"Every Newborn-INDEPTH" (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites

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  • Angela Baschieri, Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.
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  • Vladimir S Gordeev, Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.
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  • Joseph Akuze, INDEPTH Network Maternal, Newborn and Child Health Working Group Technical Secretariat.
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  • Doris Kwesiga, INDEPTH Network Maternal, Newborn and Child Health Working Group Technical Secretariat.
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  • Hannah Blencowe, Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.
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  • Simon Cousens, Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.
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  • Peter Waiswa, INDEPTH Network Maternal, Newborn and Child Health Working Group Technical Secretariat.
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  • Ane B Fisker, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau., Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark., c OPEN, Odense Patient data Explorative Network , Odense University Hospital/Institute of Clinical Research, University of Southern Denmark , Odense , Denmark.
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  • Sanne M Thysen, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau., Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark.
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  • Amabelia Rodrigues, Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.
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  • Gashaw A Biks, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Solomon M Abebe, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Kassahun A Gelaye, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Mezgebu Y Mengistu, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Bisrat M Geremew, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Tadesse G Delele, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Adane K Tesega, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Temesgen A Yitayew, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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  • Simon Kasasa, IgangaMayuge HDSS, Uganda.
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  • Edward Galiwango, IgangaMayuge HDSS, Uganda.
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  • Davis Natukwatsa, IgangaMayuge HDSS, Uganda.
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  • Dan Kajungu, IgangaMayuge HDSS, Uganda.
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  • Yeetey Ak Enuameh, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Obed E Nettey, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Francis Dzabeng, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Seeba Amenga-Etego, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Sam K Newton, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Alexander A Manu, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Charlotte Tawiah, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Kwaku P Asante, Kintampo Health Research Centre, Kintampo, Ghana.
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  • Seth Owusu-Agyei, Malaria Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.
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  • Nurul Alam, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
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  • M M Haider, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
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  • Sayed S Alam, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
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  • Fred Arnold, ICF, Rockville, Maryland, USA.
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  • Peter Byass, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden.
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  • Trevor N Croft, ICF, Rockville, Maryland, USA.
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  • Kobus Herbst, University Medical Center Utrecht, Utrecht, Netherlands; University of Cape Town and South African Medical Research Council, Cape Town, South Africa; The George Institute for Global Health, Sydney, NSW, Australia.
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  • Sunita Kishor, The DHS Program, ICF Rockville, Maryland, USA.
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  • Florina Serbanescu, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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  • Joy E Lawn, Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene &Tropical Medicine, London, United Kingdom.

Background: Under-five and maternal mortality were halved in the Millennium Development Goals (MDG) era, with slower reductions for 2.6 million neonatal deaths and 2.6 million stillbirths. The Every Newborn Action Plan aims to accelerate progress towards national targets, and includes an ambitious Measurement Improvement Roadmap. Population-based household surveys, notably Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys, are major sources of population-level data on child mortality in countries with weaker civil registration and vital statistics systems, where over two-thirds of global child deaths occur. To estimate neonatal/child mortality and pregnancy outcomes (stillbirths, miscarriages, birthweight, gestational age) the most common direct methods are: (1) the standard DHS-7 with Full Birth History with additional questions on pregnancy losses in the past 5 years (FBH+) or (2) a Full Pregnancy History (FPH). No direct comparison of these two methods has been undertaken, although descriptive analyses suggest that the FBH+ may underestimate mortality rates particularly for stillbirths.

Methods: This is the protocol paper for the Every Newborn-INDEPTH study (INDEPTH Network, International Network for the Demographic Evaluation of Populations and their Health Every Newborn, Every Newborn Action Plan), aiming to undertake a randomised comparison of FBH+ and FPH to measure pregnancy outcomes in a household survey in five selected INDEPTH Network sites in Africa and South Asia (Bandim in urban and rural Guinea-Bissau; Dabat in Ethiopia; IgangaMayuge in Uganda; Kintampo in Ghana; Matlab in Bangladesh). The survey will reach >68 000 pregnancies to assess if there is ≥15% difference in stillbirth rates. Additional questions will capture birthweight, gestational age, birth/death certification, termination of pregnancy and fertility intentions. The World Bank's Survey Solutions platform will be tailored for data collection, including recording paradata to evaluate timing. A mixed methods assessment of barriers and enablers to reporting of pregnancy and adverse pregnancy outcomes will be undertaken.

Conclusions: This large-scale study is the first randomised comparison of these two methods to capture pregnancy outcomes. Results are expected to inform the evidence base for survey methodology, especially in DHS, regarding capture of stillbirths and other outcomes, notably neonatal deaths, abortions (spontaneous and induced), birthweight and gestational age. In addition, this study will inform strategies to improve health and demographic surveillance capture of neonatal/child mortality and pregnancy outcomes.

Original languageEnglish
Article number010901
JournalJournal of global health
Volume9
Issue1
Number of pages15
ISSN2047-2978
DOIs
Publication statusPublished - 2019

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