Metadata for Indicators to Monitor the Safe Motherhood Programro11.doh.gov.ph/dashboard/docs/SM...

Metadata for Indicators

to Monitor the Safe Motherhood

Program

Last updated on August 15, 2016

Republic of the Philippines

Department of Health

REGIONAL OFFICE XI

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List of Indicators of Safe Motherhood Program

Indicator

code Indicator M&E level

Governance and policies

SMP-001 Proportion of LGUs with Maternal, Newborn, Child Health and

Nutrition (MNCHN) policy

Input and

process

Maternal death review

SMP-002 Proportion of maternal deaths reviewed Input and

process

Information System

SMP-003 Proportion of BHS and RHUs utilizing the pregnancy tracking

tool

Input and

process

Family Planning

SMP-004 Proportion of LGUs with a Contraceptive Self-reliance (CSR)

policy

Input and

process

SMP-005 Proportion of health facilities with FP-trained provider Input and

process

SMP-006 Proportion of public health facilities that experienced near

stock-out of any FP commodity

Input and

process

SMP-007 Proportion of public health facilities that experienced stock-

out of any FP commodity

Input and

process

Prenatal care

SMP-008 Proportion of BHS and RHUs with trained midwife on quality

assurance package

Input and

process

SMP-009 Proportion of RHUs that experienced stock-out on iron with

folic acid

Input and

process

SMP-010 Proportion of accredited BHWs trained on interpersonal

communication (IPC) and community tracking tool

Input and

process

SMP-011 Proportion of RHUs with trained PHNs on Supportive

Supervision

Input and

process

SMP-012 Proportion of RHUs with 3 basic laboratory services Input and

process

Safe Delivery

SMP-013 Proportion of birth attendants trained on Essential

Intrapartum and Newborn Care and lactation management

Input and

process

SMP-014 Proportion of birthing facilities with at least one midwife

trained on BEmONC, lactation management and basic life

support

Input and

process

SMP-015 Proportion of birthing facilities with access to an emergency

transport

Input and

process

SMP-016 Proportion of BEmONC facilities with no stock-out on life-

saving drugs and commodities

Input and

process

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Indicator


SMP-017 Proportion of hospitals with capability of advance life support Input and

process

Family Planning

SMP-018 Proportion of public health facilities with readiness to provide

family planning services

Output

Prenatal care

SMP-019 Proportion of RHUs with readiness to provide quality prenatal

care

Output

Safe Delivery

SMP-020 Proportion of public health facilities with readiness to provide

BEmONC services

Output

SMP-021 Proportion of licensed birthing facilities Output

SMP-022 Proportion of BEmONC-accredited birthing facilities Output

SMP-023 Proportion of BEmONC-licensed birthing facilities Output

SMP-024 Proportion of municipalities with at least one licensed

BEmONC facility

Output

SMP-025 Proportion of hospitals with readiness to provide CEmONC

services

Output

Postpartum care

SMP-026 Proportion of RHUs with readiness to provide quality

postpartum care

Output

Family Planning

SMP-027 Unmet need for family planning Outcome

SMP-028 Contraceptive prevalence rate for modern family planning

method use of women in reproductive age

Outcome

SMP-029 Proportion of new acceptors Outcome

SMP-030 Proportion of current users who dropped out Outcome

Prenatal care

SMP-031 Proportion of pregnant women with quality prenatal care Outcome

SMP-032 Proportion of pregnant women with 4 or more prenatal visits Outcome

SMP-033 Proportion of pregnant women given complete iron with folic

acid supplementation

Outcome

SMP-034 Proportion of pregnant women examined by a doctor Outcome

SMP-035 Pregnant women provided with Basic Oral Health Care Outcome

SMP-036 Proportion of pregnant women with basic laboratory

examinations

Outcome

SMP-037 Proportion of pregnant women given health information Outcome

SMP-038 Proportion of pregnant women given 2 doses of tetanus

toxoid

Outcome

Safe Delivery

SMP-039 Proportion of births attended by skilled health personnel Outcome

SMP-040 Facility-based delivery Outcome

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Indicator


Postpartum care

SMP-041 Proportion of postpartum women with at least 2 postpartum

visits

Outcome

SMP-042 Proportion of postpartum women with at least 1 clinic visit Outcome

Mortality

SMP-043 Number of maternal deaths Impact

SMP-044 Maternal mortality ratio Impact

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Proportion of LGUs with a Maternal, Newborn, Child Health and Nutrition policy

Indicator code SMP-001

Indicator name Proportion of LGUs with a Maternal, Newborn, Child Health and

Nutrition (MNCHN) policy

Abbreviated name LGUs with MNCHN policy

International name

Topic Governance and Policies

M&E Framework Input and process

Rationale The MNCHN policy provides basis on program implementation.

Definition This refers to the proportion of LGUs (provinces, municipalities

and cities) with a Maternal, Newborn, Child Health and Nutrition

(MNCHN) policy. The MNCHN policy may be an ordinance, an

executive order or a resolution. The MNCHN Policy is based on

the MNCHN Strategy of the Department of Health and aligned to

existing laws and policies such as the Responsible Parenthood

and Reproductive Health Law.

Data type Percentage

Unit of measurement

Numerator Number of LGUs with a MNCHN policy

Denominator Total number of LGUs

Disaggregation By city/municipality

By province

Data source Numerator: Family Planning Program Coordinator

Denominator: Local Health Systems Division

Frequency of collection Annual

Limitations/ Comments

Links and references

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Proportion of maternal deaths reviewed


Indicator name Proportion of maternal deaths reviewed

Abbreviated name Maternal deaths reviewed

International name

Topic Maternal Death Review


Rationale Maternal deaths review provides information on avoidable factors

and causes of death and the recommendations to address these

and prevent more deaths.

Definition This refers to the proportion of maternal deaths that were

reviewed. Maternal deaths are deaths of woman while pregnant

or within 42 days of termination of pregnancy, irrespective of the

duration and the site of the pregnancy, from any cause related to

or aggravated by the pregnancy or its management, but not from

accidental or incidental causes. Maternal death review means

that a community investigation using verbal autopsy was

performed, facility staff were interviewed, medical records

reviewed and case discussed by the provincial and regional

maternal death review (MDR) team based on the Regional

Maternal Death Review Policy.


Unit of measurement

Numerator Number of maternal deaths reviewed

Denominator Total number of maternal deaths


By province

Data source Numerator: Maternal Health Program Coordinator based on

maternal death review list

Denominator: Regional Health Information System

Frequency of collection Quarterly



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Proportion of BHS and RHUs utilizing the pregnancy tracking tool


Indicator name Proportion of BHS and RHUs utilizing the pregnancy tracking tool

Abbreviated name BHS and RHUs utilizing the pregnancy tracking tool

International name

Topic Information System


Rationale The pregnancy tracking tool ensures that all pregnant women are

listed and are tracked for service provision.

Definition BHS and RHUs utilizing the pregnancy tracking tool are those that

list all pregnant women into the tool and update information for

all parameters of tool such as schedule of prenatal visits and

referral of pregnant women to the midwife. The tool is filled in

and updated by the BHW.


Unit of measurement

Numerator Number of BHS and RHUs utilizing the pregnancy tracking tool

Denominator Total number of BHS and RHUs

Disaggregation By facility type

By city/municipality

By province

Data source Numerator: Maternal Health Program Coordinator



Limitations/ Comments Reporting form to be developed and data to be collected


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Proportion of LGUs with a Contraceptive Self-reliance (CSR) policy


Indicator name Proportion of LGUs with a Contraceptive Self-reliance (CSR) policy

Abbreviated name LGUs with CSR policy

International name

Topic Family Planning


Rationale CSR policy is a basis of LGUs in the implementation of Family

Planning program.

Definition This refers to the proportion of LGUs which includes

municipalities and cities in the province with a CSR policy. The

CSR policy may be an ordinance, an executive order or a

resolution that is based on the National Family Planning Program

of the Department of Health and aligned to existing laws and

policies such as the Responsible Parenthood and Reproductive

Health Law.


Unit of measurement

Numerator Number of LGUs with CSR policy

Denominator Total number of LGUs


By province


Denominator: Local Health Systems Division



Links and references DOH Administrative Order No. 50-A s. 2001: National Family

Planning Policy (http://www.youth-

policy.com/policies/PHIadminord50A_01NatlFP.pdf)

http://www.youth-policy.com/policies/PHIadminord50A_01NatlFP.pdf

http://www.youth-policy.com/policies/PHIadminord50A_01NatlFP.pdf

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Proportion of health facilities with FP-trained provider


Indicator name Proportion of health facilities with FP-trained provider

Abbreviated name Health facilities with FP-trained provider

International name



Rationale The presence of facilities with FP-trained providers will ensure that

FP services are nearest and accessible to the people.

Definition Proportion of health facilities, that is, BHS, RHU, DHO, government

hospitals, private lying-in/birthing facilities with at least one FP-

trained provider. The following are the minimum requirements:

1. BHS, RHU, DHO- Competency-based Training 1 and 2 (Interval

and NFP)

2. Government hospital - Competency-based Training 1 and 2,

Bilateral Tubal Ligation-Mini-Laparotomy under Local Anesthesia,

Subdermal Implant, Postpartum IUD insertion, Natural Family

Planning, No Scalpel Vasectomy.

3. Private lying-in/ birthing - Competency-based Training 1 and 2

(Interval, post-partum IUD insertion and removal and NFP)


Unit of measurement

Numerator Number of BHS, RHU, DHO, government hospitals, private lying-

in/ birthing facilities with at least one FP-trained provider

Denominator Total number of BHS, RHU, DHO, government hospitals, private

lying-in/birthing facilities



By province

Data source Numerator: Family Planning Program Coordinator based on list of

facilities with FP-trained provider

Denominator: Regional Health Information System and Regulation,

Licensing and Enforcement Division (number of lying-in/ birthing

facilities)


Limitations/ Comments Program coordinator has inventory but may not be updated and

may not be complete.


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Proportion of public health facilities that experienced near stock-out of any FP

commodity


Indicator name Proportion of public health facilities that experienced near stock-

out of any FP commodity

Abbreviated name Public health facilities that experienced near stock-out of any FP

commodity

International name



Rationale Information on nearing stock-out will provide for better planning

and logistics management.

Definition This indicator refers to the proportion of RHUs, CHOs, DHOs and

government hospitals that experienced near stock-out of any FP

commodity within a calendar month.

Near stock-out means having less than the three-month buffer of

any FP commodity.


Unit of measurement

Numerator Number of RHUs, DHOs, and government hospitals that

experienced near stock-out of any FP commodity within a

calendar month

Denominator Total number of RHUs and DHOs, and government hospitals



By province

Data source Numerator: Family Planning Program Coordinator using FP

Commodity Inventory Form


Frequency of collection Monthly

Limitations/ Comments System of reporting of stock-outs is not fully in place. Present

data is retrieved from nurses under Nurse Deployment Project

and actual follow-up.


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Proportion of public health facilities that experienced stock-out of any FP commodity


Indicator name Proportion of public health facilities that experienced stock-out of

any FP commodity

Abbreviated name Public health facilities that experienced stock-out of any FP

commodity

International name



Rationale Stock-outs would mean that logistics management is not effective.

This may affect access to service provision.

Definition This refers to the proportion of RHUs, CHOs, DHOs and

government hospitals that experienced stock-out of any FP

commodity within a calendar month.

Stock-out means having no supply of any FP commodity.


Unit of measurement

Numerator Number of RHUs and DHOs, and government hospitals that

experienced stock-out of any FP commodity within a calendar

month

Denominator Total number of RHUs and DHOs, and government hospitals



By province

Data source Numerator: Family Planning Program Coordinator using FP

Commodity Inventory Form



Limitations/ Comments System of reporting of stock-outs is not fully in place. Present data

is retrieved from nurses under Nurse Deployment Project and

actual follow-up.


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Proportion of BHS and RHUs with trained midwife on quality assurance package


Indicator name Proportion of BHS and RHUs with trained midwife on quality

assurance package

Abbreviated name BHS and RHUs with trained midwife on QAP

International name

Topic Prenatal Care


Rationale Quality Assurance Package (QAP) is a toolkit for midwives

intended to set the standards of quality so that the practicing

professional midwives will be able to deliver optimal MNCHN

services to their clients/patients and to the community.

Midwives will readily have a ‘reference’ that can guide them in

their clinical practice with this toolkit.

Definition This indicator refers to the proportion of BHS and RHU with

trained midwives on QAP. The QAP is a DOH-approved course for

midwives on the different skills and knowledge on providing the

continuum of care for women from pre-pregnancy to postpartum


Unit of measurement

Numerator Number of BHS and RHUs with trained midwife on QAP

Denominator Total number of BHS and RHUs



By province

Data source Numerator: Program coordinator using the Training Completion

Report



Limitations/ Comments The implementation of training only started in 2015. Information

should be shared with the Human Resource Development Unit,

which created a training information system in 2015. Encoding of

data is required.


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Proportion of RHUs that experienced stock-out on iron with folic acid


Indicator name Proportion of RHUs that experienced stock-out on iron with folic

acid

Abbreviated name RHUs that experienced stock-out on iron with folic acid

International name

Topic Prenatal Care


Rationale Stock-outs would mean that logistics management is not

effective.

Definition This refers to the proportion of RHUs that experienced stock-out

on iron with folic acid.

Stock-out means having no available iron in the facility within a

calendar month.


Unit of measurement

Numerator Number of RHUs that experienced stock-out on iron with folic

acid

Denominator Total number of RHUs


By province

Data source Numerator: Maternal Health Program Coordinator through a tool

to be developed



Limitations/ Comments No existing reporting system for Safe Motherhood commodities at

present.


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Proportion of accredited BHWs trained on interpersonal communication (IPC) and

community tracking tool


Indicator name Proportion of accredited BHWs trained on interpersonal

communication (IPC) and community tracking tool

Abbreviated name Accredited BHWs trained on IPC and community tracking tool

International name

Topic Prenatal Care


Rationale Interpersonal communication and community tracking tools are

used by BHWs in their functions as navigators and information

providers for demand generation in their areas.

Definition Proportion of accredited barangay health workers (BHWs) trained

on IPC and community tracking tool.

Interpersonal communication training is a one-day DOH-approved

curriculum for BHWs which provides information on maternal

health programs and the key message to be conveyed to their

constituents.

On the other hand, the Training on the Community Tracking Tool

is a training for BHWs on the use of the tool to track pregnant

women to ensure provision of services from prenatal to

postpartum FP.


Unit of measurement

Numerator Number of accredited BHWs trained on IPC and community

tracking tool

Denominator Total number of accredited BHWs

Disaggregation By type of training


By province

Data source Numerator: Maternal Health Program Coordinator using the

Training Completion Report

Denominator: BHW Registry


Limitations/ Comments Information should be shared with the Human Resource

Development Unit, which created a training information system in

2015. Encoding of data is required. There is a fast turnover of

BHWs especially during election time (3 years interval).


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Proportion of RHUs with trained PHNs on Supportive Supervision


Indicator name Proportion of RHUs with trained PHNs on Supportive Supervision

Abbreviated name RHUs with trained PHNs on Supportive Supervision

International name

Topic Prenatal Care


Rationale Supportive supervision is a course approved by DOH provided for

public health nurses (PHNs) to assess, supervise, and coach their

midwives to deliver optimal MNCHN services to their

clients/patients and to the community.

Definition This refers to the proportion of RHUs with trained PHNs on

Supportive Supervision. Supportive supervision is conducted

monthly by PHNs using the standard supervisory tool.


Unit of measurement

Numerator Number of RHUs with trained PHNs on Supportive Supervision



By province

Data source Numerator: Maternal Health Program Coordinator using the

Training Completion Report



Limitations/ Comments The implementation of training only started in 2015. Information

should be shared with the Human Resource Development Unit,

which created a training information system in 2015. Encoding of

data is required.


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Proportion of RHUs with 3 basic laboratory services


Indicator name Proportion of RHUs with 3 basic laboratory services

Abbreviated name RHUs with basic laboratory services

International name

Topic Prenatal Care


Rationale Urinalysis, hemoglobin determination and blood typing are the

basic laboratory examinations needed during pregnancy to

identify presence of infection and anemia that commonly affect

pregnancy and which can actually be managed once detected.

Blood typing information would prepare pregnant women and

providers which blood type to prepare in any cases of bleeding

that may need blood transfusion.

Definition Proportion of RHUs with 3 basic laboratory services that include

urinalysis, hemoglobin determination and blood typing services.


Unit of measurement

Numerator Number of RHUs with 3 basic laboratory services



By province

Data source Numerator: Maternal Health Program Coordinator using Health

Facility Inventory Tool



Limitations/ Comments Health facility inventory tool to be developed.


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Proportion of birth attendants trained on Essential Intrapartum and Newborn Care

and lactation management


Indicator name Proportion of birth attendants trained on Essential Intrapartum

and Newborn Care and lactation management

Abbreviated name Birth attendants trained on EINC and lactation management

International name

Topic Safe Delivery


Rationale EINC and lactation management trainings are required for birth

attendants in licensed birthing facilities. These trainings provide

the skills and knowledge providers must have to handle normal

deliveries and to ensure that quality maternal and newborn

services are provided.

Definition Proportion of birth attendants who are public health doctors

(MHOs), nurses (PHNs) and midwives (RHMs) trained on EINC

and lactation management. EINC training is a 3-day course with

series of time-bound, chronologically ordered, standard

procedures that can be enforced immediately in all health care

settings. Lactation management training (LMT) is a training on

the general care of a mother-infant nursing couple during the

mother's prenatal, immediate postpartum and postnatal periods.


Unit of measurement

Numerator Number of birth attendants trained on EINC and lactation

management

Denominator Total number of birth attendants

Disaggregation By type of birth attendants


By province

By geographical location

Data source Numerator: Program coordinator using the training completion

report

Denominator: Program coordinator using inventory tool of

personnel attending deliveries


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Limitations/ Comments 1. There is still a need to identify the regional "universe" of birth

attendants for the public sector. There are nurses and midwives

not handling deliveries, which may exclude them to the regional

"universe" of birth attendants. OR total birth attendants may

mean ALL government doctors (MHOs), nurses (PHNs) and

midwives (RHMs);

2. There are EINC trainings done before which were only for 2

days; and

3. The training information system was just developed. Encoding

must still be done. The program coordinator has an inventory

but may not be updated and complete.


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Proportion of birthing facilities with at least one midwife trained on BEmONC,

lactation management and basic life support


Indicator name Proportion of birthing facilities with at least one midwife trained on

BEmONC, lactation management and basic life support

Abbreviated name Birthing facilities with at least one midwife trained on BEmONC,

lactation management and BLS

International name

Topic Safe Delivery


Rationale BEmONC, Lactation management and Basic life support trainings

are trainings required from birth attendants in licensed birthing

facilities to be able to handle basic emergency obstetrics and

neonatal care cases.

Definition This indicator refers to the proportion of birthing facilities with at

least one (1) BEmONC certified midwife, trained on lactation

management and basic life support. Birthing facilities may include

a BHS, RHU, public or private lying-in facility, public or private

hospital handling deliveries but may or may not be licensed. A

midwife may be a public or private midwife with certificate of

completion signifying competency in BEmONC skills, lactation

management and basic life support.


Unit of measurement

Numerator Number of birthing facilities with at least 1 midwife trained on

BEmONC, lactation management and basic life support

Denominator Total number of birthing facilities



By province


Denominator: Regulation, Licensing and Enforcement Division


Limitations/ Comments There is no official complete list of birthing facilities. Safe

Motherhood program managers may have a list of public facilities

handling deliveries based on the mapping conducted and list of

private facilities handling deliveries based on previous lists and

engagements. RLED may have a list from previously PhilHealth

accredited facilities and from those who applied for a license. The

"universe" or the "total number of birthing facilities" may not be

accurate and may change by time.


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Proportion of birthing facilities with access to an emergency transport


Indicator name Proportion of birthing facilities with access to an emergency

transport

Abbreviated name Birthing facilities with access to an emergency transport

International name

Topic Safe Delivery


Rationale Emergency transport is one of the licensing requirements for

birthing homes. This ensures that patients are facilitated and

referred without delay to higher level of facilities.

Definition This refers to the proportion of birthing facilities with access to an

emergency transport. Birthing facilities may include a BHS, RHU,

public or private lying-in facility, public or private hospital

handling deliveries but may or may not be licensed. Access to an

emergency transport may be an actual birthing facility-owned

vehicle or a partner with a MOA for vehicle to be used for

transporting patients with complications before, during or after

delivery especially in geographically isolated depressed areas.


Unit of measurement

Numerator Number of birthing facilities with access to an emergency

transport


Disaggregation By service delivery network


By province

Data source Service Delivery Network point person


Limitations/ Comments There is no official complete list of birthing facilities. Safe

Motherhood Program Managers may have a list of public facilities

handling deliveries based on the mapping conducted and list of

private facilities handling deliveries based on previous lists and

engagements. RLED may have a list from previously PhilHealth

accredited facilities and from those who applied for a license. The

"universe" or the "total number of birthing facilities" may not be

accurate and may change by time.


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Proportion of BEmONC facilities with no stock-out on life-saving drugs and

commodities


Indicator name Proportion of BEmONC facilities with no stock-out on life-saving

drugs and commodities

Abbreviated name BEmONC facilities with no stock-out on life-saving drugs and

commodities

International name

Topic Safe Delivery


Rationale Stock-outs would mean that logistics management is not effective.

This may affect access to service provision.

Definition This refers to the proportion of public BEmONC facilities with no

stock-out on life-saving drugs and commodities. Life-saving drugs

include oxytocin, magnesium sulfate, steroids and antibiotics.

Stock-out means no available life-saving drugs.


Unit of measurement

Numerator Number of public BEmONC facilities with no stock-out on life-

saving drugs and commodities

Denominator Total number of public BEmONC facilities

Disaggregation By type of life-saving drugs


By province

Data source Maternal Health Program Coordinator using BEmONC Commodity

Inventory Form


Limitations/ Comments 1. Based on the DOH memorandum issued last year, there is no

more certification of BEmONC facility. The licensing

requirements only includes BEmONC certificate of training and

not accreditation as BEmONC facility.

2. There is no existing system on checking stock-outs for BEmONC

commodities at present. This may only be taken from actual

findings of assessment results.


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Proportion of hospitals with capability of advance life support


Indicator name Proportion of hospitals with capability of advance life support

Abbreviated name

International name

Topic Safe Delivery


Rationale Maternal, newborn and child services follows a continuum of

care. This means that services must be laid out from community

to rural health centers to hospitals. Hospitals are the end referral

facilities which require them to be able to provide advance life

support for mothers and newborns.

Definition This refers to the proportion of public health hospitals of at least

level 1 with readiness to provide advance life support; Advance

life support for mothers and newborns include emergency

cesarean section, oxygenation and intubation and blood

transfusion.


Unit of measurement

Numerator Number of public health hospitals of at least level 1 with

readiness to provide advance life support

Denominator Total number of levels 1 to 3 public health hospitals


By province






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Proportion of public health facilities with readiness to provide family planning

services


Indicator name Proportion of public health facilities with readiness to provide

family planning services

Abbreviated name

International name


M&E Framework Output

Rationale This indicator will check the availability of family planning services

in public health facilities.

Definition Proportion of public health facilities with readiness to provide

family planning services refers to BHS, RHUs/CHOs/DHOs and

government hospitals that meet the following requirements:

1. Guideline: FP Clinical Standards Manual

2. Checklist: FP Form 1

3. With trained staff:

a. BHS - Competency-based Training 1 and 2 (Interval and NFP);

midwife

b. RH/CHO/DHO - Competency-based Training 1 and 2 (Interval,

Postpartum and NFP); at least one staff (midwife or nurse)

c. Government hospital

(1) Midwife/nurse: Competency-based Training 1 and 2 (IUD

insertion, interval, postpartum and natural FP)

(2) Doctor: Competency-based Training 1 and 2 (IUD

insertion, interval, postpartum, natural FP, bilateral tubal ligation-

mini-laparotomy under local anesthesia, subdermal implant, and

no scalpel vasectomy)

d. Private lying-in/ birthing - Competency-based Training 1 and 2

4. Equipment:

a. BHS: BP app with stethoscope, IUD set (vaginal speculum (all

sizes), tenaculum, uterine sound, mayo scissors, ovum forceps)

b. RHU, hospitals: BP app with stethoscope, IUD set (vaginal

speculum (all sizes), tenaculum, uterine sound, mayo scissors,

ovum forceps, placental forceps)

5. Commodities:

a. BHS: progestin-only pills, combined oral contraceptives,

injectables, condom, SDM beads

b. RHU: progestin-only pills, combined oral contraceptives,

injectables, condom, SDM beads, IUD

c. Government hospitals: progestin-only pills, combined oral

contraceptives, injectables, condom, SDM beads, IUD, voluntary

surgical contraception procedures

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Unit of measurement

Numerator Number of BHS, RHUs/CHOs/DHOs and government hospitals

with readiness to provide family planning services

Denominator Total number of BHS, RHUs/CHOs/DHOs and government

hospitals


By province






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Proportion of RHUs with readiness to provide quality prenatal care


Indicator name Proportion of RHUs with readiness to provide quality prenatal care

Abbreviated name

International name

Topic Prenatal Care


Rationale Prenatal care is the basic service provided to pregnant woman to

ensure good health outcome. Quality prenatal care leads to

reduced maternal death.

Definition Proportion of RHUs with readiness to provide quality prenatal care

refers to RHUs that meet the following requirements:

1. Guidelines: Quality Assurance Package Manual (or Pregnancy,

Childbirth, Postpartum and Newborn Care Manual) and Mother-

Baby Book

2. With doctor and dentist

3. At least one midwife trained on QAP (or PCPNC)

4. Equipment: BP app with stet, adult weighing scale

5. Laboratory: urinalysis, hemoglobin testing and blood typing

6. Commodities: iron with folic acid and tetanus toxoid vaccine


Unit of measurement

Numerator Number of RHUs with readiness to provide quality prenatal care



By province

Data source Numerator:

For presence of doctor and dentist – Human Resource

Development Unit

For iron supply and diagnostic capacity - Maternal Health Program

Coordinator using a tool to be developed



Limitations/ Comments Reporting form to be developed and data to be collected


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Proportion of public health facilities with readiness to provide BEmONC services


Indicator name Proportion of public health facilities with readiness to provide

BEmONC services

Abbreviated name

International name

Topic Safe Delivery


Rationale BEmONC services are provided by public health facilities to ensure

that basic emergency obstetric and neonatal complications are

responded to. Such service capabilities reduce maternal deaths.

These include administration of magnesium sulfate for pre-

eclampsia, administration of corticosteroids for prematurity,

administration of parenteral antibiotics for infections,

administration of oxytocin for uterine contraction and bleeding,

handling of imminent breach delivery and manual removal of

placental products.

Definition Proportion of public health facilities with readiness to provide

BEmONC services refers to BHS, RHUs/CHOs/DHOs and

government hospitals that meet the following requirements:

1. Guideline: Pregnancy, Childbirth, Postpartum and Newborn Care

Manual

2. With midwife trained on BEmONC, LMT and basic life support

3. Equipment: examining table/bed with clean linen and stool,

delivery table with pail, recovery bed, gooseneck lamp, forceps

(alligator 10"; straight 10"; tissue regular 6"; hemostatic straight;

ovum; uterine 10"; tenaculum; pick-up), vaccine refrigerator, adult

and baby weighing scale, BP apparatus and stethoscope, body

thermometer, IV stand, suction machine and suction

bulb/penguin, ambu bag (adult and pediatric), sponge holder,

needle holder, uterine sound, ultraviolet sterilizer or autoclave

4. Medicines and commodities:

a. Medicines/Drugs and Vaccines:

(1) IV fluids: glucose 50% solution (1 polyamp 50 mL),

normal saline 0.9% (at least 3 bottles), Ringer Lactate (at least 5

bottles D5LR) and plain LR (at least 3 bottles)

(2) Anticonvulsant: magnesium sulfate (at least 5 ampules

500 mg/2 mL ampule)

(3) Antihypertensive: methyldopa, hydralazine (injectable),

nifedipine,

(4) At least one of the following oral antibiotics (preferably

amoxicillin): amoxicillin, ampicillin, cephalosporin, cloxacillin,

erythromycin, azithromycin, trimethoprim + sulfamethoxazole,

tetracycline or doxycycline (RPR + partner), metronidazole

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(5) Injectable antibiotics: at least ampicillin, gentamicin and

metronidazole but may also include ceftriaxone and benzathine

penicillin

(6) At least one of the following tetracycline eye ointment:

eye antimicrobial (1% silver nitrate or 2.5% povidone iodine) or

erythromycin ophthalmic ointment 5%

(7) Oxytoxic: ergometrine (injectable) and oxytocin

(injectable) at least 100 ampules

(8) Endemic diseases: at least mebendazole or all of the

following if area is malaria infested: arthemether or quinine,

chloroquine tablet, sulphadoxine-pyremethane and mebendazole

(9) Vaccine: tetanus toxoid, Hepatitis B and BCG

(10) At least one of the following corticosteroids:

dexamethasone vial or ampule or betamethasone vial or ampule

(11) Others: iron plus folic acid tablet (at least 2 boxes of

100's); vitamin A 200,000 iu (at least 2 boxes); aquamephyton 10

mg/mL (0.1 mL); adrenaline/epinephrine;

lignocaine/lidocaine/xylocaine (multidose at 50 mL) 5 poly amp 5

mL; calcium gluconate; paracetamol 500 mg (at least 1 box of

100's); at least one of the following FP supplies: progesterone-only

pills, D-medroxyprogesterone acetate (DMPA) or intrauterine

device (copper T); and printed materials/posters for patient

education

b. Commodities/Supplies: antiseptic solution (iodophors or

chlorhexidine/cetrinide); bleach powder/tablet-Jik (chlorine base

compound); jar with cover and without cover; sterile gloves;

surgical spirit (70% isopropyl alcohol); suture material for tear or

episiotomy repair (sterile cutting and round needles; absorbable

sutures); cotton swabs/pledgets/gauze; syringes and needles

(disposable); urinary catheter; container for catching urine;

disposable delivery kit (sterile cord clip or ties, plastic sheet to

place under mother and sterile blade); soap, clean towels and

sanitary pads; delivery record/ logbook (admission; consultation

logbook; patients clinical record; referral forms); surgical scissors

(straight); vaginal speculum (medium or large); baby feeding cup;

bed sheet; sterile drape; plastic apron; surgical map/ mask;

patient gown/ scrub suit; clean towels for drying and wrapping the

baby; IV tubing; IV cannula G19; plaster; supplies for newborn

screening (alcohol or sterile water, clean gloves, dry and wet

cotton balls/swabs, drying rack, newborn screening filter, sterile

lancets 3mm, warm moist towel)


Unit of measurement

Numerator Number of BHS, RHUs/CHOs/DHOs and government hospitals

with readiness to provide BEmONC services

Denominator Total number of BHS, RHUs/CHOs/DHOs and government

hospitals

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By province

Data source Regional Health Information System



Links and references 1. Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide

for Essential Practice

(http://www.afro.who.int/index.php?option=com_docman&tas

k=doc_download&gid=2011)

2. BEmONC Monitoring Tools: Assessment of the Facility and Its

Services

(https://www.dropbox.com/s/53xqpjn3pie0l9s/BEmONC%20A

ssessment%20and%20Monitoring%20Forms.doc?dl=0)

http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=2011


https://www.dropbox.com/s/53xqpjn3pie0l9s/BEmONC%20Assessment%20and%20Monitoring%20Forms.doc?dl=0


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Proportion of licensed birthing facilities


Indicator name Proportion of licensed birthing facilities

Abbreviated name Licensed birthing facilities

International name

Topic Safe Delivery


Rationale Birthing facilities are being licensed by the Department of Health

to ensure that these facilities comply with the standards of a

birthing facility in the provision of quality services to target

population. These include compliance to requirements of

infrastructure, equipment and supplies, human resource,

policies, records, transportation and communication system.

Definition This refers to the licensed birthing facilities which are birthing

facilities with a license to operate issued by DOH.


Unit of measurement

Numerator Number of licensed birthing facilities




By province

Data source Numerator: Regulation, Licensing and Enforcement Division

Denominator: Maternal Health Program Coordinator




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Proportion of BEmONC-accredited birthing facilities


Indicator name Proportion of BEmONC-accredited birthing facilities

Abbreviated name BEmONC-accredited birthing facilities

International name

Topic Safe Delivery


Rationale This is to monitor the number of BEmONC-accredited birthing

facilities to ensure that they are capable of performing the seven

signal functions. This capability of birthing facilities ensures

reduction of maternal and newborn mortality.

Definition This refers to the proportion of BEmONC-accredited birthing

facilities which are facilities capable to perform the seven signal

functions: 1) administration of antenatal steroids, 2)

administration of anti-convulsant, 3) administration of oxytocin 4)

manual removal of placenta, 5) removal of retained placental

products, 6) administration of parenteral antibiotic, and 7)

imminent breech.


Unit of measurement

Numerator Number of BEmONC-accredited birthing facilities




By province

Data source Maternal Health Program Coordinator




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Proportion of BEmONC-licensed birthing facilities


Indicator name Proportion of BEmONC-licensed birthing facilities

Abbreviated name BEmONC-licensed birthing facilities

International name

Topic Safe Delivery


Rationale Birthing facilities are being licensed by the Department of Health

to ensure that these facilities comply with the standards of a

birthing facility in the provision of quality services to target

population. These include compliance to requirements of

infrastructure, equipment and supplies, human resource,

policies, records, transportation and communication system.

Definition Proportion of BEmONC-licensed birthing facilities which refers to

birthing facilities with license to operate issued by DOH. A

BEmONC facility is a facility capable to perform the seven signal


administration of anti-convulsant, 3) administration of oxytocin,

4) manual removal of placenta, 5) removal of retained placental


imminent breech.


Unit of measurement

Numerator Number of BEmONC-licensed birthing facilities




By province






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Proportion of municipalities with at least one licensed BEmONC facility


Indicator name Proportion of municipalities with at least one licensed BEmONC

facility

Abbreviated name Municipalities with at least one licensed BEmONC facility

International name

Topic Safe Delivery


Rationale This is to check the number of municipalities with BEmONC

facility. Each municipality must have a BEmONC facility that could

respond to basic emergency obstetrics and neonatal care to

ensure availability of services within an hour from the barangays

where pregnant women come from.

Definition This refers to the proportion of municipalities with at least one

licensed BEmONC facility. Licensed BEmONC facilities are those

public health facilities with license to operate issued by DOH. A

BEmONC facility is a facility capable to perform the seven signal


administration of anti-convulsant, 3) administration of oxytocin,

4) manual removal of placenta, 5) removal of retained placental


imminent breech.


Unit of measurement

Numerator Number of municipalities with at least one licensed BEmONC

facility

Denominator Number of municipalities with BEmONC facility


By province






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Proportion of hospitals with readiness to provide CEmONC services


Indicator name Proportion of hospitals with readiness to provide CEmONC

services

Abbreviated name

International name

Topic Safe Delivery


Rationale CEmONC facilities are facilities that are capable of doing the

seven signal functions of a BEmONC facility plus emergency

caesarean section, blood transfusion and advanced life support.

CEmONC facilities should be within one to two hours away from

the BEmONC facility.

Definition Proportion of hospitals with readiness to provide CEmONC

services refers to hospitals that meet the following requirements:

1. Guideline: Pregnancy, Childbirth, Postpartum and Newborn Care

Manual

2. With 24/7 duty OB-gynecologist, anesthesiologist and

pediatrician

3. Equipment: examining table/bed with clean linen and stool,

delivery table with pail, recovery bed, gooseneck lamp, forceps

(alligator 10"; straight 10"; tissue regular 6"; hemostatic straight;

ovum; uterine 10"; tenaculum; pick-up), vaccine refrigerator, adult

and baby weighing scale, BP apparatus and stethoscope, body

thermometer, IV stand, suction machine and suction

bulb/penguin, ambu bag (adult and pediatric), sponge holder,

needle holder, uterine sound, ultraviolet sterilizer or autoclave,

anesthesia equipment, resuscitation table for newborn, incubator,

oxygen, spinal needle, endotracheal set

4. Diagnostics: blood typing and crossmatch testing


a. Medicines/Drugs and Vaccines:

(1) IV fluids: glucose 50% solution (1 polyamp 50 mL,

normal saline 0.9% (at least 3 bottles), Ringer Lactate (at least 5

bottles D5LR) and plain LR (at least 3 bottles)

(2) Anticonvulsant: magnesium sulfate (at least 5 ampules

500 mg/2 mL ampule)

(3) Antihypertensive: methyldopa, hydralazine (injectable),

nifedipine

(4) At least one of the following oral antibiotics (preferably

amoxicillin): amoxicillin, ampicillin, cephalosporin, cloxacillin,

erythromycin, azithromycin, trimethoprim + sulfamethoxazole,

tetracycline or doxycycline (RPR + partner), metronidazole

(5) Injectable antibiotics: at least ampicillin, gentamicin and

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metronidazole but may also include ceftriaxone and benzathine

penicillin

(6) At least one of the following tetracycline eye ointment:

eye antimicrobial (1% silver nitrate or 2.5% povidone iodine) or

erythromycin ophthalmic ointment 5%

(7) Oxytoxic: ergometrine (injectable) and oxytocin

(injectable) at least 100 ampules

(8) Endemic diseases: at least mebendazole or all of the

following if area is malaria infested: arthemether or quinine,

chloroquine tablet, sulphadoxine-pyremethane and mebendazole

(9) Vaccine: tetanus toxoid, Hepatitis B and BCG

(10) At least one of the following corticosteroids:

dexamethasone vial or ampule or betamethasone vial or ampule

(11) Others: iron plus folic acid tablet (at least 2 boxes of

100's); vitamin A 200,000 iu (at least 2 boxes); aquamephyton 10

mg/mL (0.1 mL); adrenaline/epinephrine;

lignocaine/lidocaine/xylocaine (multidose at 50 mL) 5 poly amp 5

mL; calcium gluconate; paracetamol 500 mg (at least 1 box of

100's); at least one of the following FP supplies: progesterone-only

pills, D-medroxyprogesterone acetate (DMPA) or intrauterine

device (copper T); and printed materials/posters for patient

education

b. Commodities/Supplies: antiseptic solution (iodophors or

chlorhexidine/cetrinide); bleach powder/tablet-Jik (chlorine base

compound); jar with cover and without cover; sterile gloves;

surgical spirit (70% isopropyl alcohol); suture material for tear or

episiotomy repair (sterile cutting and round needles; absorbable

sutures); cotton swabs/pledgets/gauze; syringes and needles

(disposable); urinary catheter; container for catching urine;

disposable delivery kit (sterile cord clip or ties, plastic sheet to

place under mother and sterile blade); soap, clean towels and

sanitary pads; delivery record/ logbook (admission; consultation

logbook; patients clinical record; referral forms); surgical scissors

(straight); vaginal speculum (medium or large); baby feeding cup;

bed sheet; sterile drape; plastic apron; surgical map/ mask;

patient gown/ scrub suit; clean towels for drying and wrapping the

baby; IV tubing; IV cannula G19; plaster; supplies for newborn

screening (alcohol or sterile water, clean gloves, dry and wet

cotton balls/swabs, drying rack, newborn screening filter, sterile

lancets 3mm, warm moist towel)

c. CEmONC-added commodities: blood supply sufficiency (no

interruption of blood supply), blood supply safety (blood obtained

from DOH and PNRC or screened for HIV, syphilis, HepB, HepC and

malaria) and anesthetics


Unit of measurement

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Numerator Number of hospitals with readiness to provide CEmONC services

Denominator Total number of hospitals

Disaggregation By service delivery network


By province

Data source Numerator: Health Facility Development Unit

Denominator: Regulation, Licensing and Enforcement Division



Links and references 1. Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide

for Essential Practice

(http://www.afro.who.int/index.php?option=com_docman&tas

k=doc_download&gid=2011)

2. BEmONC Monitoring Tools: Assessment of the Facility and Its

Services

(https://www.dropbox.com/s/53xqpjn3pie0l9s/BEmONC%20A

ssessment%20and%20Monitoring%20Forms.doc?dl=0)





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Proportion of RHUs with readiness to provide quality postpartum care


Indicator name Proportion of RHUs with readiness to provide quality postpartum

care

Abbreviated name RHUs with readiness to provide quality postpartum care

International name

Topic Postpartum Care

M&E Framework Outcome

Rationale Basic quality postpartum care must be available in the public

health facilities to ensure that postpartum women are provided

consultation and treatment to prevent postpartum complications

such as postpartum hemorrhage and postpartum eclampsia.

Definition Proportion of RHUs with readiness to provide quality postpartum

care refers to RHUs that meet the following requirements:

1. Guidelines: Quality Assurance Package Manual (or Pregnancy,

Childbirth, Postpartum and Newborn Care Manual) and Early

Childhood Care and Development Card

2. With at least one midwife trained on QAP (or PCPNC) and IYCF

3. Equipment: BP apparatus with stethoscope, infant weighing

scale, and adult weighing scale


a. Mother: Vitamin A, iron with folic acid, FP commodities

(progestin-only pills, combined oral contraceptives, injectables,

condom, SDM beads, IUD)

b. Newborn: BCG and hepatitis B vaccines, NBS kit, antibiotic

ointment for eye prophylaxis, Vitamin K


Unit of measurement

Numerator Number of RHUs with readiness to provide quality postpartum

care



By province





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Unmet need for family planning


Indicator name Unmet need for family planning

Abbreviated name Unmet need for FP

International name Unmet need for family planning



Rationale Unmet need for family planning provides a measurement of the

ability of women in achieving their desired family size and birth

spacing. It also provides an indication of the success of

reproductive health programs in addressing demand for services.

Unmet need complements the contraceptive prevalence rate by

indicating the additional extent of need to delay or limit births.

Unmet need is a rights-based measure that helps determine how

well a country’s health system and social conditions support the

ability of women to realize their stated preference to delay or limit

births.

Definition The proportion of women of reproductive age (15-49 years) who

are married or in union and who have an unmet need for family

planning, i.e. who do not want any more children or want to wait

at least two years before having a baby, and yet are not using

contraception.


Unit of measurement

Numerator Total number of women who are married or in a consensual

union who have an unmet need for family planning

Denominator Total number of women of reproductive age (15-49 years) who

are married or in consensual union

Disaggregation By desire to limit and desire to space

Data source National Demographic Health Survey

Frequency of collection Every 3-5 years



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Contraceptive prevalence rate for modern family planning method use of women in

reproductive age


Indicator name Contraceptive prevalence rate for modern family planning

method use of women in reproductive age

Abbreviated name CPR

International name



Rationale Contraceptive prevalence rate for modern family planning

method provides information on how family planning program is

implemented. It also provides information to estimate unmet

needs of reproductive age.

Definition The proportion of women of reproductive age (15‐49 years of

age) who are using (or whose partner is using) any modern FP

method at a given point in time. Modern Family Planning

Methods include Female Sterilization/BTL and Male

Sterilization/Vasectomy, intrauterine devices IUD, oral pills,

injectables and implants. NFP Methods include Cervical Mucus

Method (CCM), Basal Body Temperature (BBT), Symptothermal

Method (STM), Standard Days Method (SDM) and Lactational

Amenorrhea Method (LAM). Surgical sterilization (female and

male sterilization) is done to those couples who reached their

desired number of children.


Unit of measurement

Numerator Number of women of reproductive age who are using (or whose

partner is using) a modern FP method at a given point in time

Denominator Total number of women of reproductive age who are eligible to

practice contraception (Total Population x 12.325% ) 14.5% x

85% = 12.325%

Disaggregation By method

By equity stratified data - age, maternal education, ethnicity,

socio-economic status, place of residence

By geographic area (city/municipality/province)

Data source Numerator: Regional Health Information System (RHIS) for

method and geographic area; National Demographic and Health

Survey (NDHS) for equity stratified data

Denominator: RHIS

Frequency of collection Monthly (Regional Health Information System);

Every 3 years (National Demographic and Health Survey)

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Limitations/ Comments Data from the private sector not recorded or submitted to

reporting facilities which may lead to underreporting.

Links and references Field Health Services Information System version 2012

(https://www.dropbox.com/s/s3e1w53p0en6umt/fhsisver2012-

EditedAug302013.pdf?dl=0)

https://www.dropbox.com/s/s3e1w53p0en6umt/fhsisver2012-EditedAug302013.pdf?dl=0


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Proportion of new acceptors


Indicator name Proportion of new acceptors

Abbreviated name New acceptors

International name



Rationale Low number of new acceptors for modern contraceptive method

would indicate that demand generation or advocacy of family

planning program is not working. Hence, program strategies need

to be replanned.

Definition The proportion of women of reproductive age (or her partner)

using a modern contraceptive method for the first time or has

never accepted any modern family planning method or who is

new to the program.


Unit of measurement

Numerator Number of new acceptors

Denominator Total number of women of reproductive age who are currently

using modern FP methods.



By province



Limitations/ Comments 12.325% may change based on the census. Data from the

private sector not recorded or submitted to reporting facilities

which may lead to underreporting.


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Proportion of current users who dropped out


Indicator name Proportion of current users who dropped out

Abbreviated name Drop-outs

International name



Rationale High drop-outs for modern contraceptive method need to be

studied and reviewed to ensure proper program implementation.

Issues on drop out would indicate problem on basic counselling

and effectivity of methods.

Definition Proportion of women of reproductive age who (or whose partner)

are current modern FP users but dropped out. Drop‐outs are

clients who used a modern FP method but failed to return for the

next service date or stopped due to other conditions (e.g. bilateral

salphyngo-oophorectomy, hysterectomy).


Unit of measurement

Numerator Number of women of reproductive age (or her partner) who are

current modern FP users but dropped out

Denominator Total number of women of reproductive age who (or whose

partner) are current modern FP users



By province



Limitations/ Comments Data from the private sector not recorded or submitted to

reporting facilities which may lead to underreporting.


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Proportion of pregnant women with quality prenatal care


Indicator name Proportion of pregnant women with quality prenatal care

Abbreviated name Quality prenatal care coverage

International name

Topic Prenatal Care


Rationale Quality prenatal care ensure that quality services are provided to

pregnant women. Good accomplishment on quality prenatal care

is related to low maternal deaths.

Definition Proportion of pregnant women who received quality prenatal

care. Quality prenatal care includes: 1) examined at least once by

a doctor, 2) checked at least once by a dentist, 3) urinalysis,

blood typing and hemoglobin testing, 4) provided 180 tablets of

ferrous sulfate with 60mg elemental iron and 400mcg folic acid,

5) completed 4 prenatal visits (once in first and second trimester

and twice in the last trimester), and 6) received health

information and counseling on maternal and child care.


Unit of measurement

Numerator Number of pregnant women that received quality prenatal care

Denominator Total number of deliveries


By province



Limitations/ Comments Provision of iron with folic acid supplementation does not mean

actual intake of the pregnant woman.


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Proportion of pregnant women with 4 or more prenatal visits


Indicator name Proportion of pregnant women with 4 or more prenatal visits

Abbreviated name 4 ANC

International name Antenatal care coverage - at least four visits

Topic Prenatal Care


Rationale An indicator of access and utilization of health care during

pregnancy.

It is strongly encouraged that the first prenatal visit is during the

first trimester so that preventive, promotive health interventions

(such as micronutrient supplementation, screening for

complications) will be given to women in the earliest possible time.

Definition This refers to the proportion of pregnant women with 4 or more

prenatal visits. Four or more prenatal visits means having at least

one prenatal visit during the first trimester, one during the second

trimester and at least 2 visits during the third trimester.

First Trimester = up to 12 weeks or 0‐84 days; Second Trimester =

13‐27 weeks or 85‐189 days; Third Trimester = 28 weeks and

more or 190 days and more.

Prenatal visits that occurred outside the reporting facility should be

counted as part of the minimum required number of ANC visits.


Unit of measurement

Numerator Number of pregnant women with 4 or more prenatal visits

Denominator For FHSIS: Total number of pregnant women as estimated by total

population x 2.7%. The figure 2.7% is provided by the Philippine

Statistics Authority.

For RHIS: Total number of deliveries


By province









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Proportion of pregnant women given complete iron with folic acid supplementation


Indicator name Proportion of pregnant women given complete iron with folic acid

supplementation

Abbreviated name Pregnant women given complete iron with folic acid

supplementation

International name

Topic Prenatal Care


Rationale There is a high prevalence of anemia in pregnant mothers. This

indicator will tell us if adequate iron supplementation is given or

taken by the mother.

Definition This refers to the proportion of pregnant women given complete

iron with folic acid supplementation. Complete iron tablet with

folic acid supplementation refers to 60 mg of elemental iron with

400 mcg Folic acid, once a day for 6 months or 180 tablets for

the entire pregnancy period. The iron tablets may be given to the

mother for free or purchased by the mother from outside sources.

Purchase of iron tablets by the mothers are verified by

presentation of blister packs or receipts to the health personnel.


Unit of measurement

Numerator Number of pregnant women given complete iron with folic acid

supplementation

Denominator For FHSIS: Total number of pregnant women as estimated by

total population x 2.7%. The figure 2.7% is provided by the

Philippine Statistics Authority.



By province



Limitations/ Comments Provision of iron with folic acid supplementation does not mean

actual intake of the pregnant woman.






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Proportion of pregnant women examined by a doctor


Indicator name Proportion of pregnant women examined by a doctor

Abbreviated name Pregnant women examined by a doctor

International name

Topic Prenatal Care


Rationale Rural health midwives have limitations with regard to clinical and

medical practice which include diagnosis and treatment. Hence, a

visit with the doctor is needed.

Definition This refers to the proportion of pregnant women who were

examined and treated (if needed) by a doctor at least once during a

prenatal visit.


Unit of measurement

Numerator Number of pregnant women who were examined and treated if

needed by a doctor at least once during a prenatal visit



By province





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Pregnant women provided with Basic Oral Health Care


Indicator name Pregnant women provided with Basic Oral Health Care

Abbreviated name Pregnant women BOHC

International name

Topic Prenatal Care


Rationale This is to measure the outcome of total health care of pregnant

women for planning and evaluation.

Definition This refers to the proportion of pregnant women who were

provided with Basic Oral Health Care (BOHC).

Basic Oral Health Care (BOHC) provided to pregnant women

refers to one or more of the following services:

1. Oral Examination

2. Scaling

3. Permanent Filling

4. Gum Treatment


Unit of measurement

Numerator Number of pregnant women provided with BOHC

Denominator For FHSIS: Total number of pregnant women as estimated by

total population x 2.7%. The figure 2.7% is provided by the

Philippine Statistics Authority.



By province









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Proportion of pregnant women with basic laboratory examinations


Indicator name Proportion of pregnant women with basic laboratory

examinations

Abbreviated name Pregnant women with basic laboratory examinations

International name

Topic Prenatal Care


Rationale Basic laboratory examinations ensure that infections and

probable complications are determined earlier in the pregnancy.

This also ensure that immediate and early treatment can be

provided.

Definition This refers to the proportion of pregnant women who underwent

urinalysis, blood typing and hemoglobin testing at least once

during their pregnancy.


Unit of measurement

Numerator Number of pregnant women who underwent urinalysis, blood

typing and hemoglobin testing at least once during their

pregnancy



By province





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Proportion of pregnant women given health information


Indicator name Proportion of pregnant women given health information

Abbreviated name Pregnant women given health information

International name

Topic Prenatal Care


Rationale Health information giving is important to ensure that pregnant

women leave the visit with enough knowledge regarding her

pregnancy.

Definition This refers to the proportion of pregnant women provided with

information and counseling on maternal and child care including

family planning, nutrition, hygiene, breastfeeding, birth plan,

newborn screening, and STI/ HIV.


Unit of measurement

Numerator Number of pregnant women provided with information and

counseling on maternal and child care



By province





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Proportion of pregnant women given 2 doses of tetanus toxoid


Indicator name Proportion of pregnant women given 2 doses of tetanus toxoid

Abbreviated name TT2

International name

Topic Prenatal Care


Rationale This is to assess the level of TT immunization protection among

pregnant women.

Definition This refers to the proportion of pregnant women immunized

against tetanus, having at least two doses of tetanus toxoid

during pregnancy.


Unit of measurement

Numerator Number of pregnant women given 2 doses of tetanus toxoid

Denominator Total number of pregnant women as estimated by total

Population x 2.7%. The figure 2.7% is provided by the Philippine

Statistical Authority.


By province









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Proportion of births attended by skilled health personnel


Indicator name Proportion of births attended by skilled health personnel

Abbreviated name Skilled birth attendance or SBA

International name

Topic Safe Delivery


Rationale All women should have access to skilled care during pregnancy

and childbirth to ensure prevention, detection and management of

complications. Assistance by properly trained health personnel

with adequate equipment is key to lowering maternal deaths. As it

is difficult to accurately measure maternal mortality, and model-

based estimates of the maternal mortality ratio cannot be used for

monitoring short-term trends, the proportion of births attended by

skilled health personnel is used as a proxy indicator for this

purpose.

Definition Skilled health personnel (sometimes referred to as skilled

attendant) is defined as an accredited health professional such as

midwife, doctor or nurse. Skilled health personnel are trained to

manage pregnancies, childbirth and the immediate postnatal

period and identification, management and/ or referral of

complications in women and newborns.


Unit of measurement

Numerator Number of deliveries attended by skilled health personnel


Disaggregation By type of skilled health personnel (doctor, nurse, midwife)


By province





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Facility-based delivery


Indicator name Facility-based delivery

Abbreviated name FBD

International name

Topic Safe Delivery


Rationale It is a measure of the health system's functionality and potential

to provide adequate coverage for deliveries.

Definition Proportion of births delivered in a facility. Facility-based delivery

refers to delivery in the barangay health station, rural health

units, safe birthing facilities or lying-in clinics, hospitals both

public and private.


Unit of measurement

Numerator Number of deliveries in health facilities



By type of delivery (normal, cesarean)


By province



Limitations/ Comments This is aligned with FHSIS indicator "Proportion of deliveries by

place."






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Proportion of postpartum women with at least 2 postpartum visits


Indicator name Proportion of postpartum women with at least 2 postpartum visits

Abbreviated name Postpartum women with at least 2 postpartum visits

International name



Rationale Postpartum visits ensure that women who delivered within 42

days are checked and possible complications are identified and

managed. Good postpartum visit is also related to reduce

maternal deaths by reducing postpartum complications such as

hemorrhage.

Definition This indicator refers to the proportion of post‐partum women with

at least 2 postpartum visits. Postpartum visits refer to visits seen

by the midwife, nurse or doctor at home or at the clinic within 24

hours and within 7 days after delivery.

Note: Pregnant women who delivered in the facility is already

considered seen in the first visit which is 24 hours upon delivery.


Unit of measurement

Numerator Number of postpartum women with at least 2 postpartum visits

Denominator Total number of women delivered

Disaggregation By time of visit (within 24 hours or within 7 days)


By province









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Proportion of postpartum women with at least 1 clinic visit


Indicator name Proportion of postpartum women with at least 1 clinic visit

Abbreviated name Postpartum women with at least 1 clinic visit

International name



Rationale Postpartum visits ensure that women who delivered within 42

days are checked and possible complications are identified and

managed. Good postpartum visit is also related to reduce

maternal deaths by reducing postpartum complications such as

hemorrhage.

Definition This indicator refers to the proportion of postpartum women with

at least 1 clinic visit. Clinic visit refers to a visit seen by the

midwife, nurse or doctor at home or at the clinic within the 4th to

6th week after delivery.


Unit of measurement

Numerator Number of postpartum women with at least 1 clinic visit

Denominator Total number of women delivered


By province





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Number of maternal deaths


Indicator name Number of maternal deaths

Abbreviated name Maternal deaths

International name

Topic Mortality

M&E Framework Impact

Rationale The maternal mortality ratio is the most widely used measure of

maternal death. It measures obstetric risk – in other words, the

risk of a woman dying once she is pregnant. It does not therefore

take into account the risk of being pregnant (i.e. fertility) in a

population, which is measured by the maternal mortality rate or

the lifetime risk.

Definition Maternal death is the death of woman while pregnant or within

42 days of termination of pregnancy, irrespective of the duration

and the site of the pregnancy, from any cause related to or

aggravated by the pregnancy or its management, but not from

accidental or incidental causes.

Data type Count

Unit of measurement

Numerator Number of maternal deaths

Denominator N/A

Disaggregation By place of origin and place of occurrence

By place of delivery

By age group

By parity

By attendant at birth

By causes of death


By province



Limitations/ Comments Under reporting for deaths at home; death certification issues at

home and misdiagnosis in facilities that may lead to under or

over reporting; limitations on the conduct of investigation and

review; certification comes prior death review; results of MDR do

not update the LCR






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Maternal mortality ratio


Indicator name Maternal mortality ratio

Abbreviated name MMR

International name Maternal mortality ratio

Topic Mortality

M&E Framework Impact

Rationale The maternal mortality ratio is the most widely used measure of

maternal death. It measures obstetric risk – in other words, the

risk of a woman dying once she is pregnant. It does not therefore

take into account the risk of being pregnant (i.e. fertility) in a

population, which is measured by the maternal mortality rate or

the lifetime risk.

Definition The ratio of the number of maternal deaths per 100,000

livebirths per year.

Data type Ratio

Unit of measurement Deaths per 100,000 livebirths

Numerator Number of maternal deaths

Denominator Number of livebirths x 100,000

Disaggregation By province

Data source RHIS


Limitations/ Comments Underreporting for deaths at home; death certification issues at

home and misdiagnosis in facilities that may lead to

underreporting or over reporting; limitations on the conduct of

investigation and review; certification comes prior death review;

results of MDR do not update the LCR






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