RT Journal Article
SR Electronic
T1 Multisite, mixed methods study to validate 10 maternal health system and policy indicators in Argentina, Ghana and India: a research protocol
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e049685
DO 10.1136/bmjopen-2021-049685
VO 12
IS 1
A1 Jolivet, R Rima
A1 Gausman, Jewel
A1 Adanu, Richard
A1 Bandoh, Delia
A1 Belizan, Maria
A1 Berrueta, Mabel
A1 Chakraborty, Suchandrima
A1 Kenu, Ernest
A1 Khan, Nizamuddin
A1 Odikro, Magdalene
A1 Pingray, Veronica
A1 Ramesh, Sowmya
A1 Saggurti, Niranjan
A1 Vázquez, Paula
A1 Langer, Ana
YR 2022
UL http://bmjopen.bmj.com/content/12/1/e049685.abstract
AB Introduction Most efforts to assess maternal health indicator validity focus on measures of service coverage. Fewer measures focus on the upstream enabling environment, and such measures are typically not research validated. Thus, methods for validating system and policy-level indicators are not well described. This protocol describes original multicountry research to be conducted in Argentina, Ghana and India, to validate 10 indicators from the monitoring framework for the ‘Strategies toward Ending Preventable Maternal Mortality’ (EPMM). The overall aim is to improve capacity to drive and track progress towards achieving the priority recommendations in the EPMM strategies. This work is expected to contribute new knowledge on validation methodology and reveal important information about the indicators under study and the phenomena they target for monitoring. Validating the indicators in three diverse settings will explore the external validity of results.Methods and analysis This observational study explores the validity of 10 indicators from the EPMM monitoring framework via seven discrete validation exercises that will use mixed methods: (1) cross-sectional review of policy data, (2) retrospective review of facility-level patient and administrative data and (3) collection of primary quantitative and qualitative cross-sectional data from health service providers and clients. There is a specific methodological approach and analytic plan for each indicator, directed by unique, relevant validation research questions.Ethics and dissemination The protocol was approved by the Office of Human Research Administration at Harvard University in November 2019. Individual study sites received approval via local institutional review boards by January 2020 except La Pampa, Argentina, approved June 2020. Our dissemination plan enables unrestricted access and reuse of all published research, including data sets. We expect to publish at least one peer-reviewed publication per validation exercise. We will disseminate results at conferences and engage local stakeholders in dissemination activities in each study country.