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

 描述（由申请人提供）：全世界5岁以下死亡的风险显著下降。这一趋势主要是由于影响1至59个月儿童的疾病和状况减少（例如，麻疹、腹泻、肺炎、疟疾）。因此，在剩余的儿童中，出生后28天内死亡的比例越来越高。由联邦机构资助的新健康计划（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，现在投入大量资源在低收入国家预防这类新生儿死亡。但这些投资的影响仍不清楚，因为难以获得新生儿死亡率的可靠指标，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，人口动态登记和卫生信息系统太不充分，无法对a）人口中的出生总数和B）出生后28天内的死亡人数进行可靠的统计。相反，新生儿死亡率数据是在人口和健康调查等基于人口的调查中回顾性收集的。15-49岁的妇女被要求回忆她们的出生史，并报告她们的每一个孩子在调查之前是否仍然活着或已经死亡。由于以下原因，这些数据可能会歪曲新生儿死亡率的程度：1）出生报告不足，特别是导致新生儿死亡的出生报告不足，2）儿童死亡年龄报告错误（例如，报告的新生儿死亡发生在新生儿后期）和3）死产被错误分类为新生儿死亡，反之亦然。在本项目中，我们将测试一种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。这一工具-移动的出生史日历（mBHC）-使用简单的工具，这些工具已被广泛和成功地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。这些包括，例如，回忆线索，锚定小插曲和事件历史日历。为了进一步提高这些工具的有效性，我们将把它们整合到一个灵活的移动的数据收集平台（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，以确定这种新工具是否相对于目前使用的标准工具改善了死亡率数据。如果成功的话，拟议的mBHC将构成一种新的方法来获取新生儿死亡率的调查数据，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，国土安全部）。mBHC的源代码将公开提供，以便其他数据收集计划可以轻松地将类似的工具集成到其研究工具中。

 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.