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. 2022 Jul 27;20(1):16.
doi: 10.1186/s12963-022-00293-4.

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Nandini Choudhury #  1   2 , Aparna Tiwari #  3 , Wan-Ju Wu  1   4   5 , Ved Bhandari  6 , Laxman Bhatta  6 , Bhawana Bogati  6 , David Citrin  1   2   7   8   9 , Scott Halliday  1   7 , Sonu Khadka  6 , Nutan Marasini  6 , Sachit Pandey  6 , Madeleine Ballard  2   10 , Hari Jung Rayamazi  6 , Sabitri Sapkota  11 , Ryan Schwarz  1   12   13   14 , Lisa Sullivan  15 , Duncan Maru  1   2   16   17   18 , Aradhana Thapa  1 , Sheela Maru  1   2   16   19
Affiliations

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Nandini Choudhury et al. Popul Health Metr. .

Abstract

Background: Timely tracking of health outcomes is difficult in low- and middle-income countries without comprehensive vital registration systems. Community health workers (CHWs) are increasingly collecting vital events data while delivering routine care in low-resource settings. It is necessary, however, to assess whether routine programmatic data collected by CHWs are sufficiently reliable for timely monitoring and evaluation of health interventions. To study this, we assessed the consistency of vital events data recorded by CHWs using two methodologies-routine data collected while delivering an integrated maternal and child health intervention, and data from a birth history census approach at the same site in rural Nepal.

Methods: We linked individual records from routine programmatic data from June 2017 to May 2018 with those from census data, both collected by CHWs at the same site using a mobile platform. We categorized each vital event over a one-year period as 'recorded by both methods,' 'census alone,' or 'programmatic alone.' We further assessed whether vital events data recorded by both methods were classified consistently.

Results: From June 2017 to May 2018, we identified a total of 713 unique births collectively from the census (birth history) and programmatic maternal 'post-delivery' data. Three-fourths of these births (n = 526) were identified by both. There was high consistency in birth location classification among the 526 births identified by both methods. Upon including additional programmatic 'child registry' data, we identified 746 total births, of which 572 births were identified by both census and programmatic methods. Programmatic data (maternal 'post-delivery' and 'child registry' combined) captured more births than census data (723 vs. 595). Both methods consistently classified most infants as 'living,' while infant deaths and stillbirths were largely classified inconsistently or recorded by only one method. Programmatic data identified five infant deaths and five stillbirths not recorded in census data.

Conclusions: Our findings suggest that data collected by CHWs from routinely tracking pregnancies, births, and deaths are promising for timely program monitoring and evaluation. Despite some limitations, programmatic data may be more sensitive in detecting vital events than cross-sectional census surveys asking women to recall these events.

Keywords: Community health workers; Maternal and child health; Vital events; mHealth.

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Conflict of interest statement

A. Tiwari and A. Thapa are employed by a US-based nonprofit (Possible) and based in Nepal. SS is employed by a Nepal-based non-governmental organization (Possible). VB, LB, BB, SK, NM, HJR, and SP are employed by a nonprofit healthcare company (Nyaya Health Nepal, with support from the US-based nonprofit, Possible) that delivers free healthcare in rural Nepal using funds from the Government of Nepal and other public, philanthropic, and private foundation sources. NC, DM, and SM are employed by, and SM, DC, DM, and SS are faculty members at a private medical school (Icahn School of Medicine at Mount Sinai). DC is a faculty member at, DC and SH are employed part-time by, and SH is a graduate student at a public university (University of Washington). DM is a member of Possible’s Board of Directors, for which he receives no compensation. RS is employed at an academic medical center (Brigham and Women’s Hospital) that receives public sector research funding, as well as revenue through private sector fee-for-service medical transactions and private foundation grants. RS is a faculty member at a private medical school (Harvard Medical School) and employed at an academic medical center (Massachusetts General Hospital) that receives public sector research funding, as well as revenue through private sector fee-for-service medical transactions and private foundation grants. All authors declare that we have no competing financial interests. The authors do, however, believe strongly that healthcare is a public good, not a private commodity.

Figures

Fig. 1
Fig. 1
Timeline of programmatic and data collection events
Fig. 2
Fig. 2
Summary of data collection methods
Fig. 3
Fig. 3
Summary of births identified by census and programmatic (maternal) data, n = 713
Fig. 4
Fig. 4
Summary of births identified by census and programmatic (maternal and child registry) data, n = 746
See this image and copyright information in PMC

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References

    1. Corsi DJ, Neuman M, Finlay JE, Subramanian S. Demographic and health surveys: a profile. Int J Epidemiol. 2012;41(6):1602–1613. - PubMed
    1. UNICEF. Multiple Indicator Cluster Survey (MICS): UNICEF; [updated 2014 October 23. https://www.unicef.org/statistics/index_24302.html.
    1. Amouzou A, Kidanu A, Taddesse N, Silva R, Hazel E, Bryce J, et al. Using health extension workers for monitoring child mortality in real-time: validation against household survey data in rural Ethiopia. PLoS ONE. 2015;10(11):e0126909. - PMC - PubMed
    1. Aqil A, Lippeveld T, Hozumi D. PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems. Health Policy Plan. 2009;24(3):217–228. - PMC - PubMed
    1. Bryce J, Arnold F, Blanc A, Hancioglu A, Newby H, Requejo J, et al. Measuring coverage in MNCH: new findings, new strategies, and recommendations for action. PLoS Med. 2013;10(5):e1001423. - PMC - PubMed

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