IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0252182.html
   My bibliography  Save this article

Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa

Author

Listed:
  • Mamothena Carol Mothupi
  • Jeroen De Man
  • Hanani Tabana
  • Lucia Knight

Abstract

Introduction: The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in a province in South Africa with the possibility of nationwide use. Materials and methods: The composite index was computed as a geometric mean of four dimensions of adequacy of the continuum of care. Data was sourced from the district health information system, household surveys and the census. The index formula was tested for robustness when alternative inputs for indicators and standardization methods were used. The index was used to assess performance in service delivery in the North West province of South Africa, as well as its four districts over a five-year period (2013–2017). The index was validated by assessing associations with maternal health and other outcomes. And factor analysis was used to assess the statistical dimensions of the index. Results: The provincial level index score increased from 62.3 in 2013 to 74 in 2017, showing general improvement in service delivery over time. The district level scores also improved over time, and our analysis identified areas for performance improvement. These include social determinants of health in some districts, and access and linkages to care in others. The provincial index was correlated with institutional maternal mortality rates (rs = -0.90, 90% CI = (-1.00, -0.25)) and the Human Development Index (r = 0.97, 95% CI = (0.63, 0.99). It was robust to alternative approaches including z-score standardization of indicators. Factor analysis showed three groupings of indicators for the health system and social determinants of health. Conclusions: This study demonstrated the development and testing of a composite index to monitor and assess service delivery on the continuum of care for maternal health. The index was shown to be robust and valid, and identified potential areas for service improvement. A contextualised version can be tested in other settings within and outside of South Africa.

Suggested Citation

  • Mamothena Carol Mothupi & Jeroen De Man & Hanani Tabana & Lucia Knight, 2021. "Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0252182
    DOI: 10.1371/journal.pone.0252182
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252182
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0252182&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0252182?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Zoe Dettrick & Hebe N Gouda & Andrew Hodge & Eliana Jimenez-Soto, 2016. "Measuring Quality of Maternal and Newborn Care in Developing Countries Using Demographic and Health Surveys," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-20, June.
    2. Lenka Benova & Ann-Beth Moller & Allisyn C Moran, 2019. "“What gets measured better gets done better”: The landscape of validation of global maternal and newborn health indicators through key informant interviews," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-16, November.
    3. Salvatore Greco & Alessio Ishizaka & Menelaos Tasiou & Gianpiero Torrisi, 2019. "On the Methodological Framework of Composite Indices: A Review of the Issues of Weighting, Aggregation, and Robustness," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 141(1), pages 61-94, January.
    4. Frederik Booysen, 2002. "An Overview and Evaluation of Composite Indices of Development," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 59(2), pages 115-151, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Greco, Salvatore & Ishizaka, Alessio & Tasiou, Menelaos & Torrisi, Gianpiero, 2018. "σ-µ efficiency analysis: A new methodology for evaluating units through composite indices," MPRA Paper 83569, University Library of Munich, Germany.
    2. Samy Katumba & Julia Kadt & Mark Orkin & Paul Fatti, 2022. "Construction of a Reflective Quality of Life Index for Gauteng Province in South Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 164(1), pages 373-408, November.
    3. Lola Martin-Moro & Meltem Öztürk & Florence Laufer, 2022. "Modelling the Prison Life Index with Value Focused Thinking Methodology," Working Papers hal-03851980, HAL.
    4. Giuliano Resce & Fritz Schiltz, 2021. "Sustainable Development in Europe: A Multicriteria Decision Analysis," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 67(2), pages 509-529, June.
    5. repec:hal:journl:hal-04767405 is not listed on IDEAS
    6. Ahmad Mohd Khalid & Seema Sharma & Amlendu Kumar Dubey, 2020. "Data Gap Analysis, Indicator Selection and Index Development: A Case for Developing Economies," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 148(3), pages 893-960, April.
    7. Greco, Salvatore & Ishizaka, Alessio & Tasiou, Menelaos & Torrisi, Gianpiero, 2019. "Sigma-Mu efficiency analysis: A methodology for evaluating units through composite indicators," European Journal of Operational Research, Elsevier, vol. 278(3), pages 942-960.
    8. Fernanda Cortegoso Oliveira Frascareli & Marcelo Furlan & Enzo Barberio Mariano & Daniel Jugend, 2024. "A macro-level circular economy index: theoretical proposal and application in European Union countries," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 26(7), pages 18297-18331, July.
    9. Panagiotis Artelaris, 2022. "A development index for the Greek regions," Quality & Quantity: International Journal of Methodology, Springer, vol. 56(3), pages 1261-1281, June.
    10. Ildikó Husz & Marianna Kopasz & Márton Medgyesi, 2022. "Social Workers’ Causal Attributions for Poverty: Does the Level of Spatial Concentration of Disadvantages Matter?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 162(3), pages 1069-1091, August.
    11. Valér Veres & József Benedek & Ibolya Török, 2022. "Changes in the Regional Development of Romania (2000–2019), Measured with a Multidimensional PEESH Index," Sustainability, MDPI, vol. 14(21), pages 1-29, November.
    12. Sayel Basel & K. U. Gopakumar & R. Prabhakara Rao, 2020. "Broad-based index for measurement of development," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 22(1), pages 182-206, June.
    13. Guo, Chuanyin & Song, Qiwei & Yu, Ming-Miin & Zhang, Jian, 2024. "A digital economy development index based on an improved hierarchical data envelopment analysis approach," European Journal of Operational Research, Elsevier, vol. 316(3), pages 1146-1157.
    14. Justin Ehrlich & Simon Medcalfe & Shane Sanders, 2021. "Composite Index Ranking of Economic Well-Being in U.S. Metropolitan Areas: How Prevalent are Rank Anomalies?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 157(2), pages 543-562, September.
    15. Milica Maricic & Jose A. Egea & Veljko Jeremic, 2019. "A Hybrid Enhanced Scatter Search—Composite I-Distance Indicator (eSS-CIDI) Optimization Approach for Determining Weights Within Composite Indicators," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 144(2), pages 497-537, July.
    16. Matteo Mazziotta & Adriano Pareto, 2022. "Weighting in composite indices construction: the case of the Mazziotta-Pareto Index," RIEDS - Rivista Italiana di Economia, Demografia e Statistica - The Italian Journal of Economic, Demographic and Statistical Studies, SIEDS Societa' Italiana di Economia Demografia e Statistica, vol. 76(4), pages 4-12, October-D.
    17. Luca Farnia, 2019. "On the Use of Spectral Value Decomposition for the Construction of Composite Indices," Working Papers 2019.08, Fondazione Eni Enrico Mattei.
    18. Matteo Mazziotta & Adriano Pareto, 2022. "Normalization methods for spatio‐temporal analysis of environmental performance: Revisiting the Min–Max method," Environmetrics, John Wiley & Sons, Ltd., vol. 33(5), August.
    19. Tekic, Anja & Tekic, Zeljko, 2021. "Culture as antecedent of national innovation performance: Evidence from neo-configurational perspective," Journal of Business Research, Elsevier, vol. 125(C), pages 385-396.
    20. Gaganis, Chrysovalantis & Pasiouras, Fotios & Tasiou, Menelaos & Zopounidis, Constantin, 2021. "CISEF: A composite index of social, environmental and financial performance," European Journal of Operational Research, Elsevier, vol. 291(1), pages 394-409.
    21. Naveen P Singh & Bhawna Anand & Surendra Singh & S K Srivastava & Ch Srinivasa Rao & K V Rao & S K Bal, 2021. "Synergies and trade-offs for climate-resilient agriculture in India: an agro-climatic zone assessment," Climatic Change, Springer, vol. 164(1), pages 1-26, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0252182. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.