Percent

All women should have access to quality of care during pregnancy and childbirth to ensure prevention, detection and management of complications. Assistance by competent health care personnel working within an enabling environment is needed to eliminate preventable maternal and newborn mortality and prevent morbidity. A key strategy to ensure skilled care during childbirth is that all births take place in health facilities in which obstetric complications can be managed and treated when they arise. Achieving universal coverage for this indicator is therefore essential for reducing maternal and newborn mortality and morbidity.

Percentage of births delivered in a health facility. The indicator refers to women who had a live birth in a recent time period, generally two years for Multiple Indicator Cluster Surveys (MICS) and two to five years for Demographic and Health Surveys (DHS), and one year for administrative data.

Numerator: number of births delivered in a health facility. Denominator: the total number of live births in the same period. Births delivered in a health facility = (number of delivered births in a health facility)/(total number of live births in the same period) x 100. In household surveys, such as DHS and MICS the respondent is asked about the most recent birth and where the who helped during delivery for a period up to five years before the interview.

Outcome

Data for global monitoring are collected by WHO. WHO obtains the data from national sources; both survey, facility and registry data. Before data can be included in the global databases, WHO undertakes a process of data verification that includes correspondence with field offices to clarify any questions if needed.

Percent

Annual

Annual

Births delivered in a health facility is an indicator of health care utilization. It is a measure of the health system’s functioning and potential to provide adequate coverage for childbirth. On its own, however, this indicator does not provide insight into the availability or accessibility of services, for example in cases where emergency care is needed. Neither does this indicator capture the quality of care received.

Preferred data sources:

National-level household surveys are the main data sources used to collect data for births delivered in health facility. These surveys include DHS, MICS and Reproductive Health Surveys (RHS) and other national surveys based on similar methodologies. In these surveys the respondent is asked about the last live birth and place of birth the for a period up to five years before the interview. Surveys are undertaken every three to five years. Population-based surveys are the preferred data source in countries with a low utilization of childbirth services, where private sector data are excluded from routine data collection, and/or with weak health information systems. Routine service/facility records are a more common data source in countries where a high proportion of births occur in health facilities and are therefore recorded. These data can be used to track the indicator on an annual basis.

mollera@who.int

Ann-Beth Moller