Using process indicators to monitor and evaluate obstetric services in developing countries.

Measuring progress toward safe motherhood goals is an increasingly important priority for developing countries and their development partners. A defined set of process indicators is increasingly being used to monitor and evaluate the availability, use, and quality of emergency obstetric services as a practical alternative to maternal mortality (MM) measures. Measuring MM requires either efficient vital registration systems or large expensive surveys. Some of the data for process indicators are available from the existing recording systems at health facilities, and others are increasingly being incorporated into routine health information systems. The use of process indicators has demonstrated how poorly health services meet the basic needs of pregnant women and has already influenced major policy shifts in a number of countries. As more countries adopt the 6 basic indicators developed by the United Nations, work continues to identify and implement additional indicators, particularly those that will improve measurements of quality of care.