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close this book15. How Can We Monitor Progress Towards Improved Maternal Health?
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View the documentSummary
View the documentIntroduction
View the documentWhat Should Be Evaluated?
Open this folder and view contentsWhat Can Be Measured?
View the documentQuality of Services
Open this folder and view contentsService Use
Open this folder and view contentsService Use in a Sub-group with Specific Needs
View the documentMultiple Indicators of Use of and Need for Obstetric Care
View the documentHealth Impact
View the documentHow Can We Attribute the Observed Changes to the Programme?
View the documentConclusion
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Conclusion

There exists no blueprint for the evaluation of safe motherhood programmes and the choice of indicators and evaluation design depends on who the decision-maker is, and on what types of decisions will be taken as a consequence of the findings. Maternal mortality is not anymore recommended as a measure against which to assess the success of safe motherhood programmes, and little is known about the value of morbidity as an alternative indicator. In contrast, adequate tools exist to assess the provision, coverage and utilisation of safe motherhood services. Because none of the indicators are perfect and none are able by themselves to point to the actions required for improving access to and use of obstetric care, the assessment of safe motherhood services must rely on a variety of indicators. For the evaluation of the quality of obstetric care, it may be preferable to focus on small-scale facility based efforts that incorporate mechanisms for improvements rather than attempt to measure complex processes or outcomes across facilities or providers.