Figures & Tables
Tables
- TABLE 1.
CHAT Core Indicators With Source, Data Type, and Status as Sustainable Development Goals or Every Women Every Child Global Strategy Indicators
CHAT Core Indicator Namea CHAT Recommended Definition Country Data Source Country Comparable Estimates? SDG Indicator? EWEC GS Indicator? Under-5 mortality rate Probability of dying between birth and exactly 5 years of age, per 1,000 livebirths CRVS, population-based surveys UN-IGME (annual) 3.2.1 Yes Older child mortality rate (5–9 years) Probability of dying at age 5 to 9 years expressed per 1,000 children aged 5 CRVS, population-based surveys UN-IGME (annual) No No Causes of death in children under 5 and 5 to 9 years Age specific death rates by cause as defined by ICD-11 CRVS, population-based surveys Maternal and Child Epidemiology Estimation Group, WHO Global Health Estimates No No Wasting prevalence in children under 5 % wasted (moderate and severe) children aged 0–59 months (moderate=weight for height below -2 standard deviation from the median of the WHO Child Growth Standards; severe=weight for height below -3 standard deviations from the median of the WHO Child Growth Standards) Population-based surveys; facility data UNICEF/WHO/World Bank Joint Child Malnutrition Estimates 2.2.2 Yes Overweight prevalence in children under 5b % overweight children aged under 5 years (overweight= weight for height >+2 standard deviation from the median of the WHO Child Growth Standards) Population-based surveys, facility data UNICEF/WHO/World Bank Joint Child Malnutrition Estimates 2.2.2 Yes Stunting prevalence among children under 5 % stunted (moderate and severe) children aged 0–59 months (moderate=height-for-age below -2 standard deviations from the WHO Child Growth Standards median; severe=height-for-age below -3 standard deviations from the WHO Child Growth Standards median) Population-based surveys, facility data UNICEF/WHO/World Bank Joint Child Malnutrition Estimates 2.2.1 Yes Percentage of children under 5 years of age who are developmentally on track in health, learning, and psychosocial well-being, by sex (ECDI2030) Proportion of children under 5 years of age who are developmentally on track in health, learning, and psychosocial well-being is currently being measured by the percentage of children aged 24–59 months who are developmentally on-track in at least 3 of the following 4 domains: literacy-numeracy, physical, socio-emotional, and learning. UNICEF Multiple Indicator Cluster Surveys No 4.2.1 Yes Exclusive breastfeeding Proportion of children aged 0–5 months who are exclusively fed with breast milk National and other surveys No No Yes Vitamin A supplementation (full coverage) % children aged 6–59 months who received 2 age-appropriate doses of vitamin A in the past 12 months National and other surveys, facility data UNICEF global nutrition database based on administrative reports from countries No No Full vaccination coverage (immunization according to national schedule) Proportion of the target population covered by all vaccines included in their national program National and other surveys, facility data WHO and UNICEF Estimates of National Immunization Coverage (annual) 3.b.1 Yes Measles vaccination % children who have received 2 doses of measles containing vaccine in a given year, according to the nationally recommended schedule National and other surveys, facility data WHO and UNICEF Estimates of National Immunization Coverage (annual) No Yes Care-seeking for children with symptoms of acute respiratory infection % children aged under 5 years with acute respiratory infection (cough and difficult breathing not due to a problem from a blocked nose) in the previous 2 weeks taken to an appropriate health facility or provider National and other surveys, facility data No As part of 3.8.1 Yes Care-seeking for fever in children under the age of 5 % children aged under 5 years with fever in the previous 2 weeks taken to an appropriate health facility or provider National and other surveys, facility data No No No Diarrhea treatment (ORS and zinc) % children aged under 5 years with diarrhea in the last 2 weeks receiving ORS (fluids made from ORS packets or prepackaged ORS fluids) and zinc supplement National and other surveys, facility data No No Yes Maltreatment, harsh punishment by caregivers Proportion of children aged 1–17 years who experienced any physical punishment and/or psychological aggression by caregivers in the past month UNICEF Multiple Indicator Cluster Surveys capture this indicator for children aged 1 to 14 years No 16.2.1 No Neural tube defect (prevalence) Prevalence of disorders that occur during gestation, involving specific elements of the neural tube; consensus needed on a definition of prevalence for children younger than 5 years and for children aged 5–9 years National birth defect registries, facility data WHO and partners burden of birth defects estimates (expected 2024) No No Uncorrected refractive error (prevalence) Prevalence of refractive errors (eye disorders impeding the full development of good visual function) that have not been corrected; consensus needed on a definition of prevalence for children younger than 5 years and for children aged 5–9 years Special surveys No No No Asthma (prevalence) % of children younger than 5 years and children aged 5–9 years with asthma Special surveys, facility data Estimates from WHO, IHME, and others No No Anemia prevalence in children % of children aged 6−59 months with a hemoglobin concentration of <110 g/L, adjusted for altitude Special surveys, facility data WHO Global Database on Anemia No No Road traffic accidents Years of life lost to disability due to road traffic accidents among children aged 0–9 years Special surveys, facility data, and road traffic authority/police reports WHO Global Health Estimates, Child and Adolescent Cause of Death Estimates (CA-CODE; WHO and partners) No No Abbreviations: CHAT, Child Health Accountability Tracking; CRVS, civil registration and vital statistics; ECDI2030, Early Childhood Development Index 2030; EWEC GS, Every Woman Every Child Global Strategy; ICD-11, International Classification of Diseases 11th Revision; IHME, Institute for Health Metrics and Evaluation; ORS, oral rehydration solution; SDG, Sustainable Development Goal; UN-IGME, United Nations Inter-agency Group for Child Mortality Estimation; WHO, World Health Organization.
↵a For all indicators, data or estimates are used by national governments and international agencies.
↵b CHAT technical advisory group recommends that this indicator be extended also to ages 5–9 years.
CHAT Core Indicator Namea CHAT Recommended Definition Country Data Source Country Comparable Estimates? SDG Indicator? EWEC GS Indicator? New HIV infections Estimated number of new HIV infections per 1,000 uninfected population at risk of HIV infection National and other surveys, facility data UNAIDS (annual) 3.3.1 Yes TB incidence Number of new and recurrent (relapse) episodes of TB (all forms) occurring in a given year Country notifications, prevalence studies WHO Global TB Programme (annual) 3.3.2 Yes Thalassemia prevalence Birth prevalence of thalassemia Country notifications (birth defect registries), prevalence studies Estimates from WHO, IHME, and others No No Use of insecticide treated bed-nets in children under-5 years % children ages 0–59 months who slept under an insecticide-treated mosquito net the night prior to the survey National and other surveys No No Yes Malaria diagnostics in children under-5 years Proportion of children aged 0–59 months with fever in the last 2 weeks who had a finger or heel stick test National and other surveys, facility data No No No Malaria treatment - first-line treatment for children under-5 years % febrile children aged younger than 5 years receiving first-line antimalarial drug, among those receiving any antimalarial drug National and other surveys, facility data No No No Abbreviations: CHAT, Child Health Accountability Tracking; EWEC GS, Every Woman Every Child Global Strategy; IHME, Institute for Health Metrics and Evaluation; SDG, Sustainable Development Goal; UNAIDS, Joint United Nations Programme on HIV/AIDS; WHO, World Health Organization.
↵a For all indicators, data or estimates are used by national governments and international agencies.
Data Collection Reporting Cycle; Population Measured Original Source Strengths Limitations Link to Core Indicators and SDGs CRVS Annual; National population National administrative records for births, deaths, and marriages If registration is complete and the system functions efficiently, the data can be used to produce comparable country level estimates that are accurate and timely. Costly to set up and maintain; in the absence of good coverage and completeness of CRVS data, may not cover the whole population or it could be incomplete. Cause of death; inputs into under-5 mortality (3.2.1), mortality in children 5 to 9 years, birth registration (16.9) Population-based surveys 3 to 5 years; National/subnational National health surveys, DHS, MICS, censuses, malaria program surveys Collect data that can't be obtained through other methods; provide population-based measures of coverage and health status; allows for equity analyses and can be disaggregated by a variety of different characteristics to describe the population of interest. Conducted in-person in most LMICs, making them technically complex, expensive, and time consuming; reliance on respondents' self-report, which can add biases to the results; results reflect the survey reporting period with a 2-to-3-year time lag, so are not necessarily reflective of a country's current situation. Cause of death; inputs into under-5 mortality (3.2.1), mortality in children 5 to 9 years; service coverage indicators: care seeking for acute respiratory infection and fever; diarrhea treatment; immunization (SDG 3.1); ECDI2030; use of insecticide-treated bed nets; maltreatment, harsh punishment by caregiver; vitamin A supplementation Routine health information systems Monthly; Facility or service specific HMIS including DHIS2 and other platforms Data are continuously available for program monitoring and provide a finer level of detail on the performance of specific health services within health facilities. Data are only representative of the services provided through a health facility and only for those who seek care, leading to under-reported or biased coverage data. Many systems do not include services from the private sector or community providers. To create CHAT technical advisory group recommended indicators, these data would need to be used with another data source for a population-based denominator. Administrative records systems (e.g., national health accounts), service records systems (e.g., immunizations administered, HMIS), and individual records systems (e.g., patient medical records), captured in an HMIS Disease/condition registries, death audits Monthly, annual; Facility, national Disease/conditions specific registries, clearinghouses, death/disease audits Captures diseases/conditions that are rarely reported; provides additional sources of data for rare conditions or uncommon events. If facility based, may reflect only those seeking care in a facility; may not be representative of total population. Registries (cancer, birth defects), surveillance systems; thalassemia prevalence, neural tube defect prevalence new HIV infections, TB incidence Abbreviations: ARI, acute respiratory infection; CHAT, Child Health Accountability Tracking; CRVS; civil registration and vital statistics; DHS, Demographic and Health Survey; ECDI2030, Early Childhood Development Index 2030; HMIS, health management information system; LMICs, low- and middle-income countries; MICS, Multiple Indicator Cluster Survey; SDG, Sustainable Development Goal.
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- Article
- INTRODUCTION
- GLOBAL ACCOUNTABILITY MECHANISMS FOR IMPROVING CHILD HEALTH AND WELL-BEING
- INDICATORS CAPTURE DIFFERENT TYPES AND LEVELS OF INFORMATION AND SHOULD BE USED ACCORDINGLY
- FRAGMENTED M&E SYSTEMS REMAIN DESPITE SOME PROGRESS
- RECOMMENDATIONS FOR FUTURE GLOBAL MONITORING OF CHILD HEALTH AND WELL-BEING
- Acknowledgments
- Funding
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- Competing interests
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