Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, P.O.Box 222 Skøyen, N-0213, Oslo, Norway.
Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
BMC Public Health. 2019 Jan 30;19(1):124. doi: 10.1186/s12889-019-6427-8.
Policy making in healthcare requires reliable and local data. Different sources of coverage data for health interventions can be utilized to populate the Lives Saved Tool (LiST), a commonly used policy-planning tool for women and children's health. We have evaluated four existing sources of antenatal care data in Palestine to discuss the implications of their use in LiST.
We identified all intervention coverage and health status indicators around the antenatal period that could be used to populate LiST. These indicators were calculated from 1) routine reported data, 2) a Multiple Indicator Cluster Survey (MICS), 3) paper-based antenatal records and 4) the eRegistry (an electronic health information system) for public clinics in the West Bank, Palestine for the most recent year available. We scaled coverage of each indicator to 90%, in public clinics only, and compared this to a no-change scenario for a seven-year period.
Eight intervention coverage and health status indicators needed to populate the antenatal section of LiST could be calculated from both paper-based antenatal records and the eRegistry. Only two could be calculated from routine reports and three from a national survey. Maternal lives saved over seven years ranged from 5 to 39, with percent reduction in the maternal mortality ratio (MMR) ranging from 1 to 6%. Pre-eclampsia management accounted for 25 to 100% of these lives saved.
The choice of data source for antenatal indicators will affect policy-based decisions when used to populate LiST. Although all data sources have their purpose, clinical data collected directly in an electronic registry during antenatal contacts may provide the most reliable and complete data to populate currently unavailable but needed indicators around specific antenatal care interventions.
医疗保健政策制定需要可靠和本地的数据。可以利用健康干预措施的不同覆盖数据源来填充 Lives Saved Tool（LiST），这是一种常用于妇女和儿童健康的政策规划工具。我们评估了巴勒斯坦的四种现有的产前护理数据来源，以讨论它们在 LiST 中的使用所带来的影响。
我们确定了可以用于填充 LiST 的所有产前期间的干预覆盖和健康状况指标。这些指标是从以下四个来源计算得出的：1）常规报告数据；2）多指标类集调查（MICS）；3）纸质产前记录；4）西岸巴勒斯坦公立诊所的电子注册表（电子健康信息系统），这些数据是当年最新的。我们将每个指标的覆盖率调整到 90%，仅在公立诊所中，并将其与七年期间的不变情景进行比较。
可以从纸质产前记录和电子注册表中计算出填充 LiST 产前部分所需的八种干预覆盖和健康状况指标。只有两种可以从常规报告中计算，三种可以从国家调查中计算。七年期间挽救的产妇生命数范围从 5 到 39，孕产妇死亡率（MMR）降低百分比范围从 1 到 6%。子痫前期管理占这些挽救生命数的 25%至 100%。
在用于填充 LiST 时，产前指标数据来源的选择将影响基于政策的决策。虽然所有数据源都有其用途，但在产前接触期间直接在电子注册表中收集的临床数据可能提供最可靠和完整的数据，以填充目前缺乏但需要的特定产前护理干预措施的指标。
