title: Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.
abstract: Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations.
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Barreix
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Özge
authors.initials: Ö
authors.lastname: Tunçalp
authors.affiliation: Research, Monitoring, and Evaluation, PSI/Zambia, Lusaka, Zambia.
authors.forename: Namuunda
authors.initials: N
authors.lastname: Mutombo
authors.affiliation: Family and Reproductive Health Cluster, World Health Organization Regional Office for Africa (WHO-AFRO), Harare, Zimbabwe.
authors.forename: Ayotunde A
authors.initials: AA
authors.lastname: Adegboyega
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Lale
authors.initials: L
authors.lastname: Say
mesh_terms: D000293:Adolescent; D000328:Adult; D000350:Africa, Central / Q000453:epidemiology; D005193:Family Planning Services; D005260:Female; D006284:Health Plan Implementation; D006305:Health Status Indicators; D006801:Humans; D008428:Maternal Mortality; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D016742:Preconception Care / Q000592:standards*; D011247:Pregnancy; D058996:Quality Improvement; D012040:Regional Health Planning / Q000458:organization & administration*; D055815:Young Adult
keywords: Capacity building; Family planning; Health systems strengthening; Monitoring and evaluation; Reproductive health indicators; Safe abortion