'Effective coverage' of facility-based deliveries: exploring the relevance and feasibility of a global health indicator from the bottom up.

Encouraging women to give birth in health facilities is considered a key strategy to prevent women and babies from dying. However, facility-based delivery (FBD) is increasingly understood not to be enough to reduce maternal and perinatal mortality. Measuring only the coverage of FBD in a particular context does not reflect the content and quality of care women receive. To address this shortcoming, effective coverage measures – which introduce the dimension of quality of care to the measurement of intervention coverage – are proposed as the new best practice. However, the relevance and feasibility of measuring effective coverage of FBD (ECFBD) in low-resource contexts remains understudied. We have limited insight into the conceptual and practical challenges which may hamper operationalisation of this indicator. My project addresses this research gap by investigating the relevance and feasibility of measuring ECFBD across Tanzanian health system levels, from the facility-level in Newala district, up to regional, national, and international levels. By using qualitative research methods and studying experiences 'from the ground up', the project will shed light on the tensions between international measurement demands and local needs, as well as how they might be addressed. My findings will thus be able to inform future efforts to measure ECFBD, hereby contributing to promoting global health measurement that is truly helpful to improve local-level health services and outcomes.

Keywords:SUB-SAHARAN AFRICA, GLOBAL HEALTH

Disciplines:Social medical sciences not elsewhere classified, Reproductive medicine, Tropical medicine, Medical anthropology

Project type:Collaboration project