Table 3. Types of Questions and Sources of Information for Conducting a Situation Analysis. QUESTIONS SOURCES OF INFORMATION* The Problem and why are mothers, newborns, and children under the age of 5 years dying? What are the and ratios of mortality and morbidity? Key maternal and child health indicators should include (but are not limited to): Mortality and morbidity data (e.g., 350/100,000 live births) Proportion of with at least one antenatal care visit Skilled birth attendance rate Contraceptive prevalence rate Infant mortality rate 5 mortality rate Low birth weight Prevalence of iron deficiency anemia in pregnant What are the key risk factors associated with maternal, newborn, and child mortality and morbidity among your population of interest? What practices at the individual/household level are or are not being conducted to keep mothers, newborns and children from dying or getting sick? For example: Are mothers accessing antenatal care? Are mothers practicing exclusive breastfeeding? Do mothers provide bed nets for their newborn/child to prevent malaria? Where do families take their newborn when the infant is sick? Do mothers continue to breastfeed when their child has diarrhoea? What practices at the community are or are not being conducted to keep mothers, newborns and children from dying or getting sick? What practices at the policy level are or are not being conducted to keep mothers, newborns and children from dying or getting sick? What is the health context (e.g., literacy rate, poverty, geography/topography) What does the continuum of care look like for your population of interest? What healthcare components are available (e.g., family planning; antenatal care; delivery care by a skilled provider; obstetric emergency services; newborn care; postpartum care; diagnosis or management of HIV/AIDS including PMTCT and STIs; prevention and management of childhood illnesses; malaria prevention; prevention and management of essential vaccinations; home visits; nutrition; WASH) Secondary Sources: Multiple Indicator Cluster Survey (MICS) Demographic and Health Survey (DHS) UNICEF global databases on key indicators: Government statistics/reports (e.g., census data, registration and statistics data, health services records) reports Primary Sources: Household/community survey Focus group discussion In-depth interviews Social mapping Social network survey SWOT analysis Direct observation
Table 4. Examples of How Desired Changes, Perceived Barriers and Perceived Benefits Feed Forward Into SMART C4D Objectives. Population: of Reproductive Age Desired Changes Perceived Barriers Perceived Benefits SMART C4D Objectives Increased utilization of ANC and skilled attendance at delivery Increase in prompt healthcare for complications of delivery (emergency obstetric care and services) Increased practice of exclusive breastfeeding for at six months after delivery Lack of knowledge about when ANC visits should begin and how many are necessary Lack of confidence about benefits of skilled attendants during delivery Lack of knowledge regarding postpartum care and warning Long distance to a health facility and lack of transport Cost of giving birth in a facility Health provider attitudes Lack of confidence about the benefits of breastfeeding and how long it should be continued Religious and traditional beliefs Lack of male involvement in decision-making on RH issues Improves health of mothers and children Reduces major causes of maternal deaths, for example, obstructed labor, high blood pressure, and infections Increase by X% the number of women who feel confident that seeking a minimum of four ANC visits during pregnancy will improve their health and the health of their babies by (date) Increase by X% the number of women who seek ANC as soon as they know they are pregnant by (date) Increase by X% the number of who plan to deliver their babies at a health facility and have a transportation plan by (date) Increase by X% the number of women who think the benefits of ANC and delivering at a health facility outweigh the costs by (date) Increase by X% the number of who report positive provider-client interaction on RH by (date) Increase by X% the number of who know warning signs after delivery and
when to seek the help of a health provider by (date) Increase by X% the number of women who feel confident that breastfeeding exclusively for six months will improve the health of their babies by (date) Increase by X% the number of women who speak to their partners about preventive childcare practices issues by (date) Population: Community Leaders Desired Changes Perceived Barriers Perceived Benefits C4D Objectives Increase in quality and accessibility of reproductive health services within the community Increased integration of reproductive health information and services into other related programs Lack of confidence about the benefits of reproductive health services for communities Religious and traditional beliefs Competing issues and resources Improved economic growth with more healthy young people who are able to join the workforce Increase by X% the number of community leaders who believe that reproductive health service programs help their communities to improve their quality of life and the health of families and individuals by (date) Increase by X% the number of community leaders who understand the components of effective reproductive health service programs and how to support them in their communities by (date) Increase by X% the number of