A STRATEGY FOR THE EVALUATION OF ACTIVITIES TO REDUCE MATERNAL MORTALITY IN DEVELOPING-COUNTRIES

The expense and effort involved in collecting the data necessary for c alculating maternal mortality rates and ratios often discourages effor ts to evaluate projects. The use of a set of carefully selected proces s indicators is presented as a practical alternative. The evaluation s trategy proposed is based upon a recently published conceptual framewo rk of maternal mortality. The strategy includes four stages: (1) outli ning the causal pathway through which an intervention is hypothesized to work; (2) determining how the pathway will be affected by external factors; (3) developing indicators at each step of the pathway; and (4 ) selecting a combination of indicators that together will provide suf ficient evidence that the intervention was successful. This process is illustrated for three program interventions: providing safe abortion services, increasing knowledge of obstetric complications, and improvi ng quality of medical care.