Summary of validation results: Indicators that could not be assessed due to small cell size*.

<p>Sensitivity and specificity were not analyzed in cases where the n of any cell was <5.</p

Measuring Coverage in MNCH: Testing the Validity of Women's Self-Report of Key Maternal and Newborn Health Interventions during the Peripartum Period in Mozambique

<div><p>Background</p><p>As low-income countries strive to meet targets for Millennium Development Goals 4 and 5, there is growing need to track coverage and quality of high-impact peripartum interventions. At present, nationally representative household surveys conducted in low-income settings primarily measure contact with the health system, shedding little light on content or quality of care. The objective of this study is to validate the ability of women in Mozambique to report on facility-based care they and their newborns received during labor and one hour postpartum.</p><p>Methods and Findings</p><p>The study involved household interviews with women in Mozambique whose births were observed eight to ten months previously as part of a survey of the quality of maternal and newborn care at government health facilities. Of 487 women whose births were observed and who agreed to a follow-up interview, 304 were interviewed (62.4%). The validity of 34 indicators was tested using two measures: area under receiver operator characteristic curve (AUC) and inflation factor (IF); 27 indicators had sufficient numbers for robust analysis, of which four met acceptability criteria for both (AUC >0.6 and 0.75</p><p>Conclusions</p><p>Women are able to report on some aspects of peripartum care. Larger studies may be able to validate some indicators that this study could not assess due to the sample size. Future qualitative research may assist in improving question formulation for some indicators. Studies of similar design in other low-income settings are needed to confirm these results.</p></div

Summary of validation results: Recommended indicators.

<p>Summary of validation results: Recommended indicators.</p

Background characteristics: Percent distribution of respondents in the follow-up study; Women whose deliveries were observed in the Quality of Care Study [31]; and Women who delivered in a health facility in the 2008 MICS (a nationally representative sample of women of reproductive age).

a<p>Based on 487 women observed in the Quality of Care Study <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0060694#pone.0060694-MCHIP1" target="_blank">[31]</a> who gave consent to the follow-up interview.</p

List of 34 indicators for which validation was attempted in this study.

a<p>Any indicator referring to newborns or stillbirths refers to the second twin in cases of multiple birth.</p

Summary of validation results: Indicators not recommended.

a<p>Uterotonic (injection) within a few minutes after birth, controlled cord traction AND fundal massage after delivery of placenta.</p

Assessment of balance in recruitment, enrollment, measurement, coverage of the intervention, and early postpartum hemorrhage (PPH) treatment between groups.

<p>Assessment of balance in recruitment, enrollment, measurement, coverage of the intervention, and early postpartum hemorrhage (PPH) treatment between groups.</p

Trend in PPH-1 by study arm of trial.

<p>Trend in PPH-1 by study arm of trial.</p

Secondary safety outcome measures, by group.

*<p>Defined as: clearing of infant airways, ventilation, cardiac massage.</p

Assessment of balance between the oxytocin and control groups achieved through the randomization process among enrolled women.

*<p>Includes: Bimoba/Chokosi, Fulani, Ga/Adangbe/Ewe, Sisala/Wala, Zambraba, Banda/Pantra, and other (non-specified).</p>**<p>Score based on unweighted sum of 10 household assets (electricity, radio, cooker, refrigerator, television, sewing machine, cell phone, cement floor, cement walls, non-thatch roof).</p>***<p>Reported among singleton births only.</p