Improving survey data on pregnancy-related deaths in low-and middle-income countries: a validation study in Senegal
Improving survey data on pregnancy-related deaths in low-and middle-income countries: a validation study in Senegal
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DOI：
10.1111/tmi.12583
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发表时间：
2015-11-01
影响因子：
3.3
通讯作者：
Delaunay, Valerie
中科院分区：
文献类型：
--
作者：
Helleringer, Stephane;Pison, Gilles;Delaunay, Valerie
在低收入和中等收入国家，兄弟姐妹的生存史（SSH）通常用于估计孕产妇死亡率，但关于育龄期死亡原因的SSH数据很少得到验证。我们比较了两个SSH工具的准确性：在人口与健康调查（DHS）和兄弟姐妹的生存日历（SSC），一个新的问卷调查，旨在提高调查报告的死亡妇女的生育年龄。MethodsWe招募了1189名受访者在SSH调查在Niakhar，塞内加尔。来自健康和人口监测系统（HDSS）的死亡率记录构成了参考数据集。受访者被随机分配到与DHS或SSC问卷采访。共有164名受访者有一个妹妹谁死在生育年龄在过去的15years之前的调查根据HDSS.ResultsDHS问卷导致选择性遗漏的死亡：国土安全部的受访者更有可能报告他们的妹妹的死亡，如果她死于怀孕相关的原因比如果她死于其他原因（96.4% vs.70.9%，P90%）。但DHS问卷的特异性明显低于SSC（79.5%比95.0%，P=0.015）。DHS问卷高估的比例，由于怀孕相关的原因死亡，而SSC得到公正的估计，此parameter.ConclusionStatistical模型使用DHS问卷收集的SSH数据可能会夸大孕产妇死亡率在塞内加尔和类似的设置。一份新的调查表，即SSC，可以更好地跟踪在降低孕产妇死亡率方面取得的进展。
ObjectiveIn low- and middle-income countries (LMICs), siblings' survival histories (SSH) are often used to estimate maternal mortality, but SSH data on causes of death at reproductive ages have seldom been validated. We compared the accuracy of two SSH instruments: the standard questionnaire used during the demographic and health surveys (DHS) and the siblings' survival calendar (SSC), a new questionnaire designed to improve survey reports of deaths among women of reproductive ages.MethodsWe recruited 1189 respondents in a SSH survey in Niakhar, Senegal. Mortality records from a health and demographic surveillance system (HDSS) constituted the reference data set. Respondents were randomly assigned to an interview with the DHS or SSC questionnaires. A total of 164 respondents had a sister who died at reproductive ages over the past 15years before the survey according to the HDSS.ResultsThe DHS questionnaire led to selective omissions of deaths: DHS respondents were significantly more likely to report their sister's death if she had died of pregnancy-related causes than if she had died of other causes (96.4% vs. 70.9%, P90%) in recording pregnancy-related deaths. But the DHS questionnaire had significantly lower specificity than the SSC (79.5% vs. 95.0%, P=0.015). The DHS questionnaire overestimated the proportion of deaths due to pregnancy-related causes, whereas the SSC yielded unbiased estimates of this parameter.ConclusionStatistical models informed by SSH data collected using the DHS questionnaire might exaggerate maternal mortality in Senegal and similar settings. A new questionnaire, the SSC, could permit better tracking progress towards the reduction in maternal mortality.