Reproductive health (RH) indicators summarize data which have been collected to answer questions that are relevant to the planning and management of reproductive health programmes. The indicators provide a useful tool to assess needs, and monitor and evaluate programme implementation and impact. The indicators capture the occurrence of events such as live births, the prevalence of a characteristic in persons such as the use of contraceptive methods or the prevalence of characteristics of a health facility, for example, health centres which provide family planning services. The indicators are expressed in rates, proportions, averages, categorical variables or absolute numbers.

Following a number of international conferences in the 1990s, in particular the 1994 International Conference on Population and Development (ICPD), many countries have endorsed a number of goals and targets in the broad area of reproductive health. Most of these goals and targets have been formulated with quantifiable and time-bound objectives as part of their national health policies and programmes.

In order to assess the achievements of goals and targets, it is necessary to establish a system for monitoring and evaluation. This involves the definition of essential indicators and guidelines on how to use them. With the expansion and evolution of services of reproductive health, many agencies have been working on developing indicators. As a result, there have been a number of indicators put forward by these organizations, in addition to existing national indicators.

With the trend towards the integration and development of comprehensive reproductive health programmes and their decentralization, the responsibility for planning and management of programmes has been placed at the subnational level. Therefore, indicators are not only required at the national level but also at the subnational level to monitor the effective implementation and evaluate the impact of programmes. However, many reproductive health indicators that have been produced are not necessarily appropriate at the subnational level.

The objective of this handbook, therefore, is to present a guide to a core set of illustrative and practical indicators with examples, wherever possible, to enable programme managers at national and in particular at the subnational level to monitor and evaluate reproductive health programmes and projects. This handbook draws heavily from previous work undertaken in this area (United Nations, 1998; UNFPA, 1996, 1998; Bertrand and others, 1994; Abeykoon, 1999; WHO, 1997a, 1997b).