Feasibility of establishing a core set of sexual, reproductive, maternal, newborn, child, and adolescent health indicators in humanitarian settings: results from a multi-methods assessment in Bangladesh.

Background: Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and varies in quality across different humanitarian settings. To address this gap in quality data, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes, and assessed their feasibility in Bangladesh, Afghanistan, Jordan, and the Democratic Republic of Congo. Methods: The feasibility assessments aggregated information from global consultations and field-level assessments to reach a consensus on a set of core SRMNCAH indicators among WHO partners. The feasibility assessment in Bangladesh focused on the following constructs: relevance/usefulness of the core set of indicators, the feasibility of measurement, availability of systems and resources, and ethical issues during data collection and management. The field-level multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, and facility assessments including observations of facility-level data management. Results: The findings suggest that there is widespread support among stakeholders for developing a standardized core set of SRMNCAH indicators to be collected among all humanitarian actors in Bangladesh. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome. Conclusion: This core set of indicators would only be useful if it has the buy-in from the international community that results in harmonizing and coordinating data collection efforts and relevant indicators' reporting requirements. Plain English Summary: Reliable data on sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) in humanitarian settings is very important for addressing the needs of the refugee population. However, the quality of data collected often varies across different humanitarian settings and organizations. To address this gap, WHO developed a core set of indicators, through global consultations and field-level assessments, for monitoring and evaluating SRMNCAH services and outcomes in humanitarian settings. In Bangladesh, the feasibility assessment was conducted in Rohingya camps in Cox's Bazar and assessed the feasibility in terms of relevance/usefulness of the indicators, feasibility of measurement, availability of systems and resources for data collection, and data collection and management related ethical issues in the Rohingya context in Bangladesh. The field-level assessment applied a multi-method approach including a desk review, key informant interviews, focus group discussions, and facility assessments. The findings revealed existing multiple sources and vertical systems of data collection by different organizations and the indicators also varied depending on the requirements of the Bangladesh government, donor agencies, UN agencies leading different sector/sub-sectors/clusters, and organizations' own priorities and mandates. All the stakeholders who participated in this study agreed on developing a harmonized and standardized core set of SRMNCAH indicators. However, they raised concerns regarding the adaptation of the core set of indications to the local context. They also emphasized on the importance of adequate resources for establishing strong reporting and data management systems, capacity development of human resources and the buy-in from the international community for effective implementation. [ABSTRACT FROM AUTHOR]