학술논문
Birthweight: EN-BIRTH multi-country validation study
Document Type
Report
Author
Kong, Stefanie; Day, Louise T.; Zaman, Sojib Bin; Peven, Kimberly; Salim, Nahya; Sunny, Avinash K.; Shamba, Donat; Rahman, Qazi Sadeq-ur; K.C., Ashish; Ruysen, Harriet; El Arifeen, Shams; Mee, Paul; Gladstone, Miriam E.; Blencowe, Hannah; Lawn, Joy E.; Ali, Md. Ayub; Biswas, Bilkish; Haider, Rajib; Hasanuzzaman, Md. Abu; Hossain, Md. Amir; Jahan, Ishrat; Jahan, Rowshan Hosne; Khan, Jasmin; Mannan, M. A.; Mazumder, Tapas; Rahman, Md. Hafizur; Shaikh, Md. Ziaul Haque; Siddika, Aysha; Sumi, Taslima Akter; Talha, Md. Taqbir Us Samad; Assenga, Evelyne; Hanson, Claudia; Kija, Edward; Kisenge, Rodrick; Manji, Karim; Manzi, Fatuma; Mkopi, Namala; Mrisho, Mwifadhi; Pembe, Andrea; Ghimire, Jagat Jeevan; Gurung, Regina; Joshi, Elisha; KC, Naresh P.; Rana, Nisha; Shrestha, Shree Krishna; Singh, Dela; Shrestha, Parashu Ram; Thakur, Nishant; Moxon, Sarah G.; Amouzou, Agbessi; Azim, Tariq; Jackson, Debra; Kabuteni, Theopista John; Mathai, Matthews; Monet, Jean-Pierre; Moran, Allisyn; Ram, Pavani; Rawlins, Barbara; Requejo, Jennifer; Saeba, Johan Ivar; Serbanescu, Florina; Vaz, Lara
Source
BMC Pregnancy and Childbirth. March 26, 2021, Vol. 21 Issue Suppl 1
Subject
Language
English
Abstract
Author(s): Stefanie Kong[sup.1] , Louise T. Day[sup.1] , Sojib Bin Zaman[sup.2] , Kimberly Peven[sup.1,3] , Nahya Salim[sup.4,5] , Avinash K. Sunny[sup.6] , Donat Shamba[sup.5] , Qazi Sadeq-ur Rahman[sup.2] , Ashish [...]
Background Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affected by heaping. This paper evaluates birthweight measurement within the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study. Methods The EN-BIRTH study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017-2018). Clinical observers collected time-stamped data (gold standard) for weighing at birth. We compared accuracy for two data sources: routine hospital registers and women's report at exit interview survey. We calculated absolute differences and individual-level validation metrics. We analysed birthweight coverage and quality gaps including timing and heaping. Qualitative data explored barriers and enablers for routine register data recording. Results Among 23,471 observed births, 98.8% were weighed. Exit interview survey-reported weighing coverage was 94.3% (90.2-97.3%), sensitivity 95.0% (91.3-97.8%). Register-reported coverage was 96.6% (93.2-98.9%), sensitivity 97.1% (94.3-99%). Routine registers were complete (> 98% for four hospitals) and legible > 99.9%. Weighing of stillbirths varied by hospital, ranging from 12.5-89.0%. Observed LBW rate was 15.6%; survey-reported rate 14.3% (8.9-20.9%), sensitivity 82.9% (75.1-89.4%), specificity 96.1% (93.5-98.5%); register-recorded rate 14.9%, sensitivity 90.8% (85.9-94.8%), specificity 98.5% (98-99.0%). In surveys, "don't know" responses for birthweight measured were 4.7%, and 2.9% for knowing the actual weight. 95.9% of observed babies were weighed within 1 h of birth, only 14.7% with a digital scale. Weight heaping indices were around two-fold lower using digital scales compared to analogue. Observed heaping was almost 5% higher for births during the night than day. Survey-report further increased observed birthweight heaping, especially for LBW babies. Enablers to register birthweight measurement in qualitative interviews included digital scale availability and adequate staffing. Conclusions Hospital registers captured birthweight and LBW prevalence more accurately than women's survey report. Even in large hospitals, digital scales were not always available and stillborn babies not always weighed. Birthweight data are being captured in hospitals and investment is required to further improve data quality, researching of data flow in routine systems and use of data at every level. Keywords: Birth, Newborn, Maternal, Stillbirth, Coverage, Validity, Survey, Health management information systems, Birthweight, Low birthweight
Background Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affected by heaping. This paper evaluates birthweight measurement within the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study. Methods The EN-BIRTH study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017-2018). Clinical observers collected time-stamped data (gold standard) for weighing at birth. We compared accuracy for two data sources: routine hospital registers and women's report at exit interview survey. We calculated absolute differences and individual-level validation metrics. We analysed birthweight coverage and quality gaps including timing and heaping. Qualitative data explored barriers and enablers for routine register data recording. Results Among 23,471 observed births, 98.8% were weighed. Exit interview survey-reported weighing coverage was 94.3% (90.2-97.3%), sensitivity 95.0% (91.3-97.8%). Register-reported coverage was 96.6% (93.2-98.9%), sensitivity 97.1% (94.3-99%). Routine registers were complete (> 98% for four hospitals) and legible > 99.9%. Weighing of stillbirths varied by hospital, ranging from 12.5-89.0%. Observed LBW rate was 15.6%; survey-reported rate 14.3% (8.9-20.9%), sensitivity 82.9% (75.1-89.4%), specificity 96.1% (93.5-98.5%); register-recorded rate 14.9%, sensitivity 90.8% (85.9-94.8%), specificity 98.5% (98-99.0%). In surveys, "don't know" responses for birthweight measured were 4.7%, and 2.9% for knowing the actual weight. 95.9% of observed babies were weighed within 1 h of birth, only 14.7% with a digital scale. Weight heaping indices were around two-fold lower using digital scales compared to analogue. Observed heaping was almost 5% higher for births during the night than day. Survey-report further increased observed birthweight heaping, especially for LBW babies. Enablers to register birthweight measurement in qualitative interviews included digital scale availability and adequate staffing. Conclusions Hospital registers captured birthweight and LBW prevalence more accurately than women's survey report. Even in large hospitals, digital scales were not always available and stillborn babies not always weighed. Birthweight data are being captured in hospitals and investment is required to further improve data quality, researching of data flow in routine systems and use of data at every level. Keywords: Birth, Newborn, Maternal, Stillbirth, Coverage, Validity, Survey, Health management information systems, Birthweight, Low birthweight