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Table 2 Seven Indicators for measuring SMRAC

From: Strengthening health systems capacity to monitor and evaluate programmes targeted at reducing abortion-related maternal mortality in Jessore district, Bangladesh

SMRAC indicators Definition Recommendation
Are enough facilities providing SMRAC services?
1. Amount of SMRAC services available Number of facilities providing basic and comprehensive SMRAC For every 500,000 population: 5 SMRAC facilities, at least 1 of which offers comprehensive SMRAC
Are SMRAC services well-distributed?
2. Distribution of SMRAC facilities Number of facilities providing basic and comprehensive SMRAC in sub national areas Minimum: 100 % of sub-national areas have adequate level of SMRAC as recommended in indicator 1
What proportion of services for women with obstetric complications are services for MR/abortion complications?
3. Proportion of women treated for obstetric complications that are MR/abortion related Numerator: number of women with MR/abortion complications treated at a facility in a given period; Over time, a declining percentage of women with abortion/MR complications
Denominator: number of all women with obstetric complications treated at facility in the same time period
How common are serious abortion/MR complications?
4. Proportion of women treated for MR/abortion complications that are serious Numerator: number of women with serious MR/abortion complications treated at a facility in a given period; Denominator: number of all women with any MR/abortion complications treated at facility in the same time period Over time a declining percentage of women with serious MR/abortion complications
To what extent are MR and safe, legal abortion being provided?
5. Proportion of women who receive MR and safe, legal abortion among all women receiving MR/abortion care Numerator: number of women receiving MR and safe, legal abortion procedures at a facility in a given time period Over time, a shift towards a higher proportion of women receiving MR and safe, legal abortion
Denominator: number of all women receiving MR and abortion-related services in facility in the same time period Recommended level: Approaching 100 %
Are appropriate technologies being used?
6. Proportion of uterine evacuations performed with appropriate technology Numerator: number of uterine evacuation procedures performed with appropriate technology at facility in a given period. Over time, a shift toward a higher proportion of procedures performed with appropriate technology as per WHO recommendationsa
Denominator: number of all uterine evacuation procedures performed at facility within the same time period Recommended level: 100 %
Are women who have received MR or safe, legal abortion or treatment for MR/abortion complications provided contraception before being discharged from a facility?
7. Proportion of women receiving MR, safe, legal abortion, or treatment for MR/abortion complications who obtain contraception before leaving facility Numerator: number of women receiving MR, safe, legal abortion or treatment for MR/abortion complications who obtain contraception before leaving facility At least 60 % of all women receiving MR/abortion services accept contraception
Denominator: number of women receiving MR, safe, legal abortion, or treatment for MR/abortion complications in facility in the same time period.
  1. Adapted from Healy et al. [9]
  2. aWHO has provided evidence-based guidance on the preferred methods of uterine evacuation for different stages of pregnancy [17]