or shortly after birth

Percentage of live births in the specified time period attended by a skilled birth
attendant1
IMPACT INDICATORS

Maternal mortality ratio

Direct obstetric case fatality rate (disaggregated for severe pre-eclampsia/eclampsia, if
possible)

Estimated number of deaths averted from severe pre-eclampsia/eclampsia during
pregnancy (statistical modeling using the Lives Saved Tool2)

Percentage of screened pregnant women with severe pre-eclampsia/eclampsia
KEY DATA SOURCES WITH CORRESPONDING PE/E INDICATORS3
DATA SOURCE
Household survey (DHS,
MICS, other)
INDICATOR

Maternal mortality ratio

Percentage of live births in the specified time period attended by a
skilled birth attendant

Percentage of women with a live birth in the specified time period who
received antenatal care and had their blood pressure checked

Percentage of women with a live birth in the specified time period who
received antenatal care and had a urine sample taken

Percentage of women with a live birth in the specified time period who
received antenatal care and were counseled about danger signs of
pregnancy complications (specifically, severe headache and/or
swelling of the hands or face if possible)

Percentage of women with a live birth in the specified time period who
received calcium supplements during pregnancy

Percentage of women with a live birth in the specified time period who
were treated for convulsions during pregnancy or shortly after birth
The WHO definition of a skilled birth attendant includes doctors, nurses and midwives. It does not include traditional birth
attendants.
2 The Lives Saved Tool includes intervention effectiveness values for Calcium supplementation, Case management of pregnancy, and
Comprehensive Emergency Obstetric Care which can be used to estimate deaths averted from hypertensive diseases in pregnancy
3 Some indicators are repeated in the table as they are collected through multiple methods/sources.
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DATA SOURCE
Facility survey (SPA, SAM,
other)
HMIS (monthly facility
reports, district reports,
logistics management
information systems, etc.)
INDICATOR

Direct obstetric case fatality rate (disaggregated for severe preeclampsia/eclampsia, if possible)

Estimated number of deaths averted from severe preeclampsia/eclampsia during pregnancy (statistical modeling using the
Lives Saved Tool)

Number/percentage of antenatal care providers trained in PE/E
screening and management in the last three years , either preservice
or inservice training (including BP and urine protein testing and
treatment of severe PE/E with MgSO4)

Number/percentage of health facilities reporting a stock-out of MgSO4
in the past month or the specified time period

Number/percentage of health facilities reporting a stock-out of urine
protein test supplies in the past month or the specified time period

Number/percentage of health facilities with functional BP equipment
available in the target service delivery area (ANC clinic , maternity,
admissions, etc.) in the past month or the specified time period

Percentage of first visit ANC clients with prior pregnancies who were
asked if they had experienced any complications during a prior
pregnancy

Percentage of ANC clients who had their blood pressure checked

Percentage of ANC clients who had their urine tested for protein

Percentage of ANC clients who were asked if they had experienced
danger signs (severe headache, blurred vision and/or swelling of the
hands or face)

Number/percentage of cases of severe pre-eclampsia and eclampsia
that were managed using MgSO4

Number/percentage of health facilities offering delivery services that
report they offer parenteral administration of anti-convulsants to
women with pre-eclampsia or eclampsia

Number/percentage of health facilities offering delivery services that
administered parenteral anti-convulsants for pre-eclampsia or
eclampsia in the past three months

Number/percentage of health facilities offering delivery services that
performed newborn resuscitation in the past three months (with bag
and mask)

Number/percentage of health facilities qualified to provide
comprehensive EMOC that performed C-section in the past three
months

Number/percentage of health facilities qualified to provide
comprehensive EMOC that performed blood transfusion in the past
three months

Direct obstetric case fatality rate (disaggregated for severe preeclampsia/eclampsia, if possible)

Percentage of screened pregnant women with severe preeclampsia/eclampsia

Number/percentage of health facilities reporting a stock-out of MgSO4
in the past month or the specified time period

Number/percentage of health facilities reporting a stock-out of urine
protein test supplies in the past month or the specified time period

Number of severe pre-eclampsia and eclampsia cases treated

Number/percentage of cases of severe pre-eclampsia and eclampsia
that were managed using MgSO4
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DATA SOURCE
Supervision reports and
training information
systems
INDICATOR

Number/percentage of antenatal care providers trained in PE/E
screening and management in the last three years , either preservice
or inservice training (including BP and urine protein testing and
treatment of severe PE/E with MgSO4)

Number/percentage of health facilities reporting a stock-out of MgSO4
in the past month or the specified time period

Number/percentage of health facilities reporting a stock-out of urine
protein test supplies in the past month or the specified time period
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