Using existing data to develop and analyse health facility scorecards in order to strengthen the rights of women and children

Although progress has been made in the reduction of maternal newborn and child mortality in Brazil further progress is needed. There is also a lack of knowledge in certain groups about the rights that women can demand throughout pregnancy delivery postnatal recovery and during the childhood period. A project EU QUERO has been implemented to improve health care responsiveness and strengthen the rights of women and children. This study is related to this project. This study explores the development of scorecards using existing data for each local health centre (UBS) in two states of Brazil Goiás and Maranhão as well as to analyse the results. The aims of the scorecards are to strengthen accountability and increase community engagement with the scorecards linked directly and explicitly to the rights of women and children. A list of the rights of women and children were developed using national and international frameworks for rights. Using facility based data from PMAQ-AB a range of scorecards were designed and estimated with each focusing on a different dimension of rights. The results indicated that with some issues due to lack of data it is possible to develop a useful and relevant scorecard at the facility level which indicated if it was possible for mothers to exercise their rights easily. There were large differences between facilities although within facilities there was less variation in scorecard results. The scorecards also indicated large geographic variation. Constructing scorecards can be a useful way of conveying information to a community in a simple to understand format in order to improve health and strengthen rights. This study has shown this is possible using existing data although problems remain and further work is necessary.