A Global Perinatal Health Indicator Falters in Afghanistan

ABSTRACTThrough the life of a global health project in a maternity hospital in Kabul, Afghanistan one indicator—intrapartum mortality—was taken to represent the quality of emergency obstetric care and was at the center of a struggle over project management. The indicator was also contested by Afghan clinicians, and so was adapted, in which process the relationship between the indicator and women’s lives outside the hospital was made clear. As the indicator faltered, new possibilities for intervention emerged, although these were not fully realized. Global health governance and financing must be flexible enough to respond when indicators falter.