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Fig. 3 | BMC Pregnancy and Childbirth

Fig. 3

From: eRegistries: indicators for the WHO Essential Interventions for reproductive, maternal, newborn and child health

Fig. 3

Correlation between indicator prevalence, statistical power and population size. Not all available indicators should be used equally when evaluating different levels of a health system. The selection of evaluation indicators should vary based on whether there is adequate power to measure a significant change and whether the outcome is modifiable by that level of the health system, a different set of indicators is appropriate for quality improvement at clinics than for national planning purposes. The figure indicates that a typical clinic (e.g. a facility with 200 births per year) only has adequate power to identify large differences in relatively frequent events, such as process indicators for interventions needed universally (i.e. SBA, immediate breastfeeding). Districts (10,000 births annually) have the ability to monitor relatively rare process indicators (management of maternal haemorrhage) as well as relatively common impacts (i.e. stillbirths) while populations the size of a typical country (e.g. 500,000 births annually) are needed to monitor rare outcomes (i.e. cause specific maternal mortality ratios or early neonatal mortality rates). All levels of the health system should be aware of the full range of indicators, but should only be evaluated on those which are appropriate at that specific level

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