What to measure and why? Experience developing monitoring indicators for an emerging maternal health issue: the case of obstetric fistula

Abstract

The field of obstetric fistula has historically lacked common definitions for measuring needs and outcomes. This paper recounts the process of developing, refining, and using standardized monitoring indicators as part of a fistula prevention and repair project in fourteen countries—Bangladesh, Benin, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Liberia, Mali, Niger, Nigeria, Rwanda, Sierra Leone, Togo, and Uganda. The process included collaborative indicator development, introducing standardized data collection at health facilities, and promoting the integration of fistula indicators into national health management information systems (HMIS) to enable continued measurement and support for fistula treatment services. As monitoring of obstetric fistula continues to become more standardized and routine, the multi-country scope of the project has enabled a wide-ranging effort through which indicators for an emerging maternal health content were introduced and applied.