“Every Newborn-INDEPTH” (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites
Open Access
- 15 February 2019
- journal article
- research article
- Published by International Society of Global Health in Journal of Global Health
- Vol. 9 (1), 010901
- https://doi.org/10.7189/jogh.09.010901
Abstract
Background Under-five and maternal mortality were halved in the Millennium Development Goals (MDG) era, with slower reductions for 2.6 million neonatal deaths and 2.6 million stillbirths. The Every Newborn Action Plan aims to accelerate progress towards national targets, and includes an ambitious Measurement Improvement Roadmap. Population-based household surveys, notably Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys, are major sources of population-level data on child mortality in countries with weaker civil registration and vital statistics systems, where over two-thirds of global child deaths occur. To estimate neonatal/child mortality and pregnancy outcomes (stillbirths, miscarriages, birthweight, gestational age) the most common direct methods are: (1) the standard DHS-7 with Full Birth History with additional questions on pregnancy losses in the past 5 years (FBH+) or (2) a Full Pregnancy History (FPH). No direct comparison of these two methods has been undertaken, although descriptive analyses suggest that the FBH+ may underestimate mortality rates particularly for stillbirths. Methods This is the protocol paper for the Every Newborn-INDEPTH study (INDEPTH Network, international Network for the Demographic Evaluation of Populations and their Health Every Newborn, Every Newborn Action Plan), aiming to undertake a randomised comparison of FBH+ and FPH, to measure pregnancy outcomes in a household survey in five selected INDEPTH Network sites in Africa and South Asia (Bandim in urban and rural Guinea-Bissau; Dabat in Ethiopia; IgangaMayuge in Uganda; Kintampo in Ghana; Matlab in Bangladesh). The survey will reach >68000 pregnancies to assess if there is >= 15% difference in stillbirth rates. Additional questions will capture birthweight, gestational age, birth/death certification, termination of pregnancy and fertility intentions. The World Bank's Survey Solutions platform will be tailored for data collection, including recording paradata to evaluate timing. A mixed methods assessment of barriers and enablers to reporting of pregnancy and adverse pregnancy outcomes will be undertaken. Conclusions This large-scale study is the first randomised comparison of these two methods to capture pregnancy outcomes. Results are expected to inform the evidence base for survey methodology, especially in DHS, regarding capture of stillbirths and other outcomes, notably neonatal deaths, abortions (spontaneous and induced), birthweight and gestational age. In addition, this study will inform strategies to improve health and demographic surveillance capture of neonatal/child mortality and pregnancy outcomes.Keywords
This publication has 22 references indexed in Scilit:
- Count every newborn; a measurement improvement roadmap for coverage dataBMC Pregnancy and Childbirth, 2015
- The validity of birth and pregnancy histories in rural BangladeshJournal of Health, Population and Nutrition, 2015
- An Assessment of Childbearing Preferences in Northern MalawiStudies in Family Planning, 2015
- Every Newborn: progress, priorities, and potential beyond survivalThe Lancet, 2014
- Experiences of African American Parents Following Perinatal or Pediatric Death: A Literature ReviewDeath Studies, 2013
- Stillbirths: Where? When? Why? How to make the data count?The Lancet, 2011
- “These are not good things for other people to know”: How rural Tanzanian women’s experiences of pregnancy loss and early neonatal death may impact survey data qualitySocial Science & Medicine (1982), 2010
- Measuring Birth Weight in Developing Countries: Does the Method of Reporting in Retrospective Surveys Matter?Maternal and Child Health Journal, 2010
- Neonatal mortality in the developing worldDemographic Research, 2006
- Can accurate data on birthweight be obtained from health interview surveys?International Journal of Epidemiology, 1999