TY - JOUR
T1 - Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries
T2 - the Every Newborn-INDEPTH study
AU - Akuze, Joseph
AU - Blencowe, Hannah
AU - Waiswa, Peter
AU - Baschieri, Angela
AU - Gordeev, Vladimir S.
AU - Kwesiga, Doris
AU - Fisker, Ane B.
AU - Thysen, Sanne M.
AU - Rodrigues, Amabelia
AU - Biks, Gashaw A.
AU - Abebe, Solomon M.
AU - Gelaye, Kassahun A.
AU - Mengistu, Mezgebu Y.
AU - Geremew, Bisrat M.
AU - Delele, Tadesse G.
AU - Tesega, Adane K.
AU - Yitayew, Temesgen A.
AU - Kasasa, Simon
AU - Galiwango, Edward
AU - Natukwatsa, Davis
AU - Kajungu, Dan
AU - Enuameh, Yeetey AK
AU - Nettey, Obed E.
AU - Dzabeng, Francis
AU - Amenga-Etego, Seeba
AU - Newton, Sam K.
AU - Tawiah, Charlotte
AU - Asante, Kwaku P.
AU - Owusu-Agyei, Seth
AU - Alam, Nurul
AU - Haider, Moinuddin M.
AU - Imam, Ali
AU - Mahmud, Kaiser
AU - Cousens, Simon
AU - Lawn, Joy E.
AU - Ayele, Tadesse Awoke
AU - Bisetegn, Telake Bisetegn
AU - Delwar, Nafisa
AU - Gezie, Lemma Derseh
AU - Gyezaho, Collins
AU - Kaija, Judith
AU - Machiyama, Kazuyo
AU - Manu, Grace
AU - Manu, Alexander A.
AU - Martins, Justiniano SD
AU - Melese, Tesfahun
AU - Alam, Sayed S.
AU - Nareeba, Tryphena
AU - Hardy, Victoria Ponce
AU - Zandoh, Charles
AU - Arnold, Fred
AU - Byass, Peter
AU - Croft, Trevor
AU - Herbst, Kobus
AU - Kishor, Sunita Kishor
AU - Serbanescu, Florina
N1 - Publisher Copyright:
© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2020/4
Y1 - 2020/4
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85081663314&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(20)30044-9
DO - 10.1016/S2214-109X(20)30044-9
M3 - Article
C2 - 32199123
AN - SCOPUS:85081663314
SN - 2572-116X
VL - 8
SP - e555-e566
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 4
ER -