1. Evaluating and monitoring perinatal health in Europe
Jennifer Zeitlin

2. The EURO-PERISTAT Project
Project aim: to develop valid and reliable indicators which can be used for monitoring and evaluating perinatal health in the EU
Project is part of the European Commission’s Public Health programme (DG-SANCO) 2

3. Perinatal Indicators – Why monitor across Europe ?
European countries face common challenges in perinatal health
Approaches to perinatal health differ greatly throughout Europe
Comparing policies and outcomes
Monitoring trends
Developing European health policies
Strength in numbers: attaining critical mass 3

4. Perinatal Indicators – Routine compilation across Europe
EUROSTAT, the WHO Regional Office for Europe, and the OECD compile a number of indicators related to perinatal health and care
However, many indicators are not compiled on a comparable basis, and key indicators for comparing perinatal health and the quality of health services are not available in all member states. 4

5. EURO-PERISTAT Network
Phase I: 15 Member states
Phase II & III new MS + Norway
Phase IV: 27 MS + Norway, Switzerland + ?
Scientific Committee
Phase I: One clinician (neonatologists, obstetrician, midwife) and epidemiologist from each country
Phase II: one representative per country + a Scientific Advisory Group

6. EURO-PERISTAT Scope 3 primary components
Selection of an indicator set and development of new indicators
Collection of data on indicators
Reporting on indicators

7. EURO-PERISTAT Indicators
Based existing national and international indicators
A DELPHI consensus process to select indicators
PANEL: European clinicians (obstetrics, midwifery and neonatology) as well as epidemiologists and statisticians
Updates: with new MS in 2004, next in 2011

8. EURO-PERISTAT Indicators
10 Core Indicators
23 Recommended Indicators
11 for immediate implementation
12 for further development
Update in 2004
4 new indicators for development

9. EURO-PERISTAT Indicators
Core indicators are essential to monitoring perinatal health
Recommended indicators are those considered desirable for a more complete picture of perinatal health across the member states and
Indicators for further development represent important aspects of perinatal health, but further work is required before they can be operationalised in the member states.

10. EURO-PERISTAT Indicators
Development of new indicators
Longer term health consequences of perinatal events for infant/child health
Maternal morbidity
Positive reproductive health outcomes (support provided to women, satisfaction with care)
Social inequalities in reproductive health care and outcomes

11. Data Collection Verification of feasibility
Data collection on year 2000 in PERISTAT I
Data collection on year 2004
the European Journal of Obstetrics and Gynecology, Vol 111, Supp 1, 28 November 2003
The European Perinatal Health Report

12. Download report on www.europeristat.com

13. Data Collection: results
PERISTAT indicators available in many countries although not easily accessible
Recommendations are REALISTIC
Indicators useful NOW for monitoring and evaluating
BUT
No indicator available for ALL countries
Significant work to produce all of PERISTAT indicators
Some essential dimensions very weak everywhere

14. Results – data from 2004 Population characteristics/Risk factors
Health services
Fetal/infant/child health
Maternal health

15. Multiple birth rates per 1000 women

18. Distribution of parity

19. Mode of delivery

20. Mode of onset of labor

21. Fetal mortality Using different inclusion criteria
Countries ranked by mortality rate

22. Neonatal mortality Using different inclusion criteria
Countries ranked by mortality rate

23. Next steps: Euro-peristat Action
New project begins in April 2011
Objectives
Integrate Euro-peristat indicators into routine databases (EUROSTAT, ECHIM)
Create a sustainable network for reporting on health indicators
Produce a new report on data from 2010

24. Disseminate and publish our work to policy makers, clinicians & users
Health Information is not Health
Carefully conducted and analyzed research can save lives by helping decision makers design effective policies and programs. For research to influence policy, however, it needs to be communicated effectively and used in the decision-making process.3
We are in a time when most governments have limited resources. Data collection that leads to improvements in health is a worthwhile expenditure. Data collection that does not lead to improvements in health is a waste, and a drain on funding that could be better used for something else. If you care about the health of pregnant women and their babies, beyond your career and professional success, then you have a moral obligation to make the best use of the funding that is given for data collection and research and to ensure impact on health.
But good health policies and practices need good evidence

25. Executive Board
Sophie Alexander, Université Libre de Bruxelles, School of Public Health
Henrique Barros, University of Porto Medical School
István Berbik, Vaszary Kolos Teaching Hospital
Béatrice Blondel, INSERM U953
Marie-Hélène Bouvier-Colle, INSERM U953
Simone Buitendijk TNO Institute Prevention and Health
Mika Gissler THL National Institute for Health and Welfare
Alison Macfarlane City University, Department of Midwifery
Ashna Mohangoo TNO Institute Prevention and Health
Živa Novak-Antolic University Medical Centre
Katarzyna Szamotulska National Research Institute of Mother and Child
Jennifer Zeitlin INSERM U953 (project leader)

26. Scientific committee and data providers
Listed at:

27. More information: www.europeristat.com