Table 1.

Childbirth care indicators and data recording methods compared with birth observations (gold standard) for validation analyses

		Comparison data recording method*
Indicator	Births observation	Facility exit interview	Household follow-up interview	Facility maternity register
Skilled birth attendance and companionship during labor and delivery:
Main provider – doctor, nurse, or midwife	X	X	X	X
More than one provider present at birth	X	X	X
Support person present at birth	X	X	X
Care for the woman:
Maternal background†:
Age at delivery (adolescent births)	X			X
Prior parity (prior parity, 4 or more births)	X			X
Provider practices and respectful care:
Woman allowed to move and change position during labor	X	X
Woman allowed to drink liquids and eat during labor	X	X
Woman allowed to deliver in preferred position	X	X
Woman allowed to have a support person at birth	X	X	X
Birth attendant washed hands with soap before examinations	X	X	X
Birth attendant wore gloves during examinations	X	X	X
Partograph used to monitor labor and delivery	X			X
Clinical care:
Blood pressure taken – initial client assessment	X	X	X
Episiotomy performed	X	X	X
Prophylactic uterotonic administered during third stage of labor to prevent postpartum hemorrhage	X	X	X	X
Care for the newborn:
Immediate postnatal care:
Mother and newborn kept in same room after delivery	X	X	X
Newborn immediately dried with a towel	X	X	X
Newborn immediately placed skin-to-skin	X	X	X
Immediate initiation of breastfeeding	X	X	X
Essential newborn care‡	X	X	X	X
Chlorhexidine applied to newborn's cord to prevent infection	X	X
Baby weighed at birth	X	X	X	X
Newborn outcomes:
Low birthweight, <2500 g†	X	X		X
Pre-term birth	X			X
Stillbirth, fresh or macerated	X			X
Total indicators	25	20	15	10

*Observed women were interviewed before discharge from the facility (exit interview) and at home nine to 22 mo after childbirth (follow-up interview). Health workers documented childbirth events in facility maternity registers.

†For validation analyses, the following indicators were converted into binary variables: age at delivery (adolescent births); prior parity (prior parity, four or more births); and baby’s birthweight (low birthweight, <2500 g).

‡In the facility maternity register, essential newborn care is a composite indicator for (i) immediate initiation of breastfeeding and (ii) baby kept warm.