Attention to global newborn health policies and programs has grown over the past few years and data are increasingly available for this previously invisible issue. However there is still a need for more and better programmatically relevant data for decision making.

There is an urgent need to develop and refine standardized indicators to monitor and evaluate newborn health programs that can be tracked via large population-based surveys, such as the USAID-supported Demographic and Health Surveys (DHS) and the UNICEF-supported Multiple Indicator Cluster Surveys (MICS), and also via independent newborn research projects, and country-led health information systems at national and district level.


The newborn indicators technical working group

To address this need, in April 2008 Save the Children’s Saving Newborn Lives program (SNL) convened a meeting of experts from evaluation and measurement, researchers, UN agencies, non-governmental organizations and donors, to assess survey-based indicators to monitor and evaluate newborn health. After the April meeting, the Newborn Technical Working Group (TWG) was officially established with representatives from SNL, USAID, Macro, and UNICEF.

The TWG provides a forum to advance indicators and standard measurement tools which are critical to measure coverage of key newborn interventions in an effort to improve newborn survival.

The objectives of the working group are to:

  • Ensure consistent use of existing and expanded newborn health indicators by revising and/or developing questions on newborn health for potential inclusion in nationally representative surveys (DHS, SPA, MICS) and independent research projects.
  • Provide in-depth instruments on newborn care by developing an expanded newborn care module for consideration on a country-by-country basis for use in population-based surveys.
  • Advance the state-of-the-art in newborn care measurement by identifying priorities and opportunities to validate indicators relating to newborn health.
What has been achieved?

Several studies have been undertaken in response to the recommendations from the consultative meeting, informing revisions of indicators and survey tools. Global postnatal care coverage indicators have been finalized, and consensus has been achieved on three additional newborn indicators pertaining to immediate drying, delayed bathing, and cutting the cord with a clean instrument, with consensus to test three additional indicators on immediate skin-to-skin care, applications to the umbilical cord, and content of postnatal care.

What’s next?

The Newborn Indicators TWG is initiating smaller working groups to review and reach consensus on newborn indicators for routine monitoring systems, with a focus on HMIS; indicators to measure newborn sepsis and treatment; and indicators to measure Kangaroo Mother Care.

Learn more: Access the meeting reports

Recommended newborn indicators

Download the indicators and questions recommended by the Newborn Indicators Technical Working Group:

Household Surveys: The Newborn Indicators TWG reviewed newborn indicators that are currently collected through national surveys, including the DHS and MICS, and has recommended new indicators on newborn care practices that could be added to national and program household surveys. Download the recommended indicators for household surveys (PDF).

Health Facility Assessments: This tool includes indicators and questions for assessing newborn care services at facilities. It can be used as a stand-alone tool or can be integrated into other health facility assessment tools. Its purpose is to allow a rapid assessment of newborn care services to determine the capacity of facilities at any level to provide care for well and sick newborns. Download the newborn services rapid facility assessment tool (PDF).

We encourage you to use these tools in your own settings, and contact us if you have any questions or feedback: Tanya Guenther, Save the Children’s Saving Newborn Lives program.

Research supported by TWG

The following studies have been undertaken in response to the recommendations from the consultative meeting and Working Group:

Women’s Recall of Delivery and Neonatal Care in Bangladesh and Malawi: This study examined women’s recall of birth, postnatal, and immediate newborn care among women in Bangladesh and Malawi with deliveries at home and in health facilities in urban and rural areas in the 1-2 years and 1-3 months preceding the interview. The study was conducted between January and December 2009.

Related resources

New Signal Functions to Measure the Ability of Health Facilities to Provide Routine and Emergency Newborn Care – by Sabine Gabrysch, Giulia Civitelli, Karen M. Edmond, Matthews Mathai, Moazzam Ali, Zulfiqar A. Bhutta and Oona M. R. Campbell: This article contributes a proposed set of 23 maternal and newborn signal functions, focussing on delivery and postnatal care, that could be used to characterize both routine and emergency care in health facilities in low-income settings.

Blog by Sabine Gabrysch on new signal functions to measure provision of routine and emergency newborn care.

If you are working on research related to newborn health indicators, we want to hear from you! Send us your related research articles.