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Helleringer S, Liu L, Chu Y, Rodrigues A, Fisker AB. Biases in Survey Estimates of Neonatal Mortality: Results From a Validation Study in Urban Areas of Guinea-Bissau. Demography 2021; 57:1705-1726. [PMID: 32914335 DOI: 10.1007/s13524-020-00911-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neonatal deaths (occurring within 28 days of birth) account for close to one-half of all deaths among children under age 5 worldwide. In most low- and middle-income countries, data on neonatal deaths come primarily from household surveys. We conducted a validation study of survey data on neonatal mortality in Guinea-Bissau (West Africa). We used records from an urban health and demographic surveillance system (HDSS) that monitors child survival prospectively as our reference data set. We selected a stratified sample of 599 women aged 15-49 among residents of the HDSS and collected the birth histories of 422 participants. We cross-tabulated survey and HDSS data. We used a mathematical model to investigate biases in survey estimates of neonatal mortality. Reporting errors in survey data might lead to estimates of the neonatal mortality rate that are too high, which may limit our ability to track progress toward global health objectives.
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Affiliation(s)
- Stéphane Helleringer
- Division of Social Science Program on Social Research and Public Policy, New York University - Abu Dhabi, P.O. Box 129188, Abu Dhabi, United Arab Emirates.
| | - Li Liu
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Yue Chu
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | | | - Ane Barent Fisker
- Bandim Health Project, Bissau, Guinea-Bissau
- University of Southern Denmark, Odense, Denmark
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Haider MM, Alam N, Ibn Bashar M, Helleringer S. Adult death registration in Matlab, rural Bangladesh: completeness, correlates, and obstacles. GENUS 2021; 77:13. [PMID: 34312569 PMCID: PMC8295546 DOI: 10.1186/s41118-021-00125-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022] Open
Abstract
Civil registration of vital events such as deaths and births is a key part of the process of securing rights and benefits for individuals worldwide. It also enables the production of vital statistics for local planning of social services. In many low- and lower-middle-income countries, however, civil registration and vital statistics (CRVS) systems do not adequately register significant numbers of births and, especially, deaths. In this study, we aim to estimate the completeness of adult death registration (for age 15 and older) in the Matlab health and demographic surveillance system (HDSS) area in Bangladesh and to identify reasons for (not) registering deaths in the national CRVS system. We conducted a sample survey of 2538 households and recorded 571 adult deaths that had occurred in the 3 years preceding the survey. Only 17% of these deaths were registered in the national CRVS system, with large gender differences in registration rates (male = 26% vs. female = 5%). Respondents who reported that a recent death in the household was registered indicated that the primary reasons for registration were to secure an inheritance and to access social services. The main reasons cited for not registering a death were lack of knowledge about CRVS and not perceiving the benefits of death registration. Information campaigns to raise awareness of death registration, as well as stronger incentives to register deaths, may be needed to improve the completeness of death registration in Bangladesh. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s41118-021-00125-7.
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Affiliation(s)
- M. Moinuddin Haider
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nurul Alam
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mamun Ibn Bashar
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Stéphane Helleringer
- Division of Social Science, New York University Abu Dhabi (NYUAD), Abu Dhabi, United Arab Emirates
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Berrueta M, Ciapponi A, Bardach A, Cairoli FR, Castellano FJ, Xiong X, Stergachis A, Zaraa S, Meulen AST, Buekens P. Maternal and neonatal data collection systems in low- and middle-income countries for maternal vaccines active safety surveillance systems: A scoping review. BMC Pregnancy Childbirth 2021; 21:217. [PMID: 33731029 PMCID: PMC7968860 DOI: 10.1186/s12884-021-03686-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Most post-licensure vaccine pharmacovigilance in low- and middle-income countries (LMICs) are passive reporting systems. These have limited utility for maternal immunization pharmacovigilance in LMIC settings and need to be supplemented with active surveillance. Our study's main objective was to identify existing perinatal data collection systems in LMICs that collect individual information on maternal and neonatal health outcomes and could be developed to inform active safety surveillance of novel vaccines for use during pregnancy. METHODS A scoping review was performed following the Arksey and O'Malley six-stage approach. We included studies describing electronic or mixed paper-electronic data collection systems in LMICs, including research networks, electronic medical records, and custom software platforms for health information systems. Medline PubMed, EMBASE, Global Health, Cochrane Library, LILACS, Bibliography of Asian Studies (BAS), and CINAHL were searched through August 2019. We also searched grey literature including through Google and websites of existing relevant perinatal data collection systems, as well as contacted authors of key studies and experts in the field to validate the information and identify additional sources of relevant unpublished information. RESULTS A total of 11,817 records were identified. The full texts of 264 records describing 96 data collection systems were assessed for eligibility. Eight perinatal data collection systems met our inclusion criteria: Global Network's Maternal Newborn Health Registry, International Network for the Demographic Evaluation of Populations and their Health; Perinatal Informatic System; Pregnancy Exposure Registry & Birth Defects Surveillance; SmartCare; Open Medical Record System; Open Smart Register Platform and District Health Information Software 2. These selected systems were qualitatively characterized according to seven different domains: governance; system design; system management; data management; data sources, outcomes and data quality. CONCLUSION This review provides a list of active maternal and neonatal data collection systems in LMICs and their characteristics as well as their outreach, strengths, and limitations. Findings could potentially help further understand where to obtain population-based high-quality information on outcomes to inform the conduct of maternal immunization active vaccine safety surveillance activities and research in LMICs.
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Affiliation(s)
- Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina.
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Federico Rodriguez Cairoli
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Fabricio J Castellano
- Instituto de Efectividad Clínica y Sanitaria (IECS), Dr. Emilio Ravignani 2024 (C1014CPV), Buenos Aires, Argentina
| | - Xu Xiong
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | | | - Sabra Zaraa
- University of Washington, Seattle, WA, 98195-7631, USA
| | | | - Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
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Masquelier B, Kanyangarara M, Pison G, Kanté AM, Ndiaye CT, Douillot L, Duthé G, Sokhna C, Delaunay V, Helleringer S. Errors in reported ages and dates in surveys of adult mortality: A record linkage study in Niakhar (Senegal). Population Studies 2021; 75:269-287. [PMID: 33390060 DOI: 10.1080/00324728.2020.1854332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sibling survival histories are a major source of adult mortality estimates in countries with incomplete death registration. We evaluate age and date reporting errors in sibling histories collected during a validation study in the Niakhar Health and Demographic Surveillance System (Senegal). Participants were randomly assigned to either the Demographic and Health Survey questionnaire or a questionnaire incorporating an event history calendar, recall cues, and increased probing strategies. We linked 60-62 per cent of survey reports of siblings to the reference database using manual and probabilistic approaches. Both questionnaires showed high sensitivity (>96 per cent) and specificity (>97 per cent) in recording siblings' vital status. Respondents underestimated the age of living siblings, and age at and time since death of deceased siblings. These reporting errors introduced downward biases in mortality estimates. The revised questionnaire improved reporting of age of living siblings but not of age at or timing of deaths.
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Affiliation(s)
- Bruno Masquelier
- Université catholique de Louvain.,Institut national d'études démographiques
| | | | - Gilles Pison
- Institut national d'études démographiques.,French Museum of Natural History
| | | | | | | | | | - Cheikh Sokhna
- VITROME, Institut de recherche pour le développement
| | - Valérie Delaunay
- LPED, Institut de recherche pour le développement, Aix Marseille Univ
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Estimating mortality from external causes using data from retrospective surveys: A validation study in Niakhar (Senegal). DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.38.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Liu L, Kalter HD, Chu Y, Kazmi N, Koffi AK, Amouzou A, Joos O, Munos M, Black RE. Understanding Misclassification between Neonatal Deaths and Stillbirths: Empirical Evidence from Malawi. PLoS One 2016; 11:e0168743. [PMID: 28030594 PMCID: PMC5193424 DOI: 10.1371/journal.pone.0168743] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 12/05/2016] [Indexed: 12/02/2022] Open
Abstract
Improving the counting of stillbirths and neonatal deaths is important to tracking Sustainable Development Goal 3.2 and improving vital statistics in low- and middle-income countries (LMICs). However, the validity of self-reported stillbirths and neonatal deaths in surveys is often threatened by misclassification errors between the two birth outcomes. We assessed the extent and correlates of stillbirths being misclassified as neonatal deaths by comparing two recent and linked population surveys conducted in Malawi, one being a full birth history (FBH) survey, and the other a follow-up verbal/social autopsy (VASA) survey. We found that one-fifth of 365 neonatal deaths identified in the FBH survey were classified as stillbirths in the VASA survey. Neonatal deaths with signs of movements in the last few days before delivery reported were less likely to be misclassified stillbirths (OR = 0.08, p<0.05). Having signs of birth injury was found to be associated with higher odds of misclassification (OR = 6.17, p<0.05). We recommend replicating our study with larger sample size in other settings. Additionally, we recommend conducting validation studies to confirm accuracy and completeness of live births and neonatal deaths reported in household surveys with events reported in a full birth history and the extent of underestimation of neonatal mortality resulting from misclassifications. Questions on fetal movement, signs of life at delivery and improved probing among older mother may be useful to improve accuracy of reported events.
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Affiliation(s)
- Li Liu
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Henry D. Kalter
- Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Yue Chu
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Narjis Kazmi
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Alain K. Koffi
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Agbessi Amouzou
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Olga Joos
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Melinda Munos
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Robert E. Black
- The Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, Fat DM, Boerma T, Temmerman M, Mathers C, Say L. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet 2016; 387:462-74. [PMID: 26584737 PMCID: PMC5515236 DOI: 10.1016/s0140-6736(15)00838-7] [Citation(s) in RCA: 1148] [Impact Index Per Article: 143.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Millennium Development Goal 5 calls for a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed projections to show the requirements for the Sustainable Development Goal (SDG) of less than 70 maternal deaths per 100,000 livebirths globally by 2030. METHODS We updated the UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) database with more than 200 additional records (vital statistics from civil registration systems, surveys, studies, or reports). We generated estimates of maternal mortality and related indicators with 80% uncertainty intervals (UIs) using a Bayesian model. The model combines the rate of change implied by a multilevel regression model with a time-series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources. RESULTS We had data for 171 of 183 countries. The global MMR fell from 385 deaths per 100,000 livebirths (80% UI 359-427) in 1990, to 216 (207-249) in 2015, corresponding to a relative decline of 43·9% (34·0-48·7), with 303,000 (291,000-349,000) maternal deaths worldwide in 2015. Regional progress in reducing the MMR since 1990 ranged from an annual rate of reduction of 1·8% (0·0-3·1) in the Caribbean to 5·0% (4·0-6·0) in eastern Asia. Regional MMRs for 2015 ranged from 12 deaths per 100,000 livebirths (11-14) for high-income regions to 546 (511-652) for sub-Saharan Africa. Accelerated progress will be needed to achieve the SDG goal; countries will need to reduce their MMRs at an annual rate of reduction of at least 7·5%. INTERPRETATION Despite global progress in reducing maternal mortality, immediate action is needed to meet the ambitious SDG 2030 target, and ultimately eliminate preventable maternal mortality. Although the rates of reduction that are needed to achieve country-specific SDG targets are ambitious for most high mortality countries, countries that made a concerted effort to reduce maternal mortality between 2000 and 2010 provide inspiration and guidance on how to accomplish the acceleration necessary to substantially reduce preventable maternal deaths. FUNDING National University of Singapore, National Institute of Child Health and Human Development, USAID, and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
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Affiliation(s)
| | - Doris Chou
- World Health Organization, Geneva, Switzerland.
| | | | | | | | | | | | - Ties Boerma
- World Health Organization, Geneva, Switzerland
| | | | | | - Lale Say
- World Health Organization, Geneva, Switzerland
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