Table 2.
Primary and secondary outcome indicators
| Primary outcome indicators | Definition | Methods to obtain outcome |
|---|---|---|
| Fresh Stillbirth rate | Number of fresha stillbirths of at least 1000 g expressed per 1000 live and stillbirths | Perinatal e-registry |
| In-facility early perinatal mortality | Number of fresh stillbirths (as above) and up-to discharge neonatal deaths per 1000 live and stillbirths (composite indicator) | Perinatal e-registry |
| Secondary outcomes | ||
| Hypoxic-ischaemic event rate | No of neonates with APGAR < 7 at 5 min per 1000 live and stillbirths | Perinatal e-registry |
| Hypoxic-ischaemic event rate | Umbilical cord lactate of > 5.5 mmolb per 1000 live and stillbirths | Perinatal e-registry, (sub-sample) |
| Neonatal seizures | No of neonates diagnosed with seizures per 1000 live and stillbirths | Perinatal e-registry |
| Caesarean section rate (%) | No of caesarean section per 100 live and stillbirths | Perinatal e-registry |
| Severe maternal morbidity | No of women with morbiditiesc per 1000 live and stillbirths | Perinatal e-registry |
| Responsiveness (%) | Validated questionnaire [39] (% score) per 100 live and stillbirths | Survey among women at discharge (exit interviews) |
| Mistreatment (%) | Proportion of women reporting mistreatment per 100 live and stillbirths | Survey among women at discharge (exit interviews) |
| Process indicators (selected) | ||
| Detection of foetal distress | No. of detected foetal distress events per 100 deliveries defined by FIGO [40] | Perinatal e-registry |
| Decision-to-birth time for caesarean section | Median time (minutes) between decision to do a caesarean section to the birth of the baby | Perinatal e-registry |
aFresh stillbirth is defined a stillbirth that happened during labour at the respective facility, thus where the foetal heartbeat was positive at admission; bThe cut-off level may be revised based on data from an ongoing study in Uganda and validation work; cSevere maternal morbidity will be defined using pragmatic criteria of major interventions (hysterectomy, laparotomy, blood transfusion, admission to intensive care unit or referral to higher level facility)