Two or more population-based data points for maternal mortality in the last 10 years

The country has collected population-based data for maternal mortality at two or more time points in the past 10 years, including one in the past five years.

This indicator is one of the 26 indicators in the WHO Health Systems Strengthening (HSS) Handbook of indicators Information Systems Performance Index (HISPIX), which can be summed to form a composite score (WHO, 2010). For more background on the process and criteria used in developing the WHO Handbook of Indicators for HSS and for details on this and related indicators, see WHO (2010) and USAID (2009).

Reviews of country reports can ascertain when and how often population-based surveys have been conducted that include measures of maternal mortality, such as Demographic and Health surveys (DHS), the UNICEF Multiple Indicator Cluster Surveys (MICS), or the WHO World Health Survey (WHS).

Country reports; population-based surveys providing information on maternal mortality, such as DHS, MICS, and WHS


This indicator assesses the country’s commitment to conducting   population-based surveys that include measures of core reproductive health (RH) outcome indicators, such as maternal mortality, and are frequent and recent enough to be useful for RH policy, planning, and program evaluation purposes. Data from multiple time points permit evaluators to establish baselines and track changes. A well-functioning national health information system (HIS) that provides sound and reliable information is the foundation of decision-making across all aspects of the health system. Collection and analysis of accurate and timely data on RH outcomes, such as maternal mortality, are essential for informing health system policy development, allocation of funds, and implementation of programs and interventions.

WHO recommends that countries fund and implement surveys that provide at least the following information (WHO, 2010):

  • A 10-year costed survey plan that covers all priority health topics
  • Two or more data points available for child mortality in the past five years
  • Two or more population-based data points for maternal mortality in the past 10 years, including one in the past five years
  • Two or more data points for coverage of key health interventions in the past five years
  • One or more data point on smoking and adult nutritional status in the past five years

Strengthening national HIS capacity for collection of data on maternal mortality and other RH outcomes is fundamental to the achievement of the health-related Millennium Development Goals: #4 reduce child mortality; #5 improve maternal health; and # 6 combat HIV/AIDS, tuberculosis and malaria.

While this indicator demonstrates if the country has been collecting periodic and timely survey data on RH outcomes, it does not capture how the information is used for policy decision-making, planning and programs.

policy, health system strengthening (HSS), safe motherhood (SM)


USAID, 2009, Measuring the Impact of Health Systems Strengthening, A Review of the Literature, Washington, DC: USAID.

WHO, 2010, Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies, Geneva: WHO.

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