The Maternal and Neonatal Programme Effort Index (MNPI)

Area of Science:

• Global Health
• Public Health Policy
• Maternal and Child Health

Background:

• Maternal and neonatal mortality remain significant global health challenges.
• Measuring national program effort is crucial for effective intervention strategies.

Purpose of the Study:

• To introduce and validate the Maternal and Neonatal Programme Effort Index (MNPI).
• To assess national program efforts in reducing maternal and neonatal mortality across diverse regions.

Main Methods:

• Developed a questionnaire with 14 headings and 81 items to create the MNPI.
• Collected data from 10-25 raters per country using a 0-5 adequacy scale.
• Covered 49 countries across major geographical regions, assessing data for the current year and 3 years prior.

Main Results:

• Average country program scores reached approximately 50% of the maximum potential.
• Significant variations in scores were observed across the 14 effort components, with low scores for rural women's treatment access and high scores for neonatal care.
• Regional averages showed minimal differences overall, but South Asia scored particularly low and East Asia high.
• Program scores increased by approximately 10% over the 3-year period.
• Most MNPI components differentiated between high and medium maternal mortality countries, with about half distinguishing medium from low mortality countries.

Conclusions:

• The MNPI provides a valuable tool for measuring various dimensions of maternal and neonatal health program efforts.
• The index demonstrates a sensible relationship with maternal mortality rates, offering insights for targeted interventions.