TY - JOUR
T1 - Birth, stillbirth and death registration data completeness, quality and utility in population-based surveys
T2 - EN-INDEPTH study
AU - Kasasa, Simon
AU - Natukwatsa, Davis
AU - Galiwango, Edward
AU - Nareeba, Tryphena
AU - Gyezaho, Collins
AU - Fisker, Ane Baerent
AU - Mengistu, Mezgebu Yitayal
AU - Dzabeng, Francis
AU - Haider, M. Moinuddin
AU - Yargawa, Judith
AU - Akuze, Joseph
AU - Baschieri, Angela
AU - Cappa, Claudia
AU - Jackson, Debra
AU - Lawn, Joy E.
AU - Blencowe, Hannah
AU - Kajungu, Dan
AU - The Every Newborn-INDEPTH Study Collaborative Group
A2 - Thysen, Sanne Marie
N1 - Funding Information:
The EN-INDEPTH study (including publication costs) was funded by the Children’s Investment Fund Foundation (CIFF) by means of a grant to LSHTM (PI Joy E. Lawn) and a sub-award to the INDEPTH MNCH working group with technical leadership by Makerere School of Public Health (PI Peter Waiswa).
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Birth registration is a child’s first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth registration for live births in low- and middle-income countries is measured through population-based surveys which do not currently include completeness of stillbirth or death registration. Methods: The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017–2018). In four African sites, we included new/modified questions regarding registration for 1177 stillbirths and 11,881 livebirths (1333 neonatal deaths and 10,548 surviving the neonatal period). Questions were evaluated for completeness of responses, data quality, time to administer and estimates of registration completeness using descriptive statistics. Timing of birth registration, factors associated with non-registration and reported barriers were assessed using descriptive statistics and logistic regression. Results: Almost all women, irrespective of their baby’s survival, responded to registration questions, taking an average of < 1 min. Reported completeness of birth registration was 30.7% (6.1-53.5%) for babies surviving the neonatal period, compared to 1.7% for neonatal deaths (0.4–5.7%). Women were able to report age at birth registration for 93.6% of babies. Non-registration of babies surviving the neonatal period was significantly higher for home-born children (aOR 1.43 (95% CI 1.27–1.60)) and in Dabat (Ethiopia) (aOR 4.11 (95% CI 3.37–5.01)). Other socio-demographic factors associated with non-registration included younger age of mother, more prior births, little or no education, and lower socio-economic status. Neonatal death registration questions were feasible (100% women responded; only 1% did not know), revealing extremely low completeness with only 1.2% of neonatal deaths reported as registered. Despite > 70% of stillbirths occurring in facilities, only 2.5% were reported as registered. Conclusions: Questions on birth, stillbirth and death registration were feasible in a household survey. Completeness of birth registration is low in all four sites, but stillbirth and neonatal death registration was very low. Closing the registration gap amongst facility births could increase registration of both livebirths and facility deaths, including stillbirths, but will require co-ordination between civil registration systems and the often over-stretched health sector. Investment and innovation is required to capture birth and especially deaths in both facility and community systems.
AB - Background: Birth registration is a child’s first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth registration for live births in low- and middle-income countries is measured through population-based surveys which do not currently include completeness of stillbirth or death registration. Methods: The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017–2018). In four African sites, we included new/modified questions regarding registration for 1177 stillbirths and 11,881 livebirths (1333 neonatal deaths and 10,548 surviving the neonatal period). Questions were evaluated for completeness of responses, data quality, time to administer and estimates of registration completeness using descriptive statistics. Timing of birth registration, factors associated with non-registration and reported barriers were assessed using descriptive statistics and logistic regression. Results: Almost all women, irrespective of their baby’s survival, responded to registration questions, taking an average of < 1 min. Reported completeness of birth registration was 30.7% (6.1-53.5%) for babies surviving the neonatal period, compared to 1.7% for neonatal deaths (0.4–5.7%). Women were able to report age at birth registration for 93.6% of babies. Non-registration of babies surviving the neonatal period was significantly higher for home-born children (aOR 1.43 (95% CI 1.27–1.60)) and in Dabat (Ethiopia) (aOR 4.11 (95% CI 3.37–5.01)). Other socio-demographic factors associated with non-registration included younger age of mother, more prior births, little or no education, and lower socio-economic status. Neonatal death registration questions were feasible (100% women responded; only 1% did not know), revealing extremely low completeness with only 1.2% of neonatal deaths reported as registered. Despite > 70% of stillbirths occurring in facilities, only 2.5% were reported as registered. Conclusions: Questions on birth, stillbirth and death registration were feasible in a household survey. Completeness of birth registration is low in all four sites, but stillbirth and neonatal death registration was very low. Closing the registration gap amongst facility births could increase registration of both livebirths and facility deaths, including stillbirths, but will require co-ordination between civil registration systems and the often over-stretched health sector. Investment and innovation is required to capture birth and especially deaths in both facility and community systems.
KW - Birth certificates
KW - Birth registration
KW - Death registration
KW - Neonatal death
KW - Stillbirth
KW - Survey
KW - Vital statistics
U2 - 10.1186/s12963-020-00231-2
DO - 10.1186/s12963-020-00231-2
M3 - Journal article
C2 - 33557862
AN - SCOPUS:85100767785
SN - 1478-7954
VL - 19
JO - Population Health Metrics
JF - Population Health Metrics
IS - Suppl. 1
M1 - 14
ER -