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"Every Newborn-BIRTH" protocol: observational study validating indicators for coverage and quality of maternal and newborn health care in Bangladesh, Nepal and Tanzania
LSHTM, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.
LSHTM, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.
LSHTM, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.
LSHTM, Maternal Adolescent Reprod & Child Hlth MARCH Ctr, Keppel St, London WC1E 7HT, England.
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2019 (English)In: Journal of Global Health, ISSN 2047-2978, E-ISSN 2047-2986, Vol. 9, no 1, article id 010902Article in journal (Refereed) Published
Abstract [en]

Background: To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone, to content of care. As facility births increase, monitoring using routine facility data in DHIS2 has potential, yet validation research has mainly focussed on maternal recall surveys. The Every Newborn - Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study aims to validate selected newborn and maternal indicators for routine tracking of coverage and quality of facility-based care for use at district, national and global levels.

Methods: EN-BIRTH is an observational study including >20000 facility births in three countries (Tanzania, Bangladesh and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, immediate newborn care, neonatal resuscitation and Kangaroo mother care. Indicators including neonatal infection management and antenatal corticosteroid administration, which cannot be easily observed, will be validated using inpatient records. Trained clinical observers in Labour/Delivery ward, Operation theatre, and Kangaroo mother care ward/areas will collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerators with adequate information. Other objectives include comparison of denominator options (ie, true target population or surrogates) and quality of care analyses, especially regarding intervention timing. Barriers and enablers to routine recording and data usage will be assessed by data flow assessments, quantitative and qualitative analyses.

Conclusions: To our knowledge, this is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths.

Place, publisher, year, edition, pages
2019. Vol. 9, no 1, article id 010902
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-392054DOI: 10.7189/jogh.09.010902ISI: 000476640500085OAI: oai:DiVA.org:uu-392054DiVA, id: diva2:1349841
Funder
Swedish Research CouncilAvailable from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved

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