Selected Facility and Population-Based Indicators Documented by External Monitoring, Kigoma Region, 2013/2014 and 2018a,b
| Indicators From Facility-Based Surveys | 2013 | 2018 | % Change | Significancec |
|---|---|---|---|---|
| Institutional maternal mortality ratio (per 100,000 live births) | 303 | 174 | -43 | *** |
| Predischarge neonatal mortality rate (per 1,000 live births) | 10.7 | 7.6 | -29 | *** |
| Institutional intrapartum stillbirth rate (per 1,000 births) | 14.4 | 6.0 | -58 | *** |
| Number of BEmONC facilitiesd | 2 | 6 | +200 | NA |
| Number of CEmONC facilitiesd | 9 | 15 | +67 | NA |
| Indicators from population-based surveys (RHS) | 2014 | 2018 | % Change | Significancec |
| Contraceptive prevalence all methods (current use among married women aged 15–49 years) | 20.6 | 26.3 | +28 | *** |
| Contraceptive prevalence modern methods (current use among married women aged 15–49) | 15.6 | 21.0 | +35 | *** |
| Prevalence of implant and IUD use (current use among married women aged 15–49 years) | 2.1 | 9.4 | +348 | *** |
| Unmet need for contraception (married women aged 15–49 years) | 39.2 | 35.1 | -11 | *** |
Abbreviations: BEmONC, basic emergency obstetric and newborn care; CEmONC, comprehensive emergency obstetric and newborn care; EmONC, emergency obstetric and newborn care; IUD, intrauterine device; RHS,, reproductive health survey.
↵a Source: CDC evaluations in health facilities30,31 and population-based surveys.23,24,29
↵b Baseline/endline population-based indicators were measured in mid-2014 (2014 RHS)23 and mid-2018 (2018 RHS).24
↵c Asterisks indicate significance level of the difference between baseline and endline outcomes for all facilities combined, using a z-statistic test for rates and proportions to calculate the p-value of the difference, as follows: *** = P<.01. NA=Not applicable.
↵d Include facilities with provision of lifesaving interventions that constitute EmONC that performed these interventions in the last 3 months: BEmONC interventions include administration of parenteral antibiotics, uterotonics, or anticonvulsants; manual removal of placenta; removal of retained products; assisted vaginal delivery; and basic neonatal resuscitation. CEmONC interventions include 2 additional services: ability to perform obstetric surgery (e.g., C- section) and blood transfusion; BEmONC and CEmONC facilities may or may not have performed assisted vaginal delivery in past 3 months (i.e., BEmONC-1 and CEmONC-1). According to the World Health Organization—which recommends at least 5 EmONC facilities per 500,000 population, including at least 1 CEmONC facility—by 2018 Kigoma achieved a sufficient number of CEmONC facilities but is still lagging behind in BEmONC facilities.9