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）：全球 5 岁以下死亡风险显着下降，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）的减少。因此，剩余儿童死亡的比例越来越大，发生在出生后 28 天内。由联邦机构（例如 NIH、CDC、USAID）和国际开发署资助的新健康计划。一些组织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的衡量标准，特别是在撒哈拉以南非洲和南亚国家。在这些国家，新生儿死亡风险最高，人口动态登记和卫生信息系统不足以提供可靠的数据：a) 人口中的出生总数，b) 期间发生的死亡人数。相反，是生命的前 28 天。人口统计和健康调查 (DHS) 等基于人口的调查回顾性收集了有关新生儿死亡率的信息。要求 15-49 岁的妇女回忆自己的出生史，并报告每个孩子在出生之前是否还活着或已经死亡。此类数据可能会误报新生儿死亡率，原因是 1) 出生情况漏报，特别是那些导致新生儿死亡的情况，2) 误报儿童死亡年龄（例如新生儿）。 3) 将死产错误分类为新生儿死亡，反之亦然。 在本项目中，我们将测试新的调查工具是否有助于提高调查期间的新生儿死亡数据质量。 - 移动出生史日历（mBHC） - 使用已广泛且成功地应用于其他调查研究领域的简单工具，但尚未用于改善新生儿死亡率数据，例如，这些工具包括回忆线索、锚定。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。在几内亚比绍对新的 mBHC 进行随机对照试验，该试验将确定该新仪器相对于目前使用的标准仪器是否改善了死亡率数据。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。能进行更大规模的测试，并可能纳入全国成人死亡率调查（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其研究工具中。