Indicator

Change

Rationale

Fertility rate of women 15-19 years old

Deleted

By itself not a useful indicator of adolescent health (needs single year age breakdown) nor of the impact of family planning programmes.

Proportion of babies under four months old who are exclusively breastfed

Deleted

As a point prevalence measure of breastfeeding, it is not intuitively easy to understand, and its usefulness as an indicator of reproductive health is questionable.

Proportion of service delivery points offering PAP smear tests

Deleted

In the absence of additional indicators on the uptake of tests, it is not useful and needs to be defined strictly in terms of functioning facilities (i.e. those with equipment and appropriately skilled personnel for smear collection, with access to competent diagnostic facilities and effective communication in reporting results).

Percentage of pregnant women routinely screened for haemoglobin levels who are anaemic

Modified to: Percentage of women of reproductive age screened for haemoglobin levels who are anaemic

More useful if expanded to cover WRA, and then broken down into those pregnant, those lactating, and those non-pregnant/non-lactating.

Facility-based case-fatality rates for post-abortion complications

Modified to: Percentage of obstetric and gynaecology admissions owing to abortion

Case-fatality rates present interpretative problems, and proposed alternative gives clearer indication of case-load on reproductive health services.

Reported prevalence of urethral discharge among men aged 15-49 years

Added

Valid measure of self-reported morbidity in men, relevant to assessing the burden of sexually-transmitted disease. Understandable and direct indicator of the male dimension of reproductive health.

HIV prevalence among pregnant women aged 15-24 years

Discussed - considered important where HIV prevalence is high

UNAIDS advises that this is the most appropriate indicator of prevalence currently available.