“What gets measured gets improved”: Update on Fistula Indicators IOFWG Meeting Dhaka, Bangladesh

1. “What gets measured gets improved”: Update on Fistula Indicators IOFWG Meeting Dhaka, Bangladesh 13-14th November 2012 Erin Anastasi UNFPA

2. Data, Indicators, & Research sub-working group • IOFWG asked CDC to facilitate its Data, Indicators, and Research Group (DIRG) • DIRG, leading experts in the field representing: UNFPA, USAID, CDC, EngenderHealth, AMDD, WHO, FIGO, AMREF, Johns Hopkins & others

3. Background: Measurement, M&E • Data in countries: insufficient, scarce, unreliable • Weak health information systems • Need for standardized indicators - to be integrated into routine national data collection (HMIS) • Proposed indicators: too many, too cumbersome to track

4. Compendium Development:Collaborative and Iterative Process • Started in the early meetings of the DIRG • Extensive literature review to identify: • Programmatic needs at several levels • Existing indicators and gaps • Existing sources of data • Initial set of indicators for discussion (160+) and matrices for detailed description  sent for feed-back from DIRG and others

5. Objectives of the Compendium • Standardized indicators that can guide collection, examination, and utilization of OF data • Includes detailedguidance on technical aspects of computing indicators • Aims to build capacity for using objective data in decision-making, advocacy, and mobilization of political will

6. Short list: 12 Indicators

7. Core Policy & Social Environment Indicators • Existence of a national OF policy or strategy • Existence of OF in the health management information system database • Existence of a functional mechanism for coordinating obstetric fistula activities in country (e.g., National Task Force for Fistula)

8. Core Prevention Indicators • Number of Basic/ • comprehensive EmOC facilities per 500,000 pop. functioning 24/7 • Obstructed labor case-fatality rate (facility-level) • Births attended by skilled personnel • Training curricula for health workers includes modules or sessions on prevention, management, &treatment of OF

9. Core Treatment Indicators • Number of sites with functioning OF treatment capacity • Proportion of repair surgeries resulting in closure of fistula and continence; • alternative indicator: Number of OF patients treated

10. Core Reintegration Indicators • Proportion of fistula treatment facilities that provide or refer patients to reintegration services • Proportion of treated women who receive reproductive health counseling (psychological counseling and family planning counseling)

11. Core Health Impact Indicator • Prevalence of obstetric fistula

12. Narratives on each specific indicator • Including:Purpose • Definition • How to Calculate • Disaggregation • Data Requirements • Data Sources • Frequency of Indicator Calculation/Reporting • Analysis and Use • Strengths and Limitations • Example

13. Next steps… finalizing & mainstreaming the indicators ‘Obstetric Fistula: Guiding Principles for Clinical Management and Program Development’ (WHO)

14. Questions? Comments? Ideas? Thank you!