TY - JOUR T1 - Household Survey Measurement of Newborn Postnatal Care: Coverage, Quality Gaps, and Internal Inconsistencies in Responses JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 737 LP - 751 DO - 10.9745/GHSP-D-21-00209 VL - 9 IS - 4 AU - Kimberly Peven AU - Louise Tina Day AU - Debra Bick AU - Edward Purssell AU - Cath Taylor AU - Joseph Akuze AU - Lindsay Mallick Y1 - 2021/12/31 UR - http://www.ghspjournal.org/content/9/4/737.abstract N2 - Key FindingsReports of receipt of a newborn postnatal care check do not necessarily reflect adequate provision of interventions resulting in large gaps between reported contact coverage and recommended content of newborn postnatal care (26%–89%) in 15 low- and middle-income countries.We found internal inconsistencies in survey responses regarding receipt of newborn postnatal care (“no” to whether anyone checked on the newborn's health, but “yes” to questions on specific newborn interventions), which were as high as 16% in Malawi.Key ImplicationsCo-coverage measures may provide a useful summary of contact and content, reflecting coverage and an aspect of quality for tracking and monitoring progress towards global goals.Researchers can use this individual-level measure for equity analyses and to easily carry out multicountry studies or time-trend studies.Gaps in the provision of newborn care interventions indicate missed opportunities for delivering high-quality postnatal care. Facility managers and policy makers should identify bottlenecks or gaps in service provision that can be addressed to improve the quality of care.Background:Reliable measurement of newborn postnatal care is essential to understand gaps in coverage and quality and thereby improve outcomes. This study examined gaps in coverage and measurement of newborn postnatal care in the first 2 days of life.Methods:We analyzed Demographic and Health Survey data from 15 countries for 71,366 births to measure the gap between postnatal contact coverage and content coverage within 2 days of birth. Coverage was a contact with the health system in the first 2 days (postnatal check or newborn care intervention), and quality was defined as reported receipt of 5 health worker-provided interventions. We examined internal consistency between interrelated questions regarding examination of the umbilical cord.Results:Reported coverage of postnatal check ranged from 13% in Ethiopia to 78% in Senegal. Report of specific newborn care interventions varied widely by intervention within and between countries. Quality-coverage gaps were high, ranging from 26% in Malawi to 89% in Burundi. We found some internally inconsistent reporting of newborn care. The percentage of women who reported that a health care provider checked their newborn's umbilical cord but responded “no” to the postnatal check question was as high as 16% in Malawi.Conclusion:Reliable measurement of coverage and content of early postnatal newborn care is essential to track progress in improving quality of care. Postnatal contact coverage is challenging to measure because it may be difficult for women to distinguish postnatal care from intrapartum care and it is a less recognizable concept than antenatal care. Co-coverage measures may provide a useful summary of contact and content, reflecting both coverage and an aspect of quality. ER -