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Maternal and child health (MCH) indicators need to reflect health issue priorities for the region to enable the process of ‘monitor, review and act’. This paper assesses how well the 11 Global maternal and child health indicators proposed by the United Nations Commission on Information and Accountability for Women’s and Children’s Health suit the Pacific region. We considered the Pacific context of maternal and child health burden and priorities as well as data quality and challenges. We suggest a revised framework for MCH indicators to enable more regional relevance and country accountability. An important limitation of most current and proposed MCH indicators, with the exception of immunisation and HIV data is the lack of functional health information. Existing health information systems need strengthening, especially for civil registration and vital statistics, to enable the indicator framework to effectively measure progress in MCH.