PNC validation results
| Indicator | Study | Client-reported (n) | Don’t know (n) | Matched (n) | TP | FP | FN | TN | Observed (true) prevalence | Estimated prevalence | Sensitivity (95% CI) | Specificity (95% CI) | AUC (95% CI) | IF | Met both criteria? | No. studies both criteria met† |
| Maternal care | ||||||||||||||||
| Blood pressure check | BA | 209 | 0 | 208 | 49 | 2 | 2 | 155 | 24.5 | 24.5 | 96.1 (86.5 to 99.5) | 98.7 (95.5 to 99.8) | 0.974 (0.95 to 1.00) | 1.00 | Y | * |
| CA | 633 | 0 | 632 | 523 | 29 | 18 | 62 | 85.6 | 87.3 | 96.7 (94.8 to 98.0) | 68.1 (57.5 to 77.5) | 0.824 (0.78 to 0.87) | 1.02 | Y | ||
| KE | 1585 | 4 | 1577 | 268 | 216 | 104 | 989 | 23.6 | 30.7 | 72.0 (67.2 to 76.5) | 82.1 (79.8 to 84.2) | 0.771 (0.75 to 0.80) | 1.30 | N | ||
| Breast examination | BA | 209 | 0 | 208 | 7 | 4 | 2 | 195 | 4.3 | 5.3 | 77.8 (40.0 to 97.2) | 98.0 (94.9 to 99.4) | NA | * | ||
| CA | 633 | 0 | 632 | 267 | 75 | 50 | 240 | 50.2 | 54.1 | 84.2 (79.7 to 88.1) | 76.2 (71.1 to 80.8) | 0.802 (0.77 to 0.83) | 1.08 | Y | ||
| KE | 1585 | 1 | 1580 | 153 | 202 | 70 | 1155 | 14.1 | 22.5 | 68.6 (62.1 to 74.6) | 85.1 (83.1 to 87.0) | 0.769 (0.74 to 0.80) | 1.59 | N | ||
| Examine abdomen | BA | 209 | 0 | 208 | 6 | 4 | 10 | 188 | 7.7 | 4.8 | 37.5 (15.2 to 64.6) | 97.9 (94.8 to 99.4) | NA | * | ||
| CA | 633 | 0 | 632 | 395 | 97 | 38 | 102 | 68.5 | 77.8 | 91.2 (88.2 to 93.7) | 51.3 (44.1 to 58.4) | 0.712 (0.68 to 0.75) | 1.14 | Y | ||
| KE | 1585 | 0 | 1582 | 201 | 269 | 33 | 1079 | 14.8 | 29.7 | 85.9 (80.8 to 90.1) | 80.0 (77.8 to 82.1) | 0.830 (0.8 to 0.85) | 2.01 | N | ||
| Examine vagina | BA | 209 | 0 | 208 | 35 | 10 | 16 | 147 | 24.5 | 21.6 | 68.6 (54.1 to 80.9) | 93.6 (88.6 to 96.9) | 0.811 (0.74 to 0.88) | 0.88 | Y | * |
| CA | 633 | 0 | 632 | 234 | 110 | 25 | 263 | 41.0 | 54.4 | 90.3 (86.1 to 93.7) | 70.5 (65.6 to 75.1) | 0.804 (0.77 to 0.83) | 1.33 | N | ||
| KE | 1586 | 0 | 1582 | 53 | 215 | 35 | 1279 | 5.6 | 16.9 | 60.2 (49.2 to 70.5) | 85.6 (83.7 to 87.4) | 0.729 (0.68 to 0.78) | 3.03 | N | ||
| Check anaemia (pallor or refer to HB test) | BA | 209 | 0 | 208 | 40 | 6 | 17 | 145 | 27.4 | 22.1 | 70.2 (56.6 to 81.6) | 96.0 (91.6 to 98.5) | 0.831 (0.77 to 0.89) | 0.81 | Y | * |
| CA | 633 | 0 | 506 | 215 | 68 | 59 | 164 | 54.2 | 56.0 | 78.5 (73.1 to 83.2) | 70.7 (64.4 to 76.5) | 0.746 (0.71 to 0.78) | 1.03 | Y | ||
| KE | 1585 | 11 | 1568 | 125 | 200 | 110 | 1133 | 15.0 | 20.7 | 53.2 (46.6 to 59.7) | 85.0 (83 to 86.9) | 0.691 (0.66 to 0.72) | 1.38 | N | ||
| Ask about excessive bleeding | BA | 209 | 0 | 208 | 24 | 11 | 21 | 152 | 21.6 | 16.8 | 53.3 (37.9 to 68.3) | 93.3 (88.2 to 96.6) | NA | * | ||
| CA | 633 | 0 | 632 | 237 | 150 | 73 | 172 | 49.1 | 61.2 | 76.5 (71.3 to 81.1) | 53.4 (47.8 to 59) | 0.649 (0.61 to 0.69) | 1.25 | N | ||
| KE | 1586 | 1 | 1581 | 291 | 226 | 145 | 919 | 27.6 | 32.7 | 66.7 (62.1 to 71.2) | 80.3 (77.8 to 82.5) | 0.735 (0.71 to 0.76) | 1.19 | Y | ||
| Discuss danger signs for the mother | BA | 209 | 1 | 208 | 18 | 16 | 31 | 143 | 23.6 | 16.4 | 36.7 (23.4 to 51.7) | 89.9 (84.2 to 94.1) | 0.633 (0.56 to 0.71) | 0.69 | N | |
| CA | 633 | 0 | 632 | 131 | 120 | 80 | 301 | 33.4 | 39.7 | 62.1 (55.2 to 68.7) | 71.5 (66.9 to 75.8) | 0.668 (0.63 to 0.71) | 1.19 | N | ||
| KE | 1586 | 2 | 1578 | 100 | 184 | 154 | 1140 | 16.1 | 18.0 | 39.4 (33.3 to 45.7) | 86.1 (84.1 to 87.9) | 0.627 (0.60 to 0.66) | 1.12 | N | ||
| Provider: nurse/midwife | BA | 209 | 0 | 208 | 11 | 1 | 3 | 193 | 6.7 | 5.7 | 78.6 (49.2 to 95.3) | 99.5 (97.2 to 100.0) | NA | |||
| KE | 1419 | 0 | 1414 | 1100 | 110 | 154 | 50 | 88.7 | 85.6 | 87.7 (85.8 to 89.5) | 31.2 (24.2 to 39.0) | 0.595 (0.56 to 0.63) | 0.96 | N | ||
| Provider: doctor/medical officer | BA | 209 | 0 | 208 | 141 | 6 | 1 | 60 | 68.3 | 70.7 | 99.3 (96.1 to 100.0) | 90.9 (81.3 to 96.6) | 0.951 (0.92 to 0.99) | 1.04 | Y | * |
| KE | 1419 | 0 | 1414 | 19 | 108 | 17 | 1270 | 2.5 | 9.0 | 52.8 (35.5 to 69.6) | 92.2 (90.6 to 93.5) | NA | ||||
| Discuss STIs or HIV/AIDS | CA | 633 | 0 | 632 | 12 | 46 | 7 | 567 | 3.0 | 9.2 | 63.2 (38.4 to 83.7) | 92.5 (90.1 to 94.5) | NA | |||
| KE | 1586 | 3 | 1582 | 72 | 296 | 35 | 1179 | 6.8 | 23.3 | 67.3 (57.5 to 76.0) | 79.9 (77.8 to 81.9) | 0.736 (0.69 to 0.78) | 3.42 | N | ||
| Discuss family planning* | BA | 209 | 0 | 208 | 19 | 1 | 183 | 5 | 11.5 | 9.6 | 79.2 (57.8 to 92.9) | 99.5 (97.0 to 100.0) | NA | * | ||
| CA | 633 | 0 | 632 | 210 | 165 | 213 | 44 | 40.2 | 59.2 | 82.7 (77.5 to 87.1) | 56.3 (51.2 to 61.4) | 0.696 (0.66 to 0.73) | 1.48 | N | ||
| KE | 1586 | 0 | 1585 | 413 | 256 | 164 | 752 | 36.4 | 42.2 | 71.6 (67.7 to 75.2) | 74.6 (71.8 to 77.3) | 0.731 (0.71 to 0.75) | 1.16 | Y | ||
| Newborn care | ||||||||||||||||
| Discuss breast feeding/infant feeding | BA | 209 | 0 | 208 | 129 | 11 | 16 | 52 | 69.7 | 67.3 | 89.0 (82.7 to 93.6) | 82.5 (70.9 to 90.9) | 0.858 (0.80 to 0.91) | 0.97 | Y | * |
| CA | 605 | 0 | 605 | 428 | 51 | 58 | 68 | 80.3 | 79.2 | 88.1 (84.8 to 90.8) | 57.1 (47.7 to 66.2) | 0.726 (0.68 to 0.77) | 0.99 | Y | ||
| KE | 1585 | 1 | 1577 | 752 | 244 | 233 | 348 | 62.5 | 63.2 | 76.3 (73.6 to 79.0) | 58.8 (54.7 to 62.8) | 0.676 (0.65 to 0.70) | 1.01 | N | ||
| Examine baby (undressed) | BA | 38 | 0 | 37 | 13 | 2 | 4 | 18 | 45.9 | 40.5 | 76.5 (50.1 to 93.2) | 90.0 (68.3 to 98.8) | NA | * | ||
| CA | 605 | 0 | 521 | 208 | 151 | 20 | 142 | 43.8 | 68.9 | 91.2 (86.8 to 94.6) | 48.5 (42.6 to 54.3) | 0.698 (0.66 to 0.73) | 1.57 | N | ||
| KE | 1577 | 9 | 1564 | 345 | 677 | 137 | 405 | 30.8 | 65.3 | 71.6 (67.3 to 75.6) | 37.4 (34.5 to 40.4) | 0.545 (0.52 to 0.57) | 2.12 | N | ||
| Weigh the baby | BA | 209 | 0 | 208 | 19 | 2 | 3 | 184 | 10.6 | 10.1 | 86.4 (65.1 to 97.1) | 98.9 (96.2 to 99.9) | NA | |||
| CA | 605 | 0 | 522 | 352 | 123 | 14 | 33 | 70.1 | 91.0 | 96.2 (93.7 to 97.9) | 21.2 (15 to 28.4) | 0.587 (0.55 to 0.62) | 1.30 | N | ||
| KE | 1582 | 9 | 1537 | 987 | 247 | 102 | 201 | 70.9 | 80.3 | 90.6 (88.7 to 92.3) | 44.9 (40.2 to 49.6) | 0.677 (0.65 to 0.70) | 1.13 | N | ||
| Give advice/discuss immunisation for the baby | BA | 209 | 7 | 201 | 34 | 6 | 9 | 152 | 21.4 | 19.9 | 79.1 (64.0 to 90.0) | 96.2 (91.9 to 98.6) | 0.876 (0.81 to 0.94) | 0.93 | Y | * |
| CA | 605 | 1 | 604 | 407 | 63 | 84 | 50 | 81.3 | 77.7 | 82.7 (79.1 to 86.0) | 44.2 (34.9 to 53.9) | 0.635 (0.59 to 0.68) | 0.96 | N | ||
| KE | 1585 | 3 | 1576 | 1013 | 94 | 356 | 113 | 86.9 | 70.2 | 74 (71.6 to 76.3) | 54.6 (47.5 to 61.5) | 0.643 (0.61 to 0.68) | 0.81 | N | ||
| Immunise the baby | CA | 605 | 1 | 604 | 408 | 119 | 23 | 54 | 71.4 | 87.1 | 94.4 (91.8 to 96.4) | 31.2 (24.4 to 38.7) | 0.628 (0.59 to 0.66) | 1.22 | N | * |
| KE | 1585 | 8 | 1564 | 1207 | 72 | 44 | 241 | 80.0 | 81.8 | 96.5 (95.3 to 97.4) | 77 (71.9 to 81.5) | 0.867 (0.84 to 0.89) | 1.02 | Y | ||
| Give information on baby sickness signs | BA | 209 | 7 | 201 | 31 | 3 | 69 | 98 | 49.8 | 16.9 | 31.0 (21.1 to 41.0) | 97.0 (91.6 to 99.4) | 0.640 (0.59 to 0.69) | 0.34 | N | |
| CA | 605 | 1 | 603 | 95 | 151 | 84 | 273 | 29.7 | 40.8 | 53.1 (45.5 to 60.6) | 64.4 (59.6 to 68.9) | 0.587 (0.54 to 0.63) | 1.37 | N | ||
| KE | 1587 | 4 | 1562 | 181 | 467 | 77 | 837 | 16.5 | 41.5 | 70.2 (64.2 to 75.7) | 64.2 (61.5 to 66.8) | 0.672 (0.64 to 0.70) | 2.51 | N |
Estimated prevalence: estimated prevalence that would be obtained from a household survey applying the sensitivity, specificity and prevalence observed in this study.
Benchmark for high validity is AUC >0.7 and IF between 0.75 and 1.25.
See online supplementary tables 1 and 2 for indicator construction and differences across studies.
*In Bangladesh, a question was asked if the mother was informed or advised on child spacing and family planning.
†Number of asterisks refers to number of studies where both criteria were met.
AUC, area under the receiver operating characteristic curve; BA, Bangladesh; CA, Cambodia; FN, false negative; FP, false positive; HB, haemoglobin; IF, inflation factor; KE, Kenya; N, no; NA, not assessed; PNC, postnatal care; STI, sexually transmitted infection; TN, true negative; TP, true positive; Y, yes.