Leadership Mentorship for Maternal Newborn and Child Health
A programme for District Clinical Specialist Teams in KwaZulu-Natal
Indicators for the baseline assessment of Maternal and Newborn Health
Indicator
category
Indicator
Type
Numerator
Denominator
Data
source(s)
Provincial
target/
norm
National
target/
norm
PPIP/DHIS
385 (2010)
1646
(2010)
Data
collection
process
Data
collection
form
Comments
Perinatal
Newborn
Count
Number of maternal
deaths in a year
Perinatal mortality
rate
Proportion
Number of perinatal
deaths
Still birth rate
Proportion
Number of still births
Low Birthweight rate
Proportion
Perinatal care index
Ratio
Maternal deaths
Early neonatal death
rate
Late neonatal death
rate
Neonatal mortality
rate
Proportion
Proportion
Proportion
Number of births
<2500g
Perinatal mortality
rate
Number of early
neonatal deaths
Number of late
neonatal deaths
Total number of
neoanatl deaths
None
Total number
of births
Total number
of births
Total number
of births
Low birth
weight rate
Total number
of live births
Total number
of live births
Total number
of live births
PPIP/DHIS
PPIP/DHIS
32/1000
(2010)
23/1000
(2010)
35/1000
(2008-09)
23/1000
(2010)
13%
(2010)
PPIP/DHIS
12% (2010)
Calculated
<2
<2
10.5
(2010)
11.8
(2010)
PPIP/DHIS
PPIP/DHIS
PPIP/DHIS
Getting to know the District form
Maternal
Request from the FIO or DIO
Health outcomes
Page 1 of 12
Quality of care
ANC
Proportion clinics
reviewing ANC
patient held cards
monthly (with BANC
Checklist)
Proportion clinics
with Calcium
carbonate in stock
% 1st ANC visits
testing HIV positive
screened for TB
% eligible HIV
infected pregnant
women on HAART
% eligible HIV
infected pregnant
women initiated on
HAART within two
weeks
Proportion
Number of clinics
reviewing ANC patient
held cards monthly
(with BANC Checklist)
Total number
of Clinics
sampled
Clinic based
review
100%
100%
Direct
observation
Clinic
review
form
Proportion
Number of clinics with
Calcium carbonate in
stock
Total number
of Clinics
sampled
Clinic based
review
100%
100%
Direct
observation
Clinic
review
form
Proportion
Number of 1st ANC
visits testing HIV
positive screened for
TB
Total number
of 1st ANC visits
testing HIV
positive
Clinic based
review
Direct
observation
Clinic
review
form
Proportion
Number eligible HIV
infected pregnant
women on HAART
Proportion
Number eligible HIV
infected pregnant
women initiated on
HAART within two
weeks
Total number
eligible HIV
infected
pregnant
women (CD4
count <350 and
clinical staging)
Total number
eligible HIV
infected
pregnant
women (CD4
count <350 and
clinical staging)
DHIS
DHIS
78%
Request
from DIO
Request
from DIO
Page 2 of 12
Intrapartum
care
Proportion District
(Level 1) Hospitals
reviewing Labour
records monthly
(with Labour record
review checklist)
Proportion of
District (Level 1)
Hospitals
discharging patients
with discharge
summary
Proportion District
(Level 1) Hospitals
with written policy
on labour
companions
Newborn
Proportion District
(Level 1) Hospitals
implementing 12
steps to KMC
Proportion District
(Level 1) Hospitals
using admission
record to newborn
care unit
Proportion District
(Level 1) Hospitals
using observation
record
Proportion District
(Level 1) Hospitals
reviewing newborn
care records
monthly
Proportion
District (Level 1)
Hospitals reviewing
Labour records
monthly (with Labour
record review
checklist)
Total number
of District
(Level 1)
Hospitals
Hospital
based review
Proportion
Number of District
(Level 1) Hospitals
discharging patients
with discharge
summary
Total number
of District
(Level 1)
Hospitals
Hospital
based review
Proportion
Number of District
(Level 1) Hospitals
with policy on labour
companions
Total number
of District
(Level 1)
Hospitals
Observation
Proportion
Number of District
(Level 1) Hospitals
implementing 12 steps
to KMC
Total number
of District
(Level 1)
Hospitals
Proportion
Number of District
(Level 1) Hospitals
using admission
record to newborn
care unit
Total number
of District
(Level 1)
Hospitals
Proportion
Number of District
(Level 1) Hospitals
using observation
record
Total number
of District
(Level 1)
Hospitals
Proportion
Number District (Level
1) Hospitals reviewing
newborn care records
monthly
Total number
of District
(Level 1)
Hospitals
100%
100%
100%
100%
Direct
observation
Baseline
tool for
ESMOEEOST
Direct
observation
Addendu
m
Direct
observation
Addendu
m
Observation
Direct
observatio
n
KINC
Situation
Analysis
form
Observation
100%
Direct
observatio
n
KINC
Situation
Analysis
form
100%
Direct
observatio
n
KINC
Situation
Analysis
form
Direct
observatio
n
KINC
Situation
Analysis
form
Observation
Observation
100%
100%
Page 3 of 12
Utilisation of health services
Family
Planning
Number of post
vaginal delivery
Tubal Ligations
Number of IUCD
inserted
Count
Count
Number of post
vaginal delivery Tubal
Ligations
Number of IUCD
inserted
ANC
Postnatal
care
ANC Coverage
Proportion
Number of 1st ANC
visits
% ANC 1st visit < 13
weeks
Proportion
Number of 1st ANC
visits <13 weeks
% ANC 1st visit < 20
weeks
Proportion
Number of 1st ANC
visits <20 weeks
Percentage women
and babies
attending PN visit
within 6 days
Proportion
Number of [mothers]
[babies] attending PN
visit within 6 days
None
Data
extraction
None
DHIS
Population
under 1 year x
1.15 (as a
proxy for the
number of
pregnant
women)
Total number
of 1st ANC
visits
Total number
of 1st ANC
visits
Total number
of deliveries
DHIS
Direct
observation
99%
Addendu
m
99.00%
DHIS
DHIS
50%
DHIS
Page 4 of 12
Availability of health services
Termination
of Pregnancy
Proportion of
Hospitals/ CHCs/
MOUs/ Clinics
providing 1st
trimester
terminations
Proportion ol
District (Level 1)
Hospitals providing
2nd trimester
terminations
Proportion of
Hospitals/ CHCs/
MOUs/ Clinics not
providing
terminations with
referral system for
TOPs
Management
of
miscarriage
High risk ANC
Proportion of
District (Level 1)
Hospitals and CHCs
with availability of
MVA for evacuation
of retained
products
Proportion District
(Level 1) Hospitals
with dedicated High
Risk ANC clinic with
ADM
Proportion
Number of [hospitals]
[CHCs/MOUs] [Clinics]
providing 1st
trimester terminations
Total number
of [Hospitals]
[CHCs/MOUs]
[Clinics] in the
District
Observation
Direct
observation
Clinic
review
form /
Addendu
m
Proportion
Number District (Level
1) Hospitals providing
1st trimester
terminations
Total Number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Proportion
Number of [Hospitals]
[CHCs] [MOUs]
[Clinics] not providing
terminations with
referral system for
TOPs
Total number
of [Hospitals]
[CHCs/MOUs]
[Clinics] in the
District
Direct
observation
Clinic
review
form /
Addendu
m
Proportion
Number of District
(Level 1) Hospitals and
CHCs with availability
of MVA for evacuation
of retained products
Total Number
of District
(Level 1)
Hospitals and
CHCs in the
District
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Proportion
Number District (Level
1) Hospitals with
dedicated High Risk
ANC clinic with ADM
Total Number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Observation
Page 5 of 12
Intrapartum
care
Availability of
functioning Basic
Essential Obstetric
Care facilities
Availability of
functioning
Comprehensive
Essential Obstetric
Care facilities
Caesarean section
rate per subdistrict/referral area
Proportion District
(Level 1) Hospitals
with Mothers
Waiting Area
Postnatal
care
Proportion District
(Level 1 ) Hospitals
with KMC policy
Proportion District
(Level 1) Hospitals
with functional KMC
ward
Cervical
screening
Colposcopy waiting
time
Proportion
Number of
CHCs/MOUs
performing assisted
deliveries in the last
three months
Total number
of CHCs/MOUs
in the district
Proportion
Number of District
(Level 1) Hospitals
performing assisted
deliveries and C/S 24
hours in the last three
months
Total Number
of District
(Level 1)
Hospitals in the
District
Proportion
Total number of
Caesarean Sections in
the subdistrict/referral area
Proportion
Number of District
(Level 1) Hospitals
with Mothers Waiting
Area
Proportion
Number of District
(Level 1 ) Hospitals
with KMC policy
Proportion
Number of LBW
babies admitted to
KMC Ward
Total number
of births in the
subdistrict/referral
area
Total Number
of District
(Level 1)
Hospitals in the
District
Total Number
of District
(Level 1)
Hospitals in the
District
Total number
of LBW babies
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Observation
Direct
observation
Addendu
m
Observation
Direct
observation
KINC
Situation
Analysis
form
Observation
Direct
observation
KINC
Situation
Analysis
form
Observation
Direct
Observation
Clinic
review
form
DHIS
Page 6 of 12
Health Systems Indicators / Enabling environment
Staffing
Intrapartum
care
Proportion
CHCs/MOUs with
ADM on every shift
Midwife (Labour
ward and PNC)
staffing allocation
Labour ward
Midiwfe:patient
ratio
Proportion District
(Level 1) Hospitals
and CHCs/MOUs
with ESMOE Master
Trainers
Proportion
midwives and Drs
scoring >80% on
skill test
Proportion of
District (Level 1)
Hospitals with nonrotating maternity
staff
Proportion of
CHCs/MOUS with
100% non-rotating
maternity staff
Number of
CHCs/MOUs with
ADM on every shift
Total number
of CHCs/MOUs
in the district
Ratio
Number of midwives
allocated to labour
ward/postnatal ward
Number of
deliveries per
month
Ratio
Number of midwives
per 24-hr in labour
ward
Average
number of
deliveries per
day
Proportion
Number of District
(Level 1) Hospitals
CHCs/MOUs with at
least one ESMOE
Master Trainers
Total number
of District
(Level 1)
Hospitals and
CHC/MOUs in
the District
Observation
Proportion
Number of midwives
and Drs scoring >80%
on skill test
Total number
of midwives
and Drs tested
Observation
Proportion
Number District (Level
1) Hospitals with at
least 50% non-rotating
maternity staff
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Proportion
Number CHCs/MOUS
with 100% nonrotating maternity
staff
Total number
CHCs/MOUs in
the District
Observation
Proportion
Direct
observation
Observation
Observation
16:100
deliveries
per month
Direct
observation
Observation
and DHIS
1.15
midwife :
1delivery
Direct
observation
At least
one
ESMOE
Master
Trainer
At least
50%
Baseline
tool for
ESMOEEOST
Baseline
tool for
ESMOEEOST/
DHIS
Direct
observation
Addendu
m
Direct
observation
ESMOE
Fire drill
Direct
observation
Addendu
m
Direct
observation
Addendu
m
Page 7 of 12
Staffing
(cont)
Newborn
Care
Proportion of
newborn care units
with professional
nurses allocated to
care of neonates
only in all shifts
Proportion
Number of newborn
care units with
professional nurses
allocated to care of
neonates only
Total number
of District
(Level 1)
Hospitals in the
District
Proportion
Number of newborn
care units with
enrolled nurses
allocated to care of
neonates only
Total number
of District
(Level 1)
Hospitals in the
District
Ratio
Number of Labour
ward/delivery beds
Average
number of
deliveries per
month
Number of beds in
the neonatal
unit/1000 deliveries
Ratio
Number of beds in the
neonatal unit
Proportion of clinics
fully equipped
Proportion
Number of clinics with
essential equipment
Proportion of
newborn care units
with enrolled
nurses allocated to
care of neonates
only
Beds
Intrapartum
care
Newborn
Care
Equipment
Antenatal
care
Intrapartum
care
Newborn
care
Number of labour
ward/delivery
beds/100 deliveries
per month
Proportion District
(Level 1) Hospitals
fully equipped
Proporton of
District (Level 1)
Hospitals scoring at
least 65% for
neonatal unit
equipment and
supplies
Observation
1 PN on
duty :12
patients
(beds)
Direct
observation
KINC
Situation
Analysis
form
Observation
1 EN on
duty :4
patients
(beds)
Direct
observation
KINC
Situation
Analysis
form
Observation
3beds :
100
deliveries
per month
Direct
observation
Baseline
tool for
ESMOEEOST/
DHIS
Average
number of
deliveires per
month
Observation
4/1000
deliveries
(subdistrict)
Direct
observation
KINC
Situation
Analysis
form
Total number
of clinics
sampled
Observation
Direct
observation
Clinic
Review
form
Proportion
Number of District
(Level 1) Hospitals
with functional
essential equipment
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Proportion
Number of District
(Level 1) Hospitals
scoring at least 65%
for neonatal unit
equipment and
supplies
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
KINC
Situation
Analysis
form
Page 8 of 12
Drugs
Antenatal
care
Intrapartum
care
Blood
Supervision
Intrapartum
care
Newborn
Care
Proportion of clinics
with EOC drugs
Proportion
Number of clinics with
EOC drugs
Proportion
District (Level 1)
Hospitals with EOC
drugs
Proportion
Number of District
(Level 1) Hospitals
with at least 3 units of
blood in fridge
Proportion District
(Level 1) Hospitals
with ADM in Labour
ward on all shifts
Proportion
Number District (Level
1) Hospitals with ADM
in Labour ward on all
shifts
% Labour wards
where ESMOE fire
drills are conducted
Proportion
Number Labour wards
where ESMOE fire
drills are conducted
Proportion
Number District Level
1 ) Hospitals scoring
65% for supervision,
monitoring and audit
Proportion District
(Level 1) Hospitals
with EOC drugs
Proportion District
(Level 1) Hospitals
with at least 3 units
of blood in fridge
Proportion District
Level 1 ) Hospitals
scoring 65% for
supervision,
monitoring and
audit
Total number
of clinics
sampled
Total number
of District
(Level 1)
Hospitals in the
District
Total number
of District
(Level 1)
Hospitals in the
District
Total number
of District
(Level 1)
Hospitals in the
District
Total number
of CHCs/MOUs
in the district +
Total Number
of District
(Level 1)
Hospitals in the
District
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Clinic
Review
form
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Observation
Direct
observation
Addendu
m
Observation
Direct
observation
Addendu
m
Observation
Direct
observation
KINC
Situation
Analysis
form
Page 9 of 12
Referral
support
Proportion of
Clinics, CHC and
District Hospitals
with referral criteria
displayed
Proportion District
(Level 1) Hospitals
with allocated
obstetric
ambulances
Proportion District
(Level 1) Hospitals
with obstetric
hotline (to receive
referrals from
clinics)
Proportion District
(Level 1) Hospitals
with obstetric
hotline number for
referral to Level 2 or
3
Proportion
Number of Clinics,
CHC and District
Hospitals with referral
criteria displayed
Total number
of Clinics, CHC
and District
(Level 1)
Hospitals in the
District
Proportion
Number District (Level
1) Hospitals with
obstetric ambulances
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
(q8e)
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Proportion
Number District (Level
1) Hospitals with
obstetric hotline (to
receive referrals from
clinics)
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Proportion
Number District (Level
1) Hospitals with
obstetric hotline
number (for making
calls)
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Page 10 of 12
Monitoring and evaluation
Maternal
Perinatal,
Newborn and
Child
Proportion of
District (Level 1)
Hospitals with
evidence of
maternal death
review within 3
days of death
Proportion of
District (Level 1)
Hospitals with
evidence of
monthly audit
meeting with action
plan [Perinatal and
Child]
Proportion District
(level 1) Hospitals
where all Perinatal
and Child audit
meetings attended
by Representative
from Senior
Management
Proportion District
(Level 1) Hospitals
with PPIP/ ChPIP
champion
Proportion
Number of District
(Level 1) Hospitals
with evidence of
maternal death review
within 3 days of death
Total number
of District
(Level 1)
Hospitals in the
District
Proportion
Number of District
(Level 1) Hospitals
with evidence of
monthly audit
meeting with action
plan
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Baseline
tool for
ESMOEEOST
Proportion
Number District (level
1) Hospitals where
Perinatal and Child
monthly audit
meetings attended by
Representative from
Senior Management
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Proportion
Number District (Level
1) Hospitals with PPIP
champion
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Page 11 of 12
Proportion District
(Level 1) Hospitals
conducting 6monthly PPIP
meeting
Proportion
Number District (Level
1) Hospitals
conducting 6-monthly
PPIP meeting
Total number
of District
(Level 1)
Hospitals in the
District
Observation
Direct
observation
Addendu
m
Page 12 of 12