Evaluation of maternal health programs: approaches, methods and indicators

Evaluation of maternal health services is an essential function of any health system. Single or multiple aspects of a program can be evaluated but they must be clearly defined. To assess success of a program the dimensions of coverage, equity, quality, women's satisfaction, efficiency and cost-effectiveness must be considered. These can be measured according to some standard criteria, and various methods are described, including randomized clinical trials, randomized community trials, before and after studies, and observational studies, including the case-control approach and confidential inquiries into maternal deaths. Indicators to assess effectiveness of a maternal health program may relate to structure, i.e., available resources or organizational arrangement; process, including changes in quantity of services provided; or outcome indicators that measure maternal mortality or morbidity.