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PURPOSE: A host of recent initiatives relating to adolescent health have been accompanied by varying indicator recommendations, with little stakeholder coordination. We assessed currently included adolescent health-related indicators for their measurement focus, identified overlap across initiatives, and determined measurement gaps. METHODS: We conducted a scoping review to map the existing indicator landscape as depicted by major measurement initiatives. We classified indicators as per 33 previously identified core adolescent health measurement areas across five domains and by age groups. We also identified indicators common across measurement initiatives even if differing in details. RESULTS: We identified 413 indicators across 16 measurement initiatives, with most measuring health outcomes and conditions (162 [39%]) and health behaviors and risks (136 [33%]); followed by policies, programs, and laws (49 [12%]); health determinants (44 [11%]); and system performance and interventions (22 [5%]). Age specification was available for 221 (54%) indicators, with 51 (23%) focusing on the full adolescent age range (10-19 years), 1 (

This study examined routine newborn care practices provided in the postnatal ward of primary health care facilities, known as Puskesmas, in Sikka District of eastern Indonesia The newborn mortality rate in this region is higher than the national rate despite an increasing proportion of facility based births, suggesting suboptimal quality of newborn care.We employed a mixed methods study combining qualitative and quantitative approaches, in four purposively sampled Puskesmas. Nine mothers, twelve midwives, and four key informants were interviewed on the provision and experience of postnatal care, and an audit of postnatal care processes, including observation of routine postnatal check-up was conducted. The data were analyzed using framework analysis and standard descriptive statistics.Despite appropriate regulation, national guidance on postnatal care and adequate financing that supported continuity of supplies and equipment, postnatal care practices, including counselling around newborn danger signs, did not meet the national guidelines in any of the Puskesmas in this study. Postnatal care was a low priority, the responsibility often given to new graduates on voluntary placements with little job security, who were insufficiently trained or supervised. In addition, inadequate water and sanitation in postnatal care wards deterred women from staying for the recommended postnatal observation period.Despite strong support for postnatal care at the policy level, at the implementation level postnatal newborn care is not prioritised by midwives. Under-functioning infrastructure and inadequate planning and budgeting for postnatal check-ups are major challenges to the provision of care in the postnatal wards.

Background Quality care is essential for improving maternal and newborn health. Low- and middle-income Pacific Island nations face challenges in delivering quality maternal and newborn care. The aim of this review was to identify all published studies of interventions which sought to improve the quality of maternal and newborn care in Pacific low-and middle-income countries. Methods A scoping review framework was used. Databases and grey literature were searched for studies published between January 2000 and July 2019 which described actions to improve the quality of maternal and newborn care in Pacific low- and middle-income countries. Interventions were categorised using a four-level health system framework and the WHO quality of maternal and newborn care standards. An expert advisory group of Pacific Islander clinicians and researchers provided guidance throughout the review process. Results 2010 citations were identified and 32 studies included. Most interventions focused on the clinical service or organisational level, such as healthcare worker training, audit processes and improvements to infrastructure. Few addressed patient experiences or system-wide improvements. Enablers to improving quality care included community engagement, collaborative partnerships, adequate staff education and training and alignment with local priorities. Conclusions There are several quality improvement initiatives in low- and middle-income Pacific Island nations, most at the point of health service delivery. To effectively strengthen quality maternal and newborn care in this region, efforts must broaden to improve health system leadership, deliver sustaining education programs and encompass learnings from women and their communities.