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Improving Coverage Measurement for MNCH

Under the Improving Coverage Measurement for MNCH project, IIP-JHU continued increasing the quality and volume of evidence on trends in coverage for MNCH interventions that is available to Governments in low- and middle-income countries and their development partners, for use in guiding their investments and programs.

With support from the Bill & Melinda Gates Foundation, and guided by a Core Group of experts, IIP-JHU supported new studies in three areas.


ICM-supported studies have been completed in three areas: (1) a replication in Nigeria of the studies assessing treatment indicators for childhood pneumonia (implemented by University of Edinburgh); (2) two studies assessing the validity of caregivers’ reports of careseeking for sick children, in Zambia (Johns Hopkins University, Tulane University, and Chainama College) and India (University of Edinburgh and Vadu HDSS); (3) a study in Kenya of the validity of reports of the services received for the mother and her newborn one year after delivery (Population Council); (4) a study in Kenya and Swaziland assessing the validity of mothers’ reports of the content of postnatal care visits (Population Council); and (5) a study in Nepal validating birthweight, preterm, and careseeking indicators (Johns Hopkins University).


Several of the validation studies conducted in phase one of this work, and reported on in the PLOS Medicine Collection, showed that there are some indicators that cannot be measured well through household surveys. Examples include the treatment of childhood pneumonia and many of the interventions delivered to the mother and newborn around the time of birth. Work has therefore been conducted to find ways to link measurements of careseeking collected through household surveys with assessments of the care provided by health services providers. A technical consultation in April 2014 brought together those with relevant experience, as a basis for planning the research program. A systematic review of efforts to link household survey with provider assessments laid out the state of the data and identified technical issues in conducting this work.

ICM has supported two implementations of this linking approach: a pilot study in four catchment areas of Zambia, and a study in one region of Côte d’Ivoire in conjunction with the 2016 Côte d’Ivoire MICS. Both studies were designed to answer methodological questions related to the implementation of linking methods at scale, including comparing approaches to linking household and provider data, and the implications of different sampling approaches.


Coverage data are sometimes presented in ways that can lead to incorrect interpretation, or that are difficult for non-technical users to understand. One objective of the improving measurement of coverage work is to explore options for improving the dissemination of coverage results that will increase their correct interpretation and use to improve programs.


The Improving Coverage Measurement for MNCH project was renewed funding by the Bill and Melinda Gates Foundation under an umbrella grant entitled Improve - Improving Measurement and Program Design. You can find additional information here:


Launch Event at the National Press Club, November 2018

Special Issue of the Journal of Global Health

A new collection of research and reviews on measuring intervention coverage for MNCH through househould surveys.

The Improving Coverage Measurement (ICM) project, with funding from the Bill & Melinda Gates Foundation, brought together experts from academic and non-governmental institutions and survey programmes to generate evidence about the validity of MNCH coverage indicators and about approaches to improve coverage measurement. This Collection describes the research conducted by ICM, and also includes contributions from other initiatives addressing these questions. The studies included in this Collection include validation studies for antibiotic treatment for pneumonia, care-seeking for childhood illness, and interventions delivered in the intrapartum and postnatal period, as well as studies applying and comparing approaches for generating measures of effective coverage using population and health facility data.

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