Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study

Joseph Akuze; Hannah Blencowe; Peter Waiswa; Angela Baschieri; Vladimir S. Gordeev; Doris Kwesiga; Ane B. Fisker; Sanne M. Thysen; Amabelia Rodrigues; Gashaw A. Biks; Solomon M. Abebe; Kassahun A. Gelaye; Mezgebu Y. Mengistu; Bisrat M. Geremew; Tadesse G. Delele; Adane K. Tesega; Temesgen A. Yitayew; Simon Kasasa; Edward Galiwango; Davis Natukwatsa; Dan Kajungu; Yeetey AK Enuameh; Obed E. Nettey; Francis Dzabeng; Seeba Amenga-Etego; Sam K. Newton; Charlotte Tawiah; Kwaku P. Asante; Seth Owusu-Agyei; Nurul Alam; Moinuddin M. Haider; Ali Imam; Kaiser Mahmud; Simon Cousens; Joy E. Lawn; Tadesse Awoke Ayele; Telake Bisetegn Bisetegn; Nafisa Delwar; Lemma Derseh Gezie; Collins Gyezaho; Judith Kaija; Kazuyo Machiyama; Grace Manu; Alexander A. Manu; Justiniano SD Martins; Tesfahun Melese; Sayed S. Alam; Tryphena Nareeba; Victoria Ponce Hardy; Charles Zandoh; Fred Arnold; Peter Byass; Trevor Croft; Kobus Herbst; Sunita Kishor Kishor; Florina Serbanescu

doi:10.1016/S2214-109X(20)30044-9

Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study

Joseph Akuze
, Hannah Blencowe
, Peter Waiswa
, Angela Baschieri
, Vladimir S. Gordeev
, Doris Kwesiga
, Ane B. Fisker
, Sanne M. Thysen
, Amabelia Rodrigues
, Gashaw A. Biks
, Solomon M. Abebe
, Kassahun A. Gelaye
, Mezgebu Y. Mengistu
, Bisrat M. Geremew
, Tadesse G. Delele
, Adane K. Tesega
, Temesgen A. Yitayew
, Simon Kasasa
, Edward Galiwango
, Davis Natukwatsa

Dan Kajungu, Yeetey AK Enuameh, Obed E. Nettey, Francis Dzabeng, Seeba Amenga-Etego, Sam K. Newton, Charlotte Tawiah, Kwaku P. Asante, Seth Owusu-Agyei, Nurul Alam, Moinuddin M. Haider, Ali Imam, Kaiser Mahmud, Simon Cousens, Joy E. Lawn, Tadesse Awoke Ayele, Telake Bisetegn Bisetegn, Nafisa Delwar, Lemma Derseh Gezie, Collins Gyezaho, Judith Kaija, Kazuyo Machiyama, Grace Manu, Alexander A. Manu, Justiniano SD Martins, Tesfahun Melese, Sayed S. Alam, Tryphena Nareeba, Victoria Ponce Hardy, Charles Zandoh, Fred Arnold, Peter Byass, Trevor Croft, Kobus Herbst, Sunita Kishor Kishor, Florina Serbanescu

Epidemiology and Disease Control

London School of Hygiene & Tropical Medicine
Makerere University
Karolinska Institutet
Queen Mary University of London
Bandim Health Project
Statens Serum Institut
University of Southern Denmark
Aarhus University
Gondar University
IgangaMayuge Health and Demographic Surveillance System
Kwame Nkrumah University of Science and Technology
Kintampo Health Research Centre
University of Health and Allied Sciences
Health Systems and Population Studies Division

Research output: Contribution to journal › Article › peer-review

48 Citations (Scopus)

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.

Original language	English
Pages (from-to)	e555-e566
Journal	The Lancet Global Health
Volume	8
Issue number	4
DOIs	https://doi.org/10.1016/S2214-109X(20)30044-9
Publication status	Published - Apr 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1016/S2214-109X(20)30044-9

Cite this

Akuze, J., Blencowe, H., Waiswa, P., Baschieri, A., Gordeev, V. S., Kwesiga, D., Fisker, A. B., Thysen, S. M., Rodrigues, A., Biks, G. A., Abebe, S. M., Gelaye, K. A., Mengistu, M. Y., Geremew, B. M., Delele, T. G., Tesega, A. K., Yitayew, T. A., Kasasa, S., Galiwango, E., ... Serbanescu, F. (2020). Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study. The Lancet Global Health, 8(4), e555-e566. https://doi.org/10.1016/S2214-109X(20)30044-9

@article{5de99de0d67247849558a0599d997e5c,

title = "Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study",

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.",

author = "Joseph Akuze and Hannah Blencowe and Peter Waiswa and Angela Baschieri and Gordeev, \{Vladimir S.\} and Doris Kwesiga and Fisker, \{Ane B.\} and Thysen, \{Sanne M.\} and Amabelia Rodrigues and Biks, \{Gashaw A.\} and Abebe, \{Solomon M.\} and Gelaye, \{Kassahun A.\} and Mengistu, \{Mezgebu Y.\} and Geremew, \{Bisrat M.\} and Delele, \{Tadesse G.\} and Tesega, \{Adane K.\} and Yitayew, \{Temesgen A.\} and Simon Kasasa and Edward Galiwango and Davis Natukwatsa and Dan Kajungu and Enuameh, \{Yeetey AK\} and Nettey, \{Obed E.\} and Francis Dzabeng and Seeba Amenga-Etego and Newton, \{Sam K.\} and Charlotte Tawiah and Asante, \{Kwaku P.\} and Seth Owusu-Agyei and Nurul Alam and Haider, \{Moinuddin M.\} and Ali Imam and Kaiser Mahmud and Simon Cousens and Lawn, \{Joy E.\} and Ayele, \{Tadesse Awoke\} and Bisetegn, \{Telake Bisetegn\} and Nafisa Delwar and Gezie, \{Lemma Derseh\} and Collins Gyezaho and Judith Kaija and Kazuyo Machiyama and Grace Manu and Manu, \{Alexander A.\} and Martins, \{Justiniano SD\} and Tesfahun Melese and Alam, \{Sayed S.\} and Tryphena Nareeba and Hardy, \{Victoria Ponce\} and Charles Zandoh and Fred Arnold and Peter Byass and Trevor Croft and Kobus Herbst and Kishor, \{Sunita Kishor\} and Florina Serbanescu",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license",

year = "2020",

month = apr,

doi = "10.1016/S2214-109X(20)30044-9",

language = "English",

volume = "8",

pages = "e555--e566",

journal = "The Lancet Global Health",

issn = "2572-116X",

publisher = "Elsevier Ltd.",

number = "4",

}

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, YAK, 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, Ayele, TA, Bisetegn, TB, Delwar, N, Gezie, LD, Gyezaho, C, Kaija, J, Machiyama, K, Manu, G, Manu, AA, Martins, JSD, Melese, T, Alam, SS, Nareeba, T, Hardy, VP, Zandoh, C, Arnold, F, Byass, P, Croft, T, Herbst, K, Kishor, SK & Serbanescu, F 2020, 'Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study', The Lancet Global Health, vol. 8, no. 4, pp. e555-e566. https://doi.org/10.1016/S2214-109X(20)30044-9

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

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 - https://www.scopus.com/pages/publications/85081663314

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 -

Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study

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UN SDGs

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