|
1
|
Akuze J, Blencowe H, Waiswa P, Baschieri A, Gordeev VS, Kwesiga D, Fisker AB, Thysen SM, Rodrigues A, Biks GA, Abebe SM, Gelaye KA, Mengistu MY, Geremew BM, Delele TG, Tesega AK, Yitayew TA, Kasasa S, Galiwango E, Natukwatsa D, Kajungu D, Enuameh YA, Nettey OE, Dzabeng F, Amenga-Etego S, Newton SK, Tawiah C, Asante KP, Owusu-Agyei S, Alam N, Haider MM, Imam A, Mahmud K, Cousens S, Lawn JE. Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study. LANCET GLOBAL HEALTH 2020; 8:e555-e566. [PMID: 32199123 DOI: 10.1016/s2214-109x(20)30044-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/15/2020] [Accepted: 01/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires: a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths. METHODS Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by stillbirth rate [SBR] and neonatal mortality rate [NMR]) and mean time taken to complete the maternity history section of the questionnaire. We also assessed between-site heterogeneity. This study is registered with the Research Registry, 4720. FINDINGS 69 176 women were allocated to be interviewed by either FBH+ (n=34 805) or FPH (n=34 371). The mean time taken to complete FPH (10·5 min) was longer than for FBH+ (9·1 min; p<0·0001). Using FPH, the estimated SBR was 17·4 per 1000 total births, 21% (95% CI -10 to 62) higher than with FBH+ (15·2 per 1000 total births; p=0·20) in the 5 years preceding the survey interview. There was strong evidence of between-site heterogeneity (I2=80·9%; p<0·0001), with SBR higher for FPH than for FBH+ in four of five sites. The estimated NMR did not differ between modules (FPH 25·1 per 1000 livebirths vs FBH+ 25·4 per 1000 livebirths), with no evidence of between-site heterogeneity (I2=0·7%; p=0·40). INTERPRETATION FPH takes an average of 1·4 min longer to complete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality. FUNDING Children's Investment Fund Foundation.
Collapse
Affiliation(s)
- Joseph Akuze
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK; Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda.
| | - Hannah Blencowe
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter Waiswa
- Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Angela Baschieri
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Vladimir S Gordeev
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK; The Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Doris Kwesiga
- Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda
| | - Ane B Fisker
- Bandim Health Project, Bissau, Guinea-Bissau; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark; Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sanne M Thysen
- Bandim Health Project, Bissau, Guinea-Bissau; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark; Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Gashaw A Biks
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon M Abebe
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun A Gelaye
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Y Mengistu
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bisrat M Geremew
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse G Delele
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane K Tesega
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen A Yitayew
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Simon Kasasa
- Center of Excellence for Maternal Newborn and Child Health Research, School of Public Health, Makerere University, Kampala, Uganda; IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Edward Galiwango
- IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Davis Natukwatsa
- IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Dan Kajungu
- IgangaMayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Yeetey Ak Enuameh
- Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana; Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | | | - Sam K Newton
- Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana; Kintampo Health Research Centre, Kintampo, Ghana
| | | | | | - Seth Owusu-Agyei
- Malaria Centre, London School of Hygiene & Tropical Medicine, London, UK; Kintampo Health Research Centre, Kintampo, Ghana; University of Health and Allied Sciences, Kintampo Health Research Centre, Kintampo, Ghana
| | - Nurul Alam
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Moinuddin M Haider
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Ali Imam
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Kaiser Mahmud
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Simon Cousens
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive, and Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | |
Collapse
|