Improving survey data on births and neonatal deaths in low-income countries

改善低收入国家出生和新生儿死亡调查数据

• 批准号: 9260021
• 负责人: Stephane Helleringer
• 金额: $ 18.25万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-11 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9260021
• 关键词: Address; Adult; Affect; Africa; Africa South of the Sahara; Age; Area; Asia; Birth; Birth History; Calendar; Centers for Disease Control and Prevention (U.S.); Cessation of life; Child; Child health care; Collection; Control Groups; Country; Cues; Data; Data Collection; Data Quality; Data Set; Data Sources; Demographic and Health Surveys; Disease; Educational Status; Effectiveness; Epidemiology; Evaluation; Event; Federal Government; Field Workers; Focus Groups; Funding; Goals; Guinea-Bissau; Health; Health Information System; Infant Mortality; Institution; International; Interview; Interviewer; Investments; Life; Malaria; Measles; Measurement; Measures; Methods; Monitor; Mothers; Neonatal; Neonatal Mortality; Newborn Infant; Outcome; Pneumonia; Population; Pregnancy; Program Effectiveness; Questionnaires; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Resources; Respondent; Risk; Sampling; Sensitivity and Specificity; Source Code; Subgroup; Surveys; System; Techniques; Testing; Time; UNFPA; UNICEF; USAID; United States National Institutes of Health; Woman; aged; computer code; design; flexibility; improved; innovation; instrument; low income country; mortality; multilevel analysis; neonatal death; novel strategies; open source; population based; prevent; primary outcome; programs; prospective; public health relevance; secondary outcome; stillbirth; therapy design; tool; treatment group; trend

 DESCRIPTION (provided by applicant): The risk of dying under the age of 5 has declined significantly worldwide. This trend is primarily due to reductions in diseases and conditions that affect children aged 1 to 59 months old (e.g., measles, diarrheal diseases, pneumonia, Malaria). As a result, an increasing proportion of remaining children deaths occurs during the first 28 days of life. New health programs funded by federal institutions (e.g., NIH, CDC, USAID) and international organizations, now invest large amounts of resources in preventing such neonatal deaths in low- income countries. But the impact of such investments remains unclear because robust measures of neonatal mortality rates are difficult to obtain, particularly in countries of sub-Saharan Africa and south Asia where the risk of neonatal deaths is the highest. In these countries, vital registration and health information systems are too inadequate to yield robust counts of a) the total number of births occurring in a population, and b) the number of deaths that occurred during the first 28 days of life. Instead, data on neonatal mortality are collected retrospectively during population-based surveys such as the Demographic and Health Surveys (DHS). Women aged 15-49 years are asked to recall their birth history and report whether each of their children is still alive or has died prior to the survey. Such data may misrepresent the extent of neonatal mortality due to 1) under- reporting of births, particularly those that resultedin a neonatal death, 2) misreporting of the age at death of a child (e.g., neonatal deaths reported as occurring during the post-neonatal period) and 3) misclassifications of stillbirths as neonatal deaths and vice-versa. In this project, we will test whether a new survey instrument helps improve the quality of data on neonatal deaths during surveys. This instrument - the mobile birth history calendar (mBHC) - uses simple tools that have been widely and successfully used in other areas of survey research, but have not been used to improve neonatal mortality data. These include, for example, recall cues, anchoring vignettes and event history calendars. To further improve the effectiveness of these tools, we will integrate them into a flexible mobile dat collection platform (ODK) increasingly used for data collection in population-based surveys in low-income countries. We will then conduct a randomized controlled trial of the new mBHC in Guinea-Bissau, which will determine whether this new instrument improves mortality data relative to the standard instrument currently in use. If successful, the proposed mBHC will constitute a new approach to eliciting survey data on neonatal mortality that can be tested on a larger scale and possibly incorporated in national surveys of adult mortality (e.g., DHS). The source code for the mBHC will be made publicly-available so that other data collection initiatives can easily integrate similar tools into their study instruments.

 描述（由申请人提供）：全世界 5 岁以下死亡的风险已显着下降。这一趋势主要是由于影响 1 至 59 个月大儿童的疾病和病症（例如麻疹、腹泻病、肺炎、疟疾）减少。因此，剩余儿童死亡中发生在出生后 28 天内的比例不断增加。由联邦机构（例如美国国立卫生研究院、疾病预防控制中心、美国国际开发署）和国际组织资助的新卫生计划现在投入大量资源来预防低收入国家的此类新生儿死亡。但此类投资的影响仍不清楚，因为很难获得新生儿死亡率的强有力衡量标准，特别是在新生儿死亡风险最高的撒哈拉以南非洲和南亚国家。在这些国家，生命登记和健康信息系统太不充分，无法提供可靠的统计数据：a) 人口中的出生总数，b) 出生后 28 天内发生的死亡人数。相反，新生儿死亡率数据是在人口统计和健康调查 (DHS) 等基于人口的调查中回顾性收集的。 15-49 岁的女性被要求回忆她们的出生史，并报告她们的每个孩子在调查前是否还活着或已经死亡。这些数据可能会误报新生儿死亡率，原因如下：1) 出生情况漏报，特别是导致新生儿死亡的出生情况；2) 误报儿童死亡年龄（例如，报告的新生儿死亡发生在新生儿后期）；3) 将死产错误分类为新生儿死亡，反之亦然。在这个项目中，我们将测试新的调查工具是否有助于提高调查期间新生儿死亡数据的质量。该工具 - 移动出生史日历（mBHC） - 使用简单的工具，已广泛且成功地应用于其他调查研究领域，但尚未用于改善新生儿死亡率数据。例如，其中包括回忆线索、锚定小插图和事件历史日历。为了进一步提高这些工具的有效性，我们将把它们集成到一个灵活的移动数据收集平台（ODK）中，该平台越来越多地用于低收入国家基于人口的调查中的数据收集。然后，我们将在几内亚比绍对新的 mBHC 进行随机对照试验，以确定这种新仪器相对于目前使用的标准仪器是否可以改善死亡率数据。如果成功，拟议的 mBHC 将构成一种获取新生儿死亡率调查数据的新方法，可以在更大范围内进行测试，并可能纳入国家成人死亡率调查（例如 DHS）。 mBHC 的源代码将公开，以便其他数据收集计划可以轻松地将类似的工具集成到他们的研究工具中。