Intrapartum stillbirth

The Intrapartum Stillbirth and Early Neonatal Death Indicator (ISINDI) was intended to monitor improvements in the quality of obstetric and newborn care provided at birth by skilled attendants in health facilities. As it is currently defined, ISINDI was constructed with (1) a numerator comprising the sum of intrapartum stillbirths (with fetal heart beats perceived at admission in labor ward) and very early newborn death (within the first 24 hours of life) (all above 2,500 grams) in a given facility in a given year; and (2) a denominator comprising all births (above 2,500 grams) in the same facility. The objectives of this pilot study in 4-5 hospitals were: 1) to develop and evaluate a practical and feasible method for prospective, standardized measurement of intrapartum stillbirth and immediate neonatal death rates at health facilities performing deliveries on a routine basis; 2) to refine the indicator by analyzing its components; 3) to assess the potential cost (both human and financial) and acceptability of monitoring the indicator routinely.