United Nations Children's Fund, New York, New York, United States of America.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
PLoS One. 2024 May 2;19(5):e0300429. doi: 10.1371/journal.pone.0300429. eCollection 2024.
This article offers four key lessons learned from a set of seven studies undertaken as part of the collection entitled, "Improving Maternal Health Measurement to Support Efforts toward Ending Preventable Maternal Mortality". These papers were aimed at validating ten of the Ending Preventable Maternal Mortality initiative indicators that capture information on distal causes of maternal mortality. These ten indicators were selected through an inclusive consultative process, and the research designs adhere to global recommendations on conducting indicator validation studies. The findings of these papers are timely and relevant given growing recognition of the role of macro-level social, political, and economic factors in maternal and newborn survival. The four key lessons include: 1) Strengthen efforts to capture maternal and newborn health policies to enable global progress assessments while reducing multiple requests to countries for similar data; 2) Monitor indicator "bundles" to understand degree of policy implementation, inconsistencies between laws and practices, and responsiveness of policies to individual and community needs; 3) Promote regular monitoring of a holistic set of human resource metrics to understand how to effectively strengthen the maternal and newborn health workforce; and 4) Develop and disseminate clear guidance for countries on how to assess health system as well as broader social and political determinants of maternal and newborn health. These lessons are consistent with the Kirkland principles of focus, relevance, innovation, equity, global leadership, and country ownership. They stress the value of indicator sets to understand complex phenomenon related to maternal and newborn health, including small groupings of complementary indicators for measuring policy implementation and health workforce issues. They also stress the fundamental ethos that maternal and newborn health indicators should only be tracked if they can drive actions at global, regional, national, or sub-national levels that improve lives.
本文从题为“改善孕产妇健康衡量标准以支持努力消除可预防孕产妇死亡”的一组七项研究中总结了四条关键经验教训。这些论文旨在验证十项终结可预防孕产妇死亡倡议指标，这些指标涵盖了孕产妇死亡的间接原因信息。这十个指标是通过包容性的协商过程选择的，并且研究设计符合全球关于进行指标验证研究的建议。鉴于人们越来越认识到宏观层面的社会、政治和经济因素在孕产妇和新生儿生存中的作用，这些论文的发现是及时和相关的。这四条关键经验教训包括：1）加强努力，以收集孕产妇和新生儿健康政策，使全球能够进行进展评估，同时减少向各国提出的类似数据请求；2）监测指标“捆绑”，以了解政策实施的程度、法律与实践之间的不一致以及政策对个人和社区需求的响应情况；3）促进定期监测一整套人力资源指标，以了解如何有效地加强孕产妇和新生儿保健工作队伍；4）制定和传播如何评估卫生系统以及孕产妇和新生儿健康的更广泛社会和政治决定因素的明确指导意见，供各国使用。这些经验教训符合柯克兰的四项原则，即重点、相关性、创新性、公平性、全球领导力和国家自主权。它们强调了指标集在理解与孕产妇和新生儿健康相关的复杂现象方面的价值，包括用于衡量政策执行和卫生人力问题的小群组互补指标。它们还强调了一个基本理念，即只有在全球、区域、国家或国家以下各级能够采取行动改善生活的情况下，才能跟踪孕产妇和新生儿健康指标。
