Beruflich Dokumente
Kultur Dokumente
MONITORING
FRAMEWORK FOR THE
GLOBAL STRATEGY FOR
WOMENS, CHILDRENS
AND ADOLESCENTS
HEALTH
(2016-2030)
Contents
Executive Summary ................................................................................................................................................ 1
1. Background....................................................................................................................................................... 3
2. Process of development....................................................................................................................................... 4
3. Indicators........................................................................................................................................................... 5
4. Measurement, monitoring and investment needs.................................................................................................. 11
5. Monitoring and reporting mechanisms .............................................................................................................. 14
6. Recommendations ........................................................................................................................................... 17
EXECUTIVE SUMMARY
This report presents the indicator and monitoring
framework for the Global Strategy for Womens, Childrens
and Adolescents Health, (2016-2030) focusing on its
Survive, Thrive and Transform objectives and 17 targets.
The report details the selection process for the indicators
and implications for monitoring, measurement, investments
and reporting.
Based on technical reviews and an open consultative
process, 60 indicators were selected. They refer to
priority areas in the Global Strategy and have a proven
measurement track record. The framework aims to
minimize the burden of country-to-global reporting
by aligning with 34 indicators from the Sustainable
Development Goals (SDGs). An additional 26 indicators
are drawn from established global initiatives for
reproductive, maternal, newborn, child and adolescent
health (RMNCAH). Together these 60 indicators provide
sufficient depth and breadth for tracking progress on the
Global Strategy and for evidence-informed advocacy
and accountability for resources, results and rights.
This framework can support national SDG and health
monitoring, and countries could use additional contextual
indicators as relevant. From the 60, 16 key indicators
(see panel) are selected as a minimum subset to provide
a snapshot of progress on the Global Strategy. Other
subsets of indicators could be used for communication with
different audiences and on different topics.
Separate priority topics are identified for developmental
work and research investment. These include quality of
care, early childhood development, causes of death,
human rights and health, governance and accountability.
Monitoring the Global Strategy requires substantial
investments in data collection, compilation, analysis,
communication and use in countries. The Health Data
Collaborative and others must play a critical role to:
Advocate for and invest in strengthening and vital
statistics (CRVS) systems through the CRVS window of the
Global Financing Facility;
Ensure every country has a regular programme of
health surveys, supplemented by international survey
programmes (e.g. DHS and MICS);
Key indicators
Survive
1. Maternal mortality ratio (SDG 3.1.1)
2. Under-5 mortality rate (SDG 3.2.1)
3. Neonatal mortality rate (SDG 3.2.2)
4. Stillbirth rate
5. Adolescent mortality rate
Thrive
6. Prevalence of stunting among children under
5years of age (SDG 2.2.1)
7. Adolescent birth rate (10-14, 15-19) per
1000women in that age group (SDG 3.7.2)
8. Coverage index of essential health services,
including for infectious diseases, noncommunicable
diseases and RMNCAH: family planning,
antenatal care, skilled birth attendance,
breastfeeding, immunization, childhood illnesses
treatment (SDG 3.1.2, 3.7.1, 3.8.1)
9. Out-of-pocket health expenditure as a percentage
of total health expenditure
10. Current country health expenditure per capita
(including specifically on RMNCAH) financed from
domestic sources
11. Number of countries with laws and regulations that
guarantee women aged 15-49 access to sexual
and reproductive health care, information and
education (SDG 5.6.2)
12. Proportion of population with primary reliance on
clean fuels and technology (SDG 7.1.2)
Transform
13. Proportion of children under 5years of age whose
births have been registered with a civil authority
(SDG 16.9.1)
14. Proportion of children and young people in schools
with proficiency in reading and mathematics
(SDG 4.1.1)
15. Proportion of women, children and adolescents
subjected to violence (SDG 5.2.1, 16.2.3)
16. Percentage of population using safely managed
sanitation services including a hand-washing
facility with soap and water (SDG 6.2.1)
Note: Equity is a cross-cutting consideration aligned with
SDG 17.18.1, with disaggregation of indicators when
relevant, including by age, sex, education, wealth and
settingsrural, urban, humanitarian.
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
1. BACKGROUND
The Global Strategy for Womens, Childrens and
Adolescents Health (2016-2030) was launched in
September 2015. It sets ambitious objectives to improve
womens, childrens and adolescents health in alignment
with the Sustainable Development Goals (SDGs) along
three axes: 1) Survive (end preventable deaths); 2) Thrive
(ensure health and well-being); and 3)Transform (expand
enabling environments). Specific objectives include:
reducing mortality rates (reducing global maternal mortality
to less than 70per 100000live births, and neonatal
and under-5 mortality to at least as low as 12 and 25per
1000live births, respectively); ending major global
epidemics (HIV, tuberculosis and malaria); meeting needs
such as essential RMNCAH services coverage, adequate
nutrition, clean water and environments; and achieving
farreaching targets such as ending extreme poverty,
providing universal primary and secondary education and
ending harmful practices and violence against women
and girls.
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
2. PROCESS OF DEVELOPMENT
In recognition of the need to minimize the country reporting
burden, a main goal of the initial indicator selection
process was to harmonize with on-going monitoring
efforts at the global level. It was also necessary to ensure
adequate coverage of women, children and adolescents
across the Survive, Thrive and Transform axes and in line
with the 17 targets of the Global Strategy.
3. INDICATORS
Based on the process described above, Table 1 presents
16key indicators on the status of womens, childrens
and adolescents health. Almost all indicators align with
proposed SDG indicators and all are included in the full
table of 60 indicators in Table 2. Information presented in
parentheses in Table 1 maps the indicator to the indicator
from the SDG monitoring process.
Table 2 presents the full set of 60 indicators as a technical
resource for monitoring the Global Strategy. Each target,
organized by the Global Strategy axes, Survive, Thrive
and Transform, has at least one indicator. The set of
indicators is divided into two groups: 1) the proposed
indicators for the 17 targets identified as central to the
Global Strategy (34 indicators); and 2)indicators that are
a priority for the Global Strategy but are not proposed for
the SDG process (26 indicators). All indicators have fair
to good data availability and are considered a priority for
monitoring progress towards each of the 17 targets and
central themes of the Global Strategy. The indicators have
been mapped to the 17 targets in this table. In addition,
a number of indicators that are cross-cutting (and do not
fall within just one of the 17 targets) appear at the end of
the table.
The full set of selected indicators is large, so not all
indicators are likely to be used at all times. However,
the alignment within major strategies and monitoring efforts
for reproductive, maternal, newborn and child health
such as EPMM, ENAP, Nutrition, GFF, Countdown 2030,
etc. is good and the close correspondence with the SDG
indicators is critical. Finally, almost all health indicators
are part of the Global Reference List for 100 Core Health
Indicators 2015. This alignment is intended to minimize
the monitoring and reporting burden, but some additional
effort and investments will be required to bolster the
measurability and validity of some indicators.
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Note: Equity is a cross-cutting consideration aligned with SDG 17.18.1, with disaggregation of indicators when relevant, including by
age, sex, education, wealth and settingsrural, urban, humanitarian.
Included in SDGs
Additional to SDGs
Stillbirth rate
tuberculosis, malaria,
sex (3.3.1)
noncommunicable diseases
cervical cancer
by sex (3.4.1)
Suicide mortality rate, by age and
sex (3.4.2)
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Target
Included in SDGs
Additional to SDGs
among adolescents
pregnancy status
(SDG2.2)
health-care services
methods (3.7.1)
(SDG 4.2)
sex (3.9.1)
Included in SDGs
Target
Additional to SDGs
coverage, including
domestic sources
(SDG 1.1)
* Indicator for SDG 3.8.2 proposed by the World Health Organization and the World Bank
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Included in SDGs
Target
Additional to SDGs
upgrade technological
(disaggregated by health/RMNCAH)
(SDG 16.9)
development (17.16)
Additional equity,
10
4. MEASUREMENT, MONITORING
AND INVESTMENT NEEDS
Monitoring the 17 SDGs and their 169 targets will be
a major challenge for country statistical systems and for
global and regional monitors. Monitoring the healthrelated SDG targets will also be challenging, including
26proposed indicators under the health goal (SDG 3) and
more than a dozen health-related indicators under other
goals. The monitoring framework of the Global Strategy
is closely linked to the overall SDG monitoring framework,
building upon a selection of relevant SDG indicators and
adding other indicators where needed.
Substantial investments in country systems will be required
to support Global Strategy monitoring, including data
collection, compilation, data quality assessment and
analysis and dissemination and use. It is an essential
component of the Unified Accountability Framework
and should inform the functions of review and remedial
action. Such investments will have to come from domestic
sources and, in low- and lower-middle-income countries,
from international support mechanisms. It is essential that
global and regional support are aligned to maximize the
efficiency and effectiveness of investments to support the
creation, in each country, of a single health information
system that is closely linked to the national statistical system.
Therefore, implementation of the Global Strategy monitoring
framework will occur in the context of the Health Data
Collaborative, (www.healthdatacollaborative.org) a recent
global effort of development partners, countries, civil society
and academia to strengthen country health information
systems in order to enhance SDG-related monitoring and
accountability in countries.
MAPPING THE INDICATORS TO DATA SOURCES
The main sources for health data are civil registration
and vital statistics (CRVS) systems, household and other
population-based surveys, facility reports and facility
surveys, and health system resources or administrative data
systems. In addition, the population census is an important
source of data for the health sector.
A mapping of the indicators against the data sources shows
that multiple data sources are possible for several indicators.
This is most commonly the case for service coverage
11
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
HUMANITARIAN SETTINGS
DISAGGREGATION
The SDGs have strong emphasis on equity, expressed
most frequently as no one being left behind. Much of
the worlds attention to the MDGs has been based on
aggregate global, regional and national achievements,
but much more attention is needed for populations within
countries that are marginalized or under-served. Therefore,
disaggregated statistics, including sex, age, income/wealth,
race, ethnicity, migratory status, disability and geographic
location, or other characteristics, are required to track
all populations. SDG target 17.18 calls for countries to
increase the availability of disaggregated data by a range
of stratifiers. Age is a key stratifier for many indicators in the
Global Strategy monitoring framework.
The required disaggregation presents a major challenge to
many countries and to global and regional monitoring.
Often, disaggregated information is limited to indicators
that were collected in household surveys that provide
data on demographic and socioeconomic characteristics
and can be used to identify disadvantaged populations.
Most surveys do not have sample sizes that allow
computation of reliable subnational statistics beyond the
provincial or regional level. Data from health facilities and
administrative sources can fill the local information gap,
but data availability and quality still need considerable
improvement in many countries. Finally, countries often lack
reliable information on health indicators among migrant
populations, minorities and other marginalized populations.
Communication and the use of indicators for decisionmaking need strengthening. Score cards and dashboards
are helpful instruments for the presentation of data to
programme workers and government policy-makers, as well
as to media, civil society and parliamentarians. However,
the use of data to inform decision-making cannot be taken
for granted even if communication is carried out effectively.
It needs to be supported at national and subnational levels
through capacity strengthening and other mechanisms.
An institutionalized link between monitoring, review and
remedial action is important. Regular, transparent and
inclusive monitoring informed by independent reviews of
progress and performance at all levels are instrumental to
improving programme efficiency and effectiveness.
FURTHER RESEARCH
There are several critical target areas in the Global
Strategy for which no indicators are available that meet
the criteria for inclusion in the list of indicators. This is often
due to issues with the numerator (e.g. difficult to define
the intervention) or denominator (e.g. hard to define the
population in need of the intervention); lack of evidence that
the indicator can generate comparable data for countries
over time; and current gaps in quality data.
12
13
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
5. MONITORING AND
REPORTING MECHANISMS
The situation and trends for the indicators should be
reported on a regular basis. They are well-established
indicators with proven track records and good data
availability, and are considered highly indicative of
progress towards the target.
There is a need to set more explicit target values for the
indicators. In some cases there is a numeric value in the
Global Strategy/SDG target (e.g. for several mortality
indicators). A good example of a detailed target is
provided by the full immunization coverage rate indicator:
achieve and sustain 90% national coverage and 80%
coverage in every district with all vaccines in national
programmes.
Monitoring progress towards targets globally and for
individual countries requires a baseline value from a
year close to 2016. A target should refer to 2030 but
intermediate targets should also be set (e.g. 2020 and
2025), at country and global levels. Such interim targets
would be especially important to ensure that the equity gap
is reducing in support of the no one left behind agenda.
For some of the indicators, setting a global baseline is still
a challenge. At this point, the framework proposed here
does not include any new targets beyond those already
expressed in the SDG targets.
ALIGNMENT WITH THE SDGS: COUNTRY LEVEL
It is essential to align monitoring of the Global Strategy
with the overall SDG monitoring and reporting process.
The 2030 agenda puts strong emphasis on country
follow-up and review processes as the basis for
accountability. The SDG monitoring and review processes
will be large and complex with 17 goals, 169 targets and
230 indicators.
Discussion of how this will be done is still ongoing in
many countries. The SDGs encourage greater country
ownership and country-specificity in such processes. At the
same time, according to the proposals of the UNStatistical
14
http://www.who.int/healthinfo/indicators/2015/en/
15
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
16
6. RECOMMENDATIONS
Invest in strengthening birth and death
registration systems
The focus should be on birth registration and death
registration, with establishment of a reliable cause
of death.
Implementation of the Global Strategy monitoring
framework should support the strengthening of CRVS
systems. The health sector plays a critical role in CRVS
systems, as a provider and user of data. At the individual
level, birth registration (at the time of birth or as soon as
possible after birth) is a human right.
The CRVS window of the Global Financing Facility is
an excellent opportunity to strengthen birth and death
registration, including cause of death for women,
children and adolescents.
Such global efforts to strengthen country CRVS
systems should be fully aligned with regional and
country strategies.
Ensure every country has a programme of
regular health surveys
Without regular surveys the Global Strategy cannot
be monitored, as most indicators and disaggregation
require population-based data.
Standardized international survey programmes are
the backbone for low- and lower-middle income
countries, notably DHS and MICS. These programmes
should continue to complement countries efforts by
implementing regular surveys that collect the data for key
RMNCAH indicators.
In parallel, there is a need to strengthen national survey
capacity and enhance integration of health surveys in
support of national SDG-related statistical strategies.
Improve the functioning of facility-based
information systems
The potential for improving facility-based data is
considerable in many countries. Global partners should
align with and support country strengthening of (webbased) facility-based systems, including rationalization of
indicators, data-quality improvement and better analysis,
dissemination and use.
The need to identify key indicators is a prerequisite of
core investments in facility-based information systems.
17
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Figure 1. Strengthening country monitoring and measurement in the context of the Global Strategy
Review
Remedial action
Strengthen
health
surveys
Improve
birth &
death
registration
Strengthen
health-facility
reporting
systems
Improve
monitoring
of healthsystem
resources
Invest in
research for
better
monitoring in
priority areas
16 Key Indicators
60 indicators for Survive, Thrive, Transform
18
(SDG 3.2)
education (CSE)
19
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
encourage innovation
20
ADDITIONAL INDICATORS
by country
21
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
ADDITIONAL INDICATORS
development (17.16)
cutting considerations
22
Women
Children
Adolescents
Reduce global maternal mortality to less than 70per 100000live births (SDG 3.1)
Maternal mortality ratio (3.1.1)
Proportion of women aged 15-49 who received 4 or more antenatal care visits
Proportion of women who had postpartum contact with a health provider within
2 days
Reduce newborn mortality to at least as low as 12per 1000live births in every country (SDG 3.2)
Neonatal mortality rate (3.2.2)
Stillbirth rate
Proportion of infants who were breastfed within the first hour of birth
Proportion of newborns who had postnatal contact with a health provider within
2 days
Measurement of prevalence of low birth weight and small for gestational age
Reduce under-5 mortality to at least as low as 25per 1000live births in every country (SDG 3.2)
Under-5 mortality rate (3.2.1)
Percentage of infants <6 months who are fed exclusively with breast milk
23
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Women
Children
Adolescents
End epidemics of HIV, tuberculosis, malaria, neglected tropical diseases and other communicable diseases
(SDG 3.3)
Number of new HIV infections per 1000 uninfected population,
disaggregated by age and sex (3.3.1)
Malaria incident cases per 1000persons per year (3.3.3)
Percentage of people living with HIV who are currently receiving antiretroviral
therapy (ART), by age and sex
Proportion of households with at least 1 ITN for every 2 people and/or sprayed
by indoor residual spray (IRS) within the last 12 months
Reduce by 1/3 premature mortality from noncommunicable diseases and promote mental health and wellbeing (SDG 3.6)
Age-standardized prevalence of current tobacco use among
persons 15years and older, disaggregated by age (3.a.1)
Suicide mortality rate, by age and sex (3.4.2)
End all forms of malnutrition, and address the nutritional needs of adolescent girls, pregnant and lactating
women and children (SDG 2.2)
Prevalence of stunting (height for age <-2 standard deviation
from the median of the WHO Child Growth Standards) among
overweight) (2.2.2)
24
Women
Children
Adolescents
Ensure universal access to sexual and reproductive health-care services (including for family planning) and
rights (SDG 3.7 and 5.6)
Percentage of women of reproductive age (15-49) who have their
need for family planning satisfied with modern methods (3.7.1)
Adolescent birth rate (10-14, 15-19) per 1000 women in that age
group (3.7.2)
Proportion of women aged 15-49 who make their own informed
decisions regarding sexual relations, contraceptive use and
education (CSE)
Ensure that all girls and boys have access to good-quality early childhood development (SDG 4.2)
Percentage of children under 5years of age who are
developmentally on track in health, learning and psychosocial
25
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Women
Children
Adolescents
Achieve universal health coverage, including financial risk protection and access to quality essential services,
medicines and vaccines (SDG 3.8)
Coverage of essential health services, including RMNCAH (3.8.1)
Ensure that all girls and boys complete free, equitable and good-quality secondary education (SDG 4.1)
Proportion of children and young people: (a) in grades 2/3;
(b) at the end of primary; and (c) at the end of lower secondary
Eliminate all harmful practices and all discrimination and violence against women and girls (SDG 5.2
and 5.3)
Percentage of women aged 20-24 who were married or in a
of sex (5.1.1)
Proportion of young women and men aged 18-29 who experienced sexual
violence by age 18 (16.2.3)
26
Women
Children
Adolescents
water (6.2.1)
Percentage of population using safely managed drinking water
services (6.2.2)
Enhance scientific research, upgrade technological capabilities and encourage innovation (SDG 8.2)
Research and development expenditure as a proportion of GDP,
disaggregated by health/RMNCAH (9.5.1)
registration (17.19.2)
Enhance the global partnership for sustainable development (17.16)
Number of countries reporting progress in multistakeholder
development effectiveness monitoring frameworks that support
the achievement of the SDGs (17.16.1)
Governance Index (voice, accountability, political stability and absence of
violence, government effectiveness, regulatory quality, rule of law, control
of corruption)
27
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Women
Children
Adolescents
Does the national RMNCAH strategy/plan of action specify that there should
be community participation in decision-making, delivery of health services and
monitoring and evaluation?
Proportion of countries that address young peoples multisectoral needs within
their national development plans and poverty reduction strategies (16.7.2)
L egend:
Covers that population, including specified age ranges Covers that population if age disaggregated (no specified age range) Applicable to all
Core indicator (SDG); Core indicator (additional to SDGs); Indicator for development
28
Numerator
Denominator
Disaggregation
Number of
Age, place
live births
of residence
Number of
Place of
live births
residence, sex,
(0-59 months)
3. Neonatal mortality rate (SDG 3.2.2)
socioeconomic status
Number of
Age in days/weeks,
live births
of life
of residence, sex,
socioeconomic status
4. Stillbirth rate
Total births
Age in days/weeks,
of residence, sex,
socioeconomic status
or weighing 1000 g
5. Adolescent mortality rate
Number of
adolescents
aged 10-19
of residence,
socioeconomic status
THRIVE
Numerator
Denominator
Disaggregation
Number of
Place of
children aged
residence, sex,
0-59 months
socioeconomic status
Exposure to
Marital status,
childbearing
place of residence,
by women
socioeconomic status
aged 15-19
8. Coverage of essential health services,
based on tracer interventions that
Number
Stratified by
the intervention
of people
who need
socioeconomic
the intervention
position, geographic
29
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Total population
reporting use
wealth quintile
(SDG 7.1.2).
of any cooking,
and setting
heating or
lighting fuels
and technologies
fuel combustion)
TRANSFORM
Numerator
Denominator
Disaggregation
Total number
of children
of residence,
wealth quintiles
Number of chil-
Place of
residence, sex,
people at the
socioeconomic status
education achieving or
end of primary
or lower second-
ary education
given subject
15. Proportion of young women and men aged
Number of
young women
place of residence,
and men
wealth quintiles
aged18-24
byage18
Number of people
sanitation services
Total population
Place of residence,
socioeconomic status
(SDG 6.2.1)
30
CRVS
Survey
Facility
Other
(x)
Postpartum contact
Neonatal mortality
Stillbirth rate
Exclusive breastfeeding
HIV incidence
(x)
(x)
(x)
x denotes a source that is readily available; (x) denotes a potential source that requires further investment
31
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
INDICATOR
CRVS
Survey
Facility
Other
Child stunting
Malnutrition
x
x
(x)
Organized learning
Financial protection
x
x
(x)
x
32
INDICATOR
CRVS
Survey
Facility
Other
Poverty
Partner violence
Early marriage
(x)
Sanitation
x
x
Census
Data disaggregation
33
and rights
INDICATOR AND MONITORING FRAMEWORK FOR THE GLOBAL STRATEGY FOR WOMENS, CHILDRENS AND ADOLESCENTS HEALTH (2016-2030)
Acknowledgements
On behalf of Every Woman Every Child, the Strategy
and Coordination Group oversaw the development of
this report under the guidance of David Nabarro, United
Nations Secretary-Generals Special Adviser on the 2030
Agenda for Sustainable Development, and supported by
Nana Taona Kuo, Senior Manager of the Every Woman
Every Child Health Team.
34