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. 2021 Feb 8;19(Suppl 1):7.
doi: 10.1186/s12963-020-00232-1.

Neonatal and child mortality data in retrospective population-based surveys compared with prospective demographic surveillance: EN-INDEPTH study

Tryphena Nareeba #  1 , Francis Dzabeng #  2 , Nurul Alam #  3 , Gashaw A Biks #  4   5 , Sanne M Thysen #  6   7   8 , Joseph Akuze  9   10   11 , Hannah Blencowe  9 , Stephane Helleringer  12 , Joy E Lawn  9 , Kaiser Mahmud  3 , Temesgen Azemeraw Yitayew  4 , Ane B Fisker  13   14   15 ; the Every Newborn-INDEPTH Study Collaborative Group
Collaborators, Affiliations

Neonatal and child mortality data in retrospective population-based surveys compared with prospective demographic surveillance: EN-INDEPTH study

Tryphena Nareeba et al. Popul Health Metr. .

Abstract

Background: Global mortality estimates remain heavily dependent on household surveys in low- and middle-income countries, where most under-five deaths occur. Few studies have assessed the accuracy of mortality data or determinants of capturing births in surveys.

Methods: The Every Newborn-INDEPTH study (EN-INDEPTH) included a large, multi-country survey of women aged 15-49 interviewed about livebirths and their survival status in five Health and Demographic Surveillance Systems (HDSSs). The HDSSs undertake regular household visits to register births and deaths for a given population. We analysed EN-INDEPTH survey data to assess background factors associated with not recalling a complete date-of-birth. We calculated Kaplan-Meier survival estimates for both survey and HDSS data and describe age-at-death distributions during the past 5 years for children born to the same women. We assessed the proportion of HDSS-births that could be matched on month-of-birth to survey-births and used regression models to identify factors associated with matching.

Results: 69,176 women interviewed in the survey reported 109,817 births and 3064 deaths in children under 5 years in the 5 years prior to the survey. In the HDSS data, the same women had 83,768 registered births and 2335 under-five deaths in the same period. A complete date-of-birth was not reported for 1-7% of survey-births. Birthdates were less likely to be complete for dead children and children born to women of higher parity or with little/no education. Distributions of reported age-at-death indicated heaping at full weeks (neonatal period) and at 12 months. Heaping was more pronounced in the survey data. Survey estimates of under-five mortality rates were similar to HDSS estimates of under-five mortality in two of five sites, higher in the survey in two sites (15%, 41%) and lower (24%) in one site. The proportion of HDSS-births matched to survey-births ranged from 51 to 89% across HDSSs and births of children who had died were less likely to be matched.

Conclusions: Mortality estimates in the survey and HDSS were not markedly different for most sites. However, neither source is a "gold standard" and both sources miss some events. Research is required to improve capture and accuracy to better track newborn and child survival targets.

Keywords: Child mortality; Infant mortality; Neonatal mortality; Survey.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the EN-INDEPTH study population showing data included for mortality analyses
Fig. 2
Fig. 2
Cumulative mortality estimates among children born to women interviewed
Fig. 3
Fig. 3
Distribution of mortality during the neonatal period (excluding day 0–1)
Fig. 4
Fig. 4
Distribution of mortality during the first 2 years of life
Fig. 5
Fig. 5
Distribution of mortality during the neonatal period (excluding day 0–1) and first 2 years of life
Fig. 6
Fig. 6
Relative risks of identifying an HDSS reported birth1 to an EN-INDEPTH survey recorded birth
See this image and copyright information in PMC

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