TY - JOUR
T1 - Effect of birthweight measurement quality improvement on low birthweight prevalence in rural Ethiopia
AU - Baye, Estifanos
AU - Abate, Firehiwot Workneh
AU - Eglovitch, Michelle
AU - Shiferie, Fisseha
AU - Olson, Ingrid E.
AU - Shifraw, Tigest
AU - Kidane, Workagegnehu Tarekegn
AU - Yibeltal, Kalkidan
AU - Tsegaye, Sitota
AU - Derebe, Mulatu Melese
AU - Isanaka, Sheila
AU - Wylie, Blair J.
AU - Molina, Rose L.
AU - Chan, Grace J.
AU - Worku, Amare
AU - Mullany, Luke C.
AU - Worku, Alemayehu
AU - Berhane, Yemane
AU - Lee, Anne C.C.
N1 - Funding Information:
The ENAT study was funded by the Bill and Melinda Gates Foundation (OPP1184363).
Funding Information:
We would like to acknowledge the Amhara Regional Health Bureau, Amhara Public Health Institute and health center directors for their collaboration in implementing the study. We thank the ENAT field team (study nurses and data collectors) and health center midwives for their hard work and dedication to this study.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Low birthweight (LBW) (< 2500 g) is a significant determinant of infant morbidity and mortality worldwide. In low-income settings, the quality of birthweight data suffers from measurement and recording errors, inconsistent data reporting systems, and missing data from non-facility births. This paper describes birthweight data quality and the prevalence of LBW before and after implementation of a birthweight quality improvement (QI) initiative in Amhara region, Ethiopia. Methods: A comparative pre-post study was performed in selected rural health facilities located in West Gojjam and South Gondar zones. At baseline, a retrospective review of delivery records from February to May 2018 was performed in 14 health centers to collect birthweight data. A birthweight QI initiative was introduced in August 2019, which included provision of high-quality digital infant weight scales (precision 5 g), routine calibration, training in birth weighing and data recording, and routine field supervision. After the QI implementation, birthweight data were prospectively collected from late August to early September 2019, and December 2019 to June 2020. Data quality, as measured by heaping (weights at exact multiples of 500 g) and rounding to the nearest 100 g, and the prevalence of LBW were calculated before and after QI implementation. Results: We retrospectively reviewed 1383 delivery records before the QI implementation and prospectively measured 1371 newborn weights after QI implementation. Heaping was most frequently observed at 3000 g and declined from 26% pre-initiative to 6.7% post-initiative. Heaping at 2500 g decreased from 5.4% pre-QI to 2.2% post-QI. The percentage of rounding to the nearest 100 g was reduced from 100% pre-initiative to 36.5% post-initiative. Before the QI initiative, the prevalence of recognized LBW was 2.2% (95% confidence interval [CI]: 1.5–3.1) and after the QI initiative increased to 11.7% (95% CI: 10.1–13.5). Conclusions: A QI intervention can improve the quality of birthweight measurements, and data measurement quality may substantially affect estimates of LBW prevalence.
AB - Background: Low birthweight (LBW) (< 2500 g) is a significant determinant of infant morbidity and mortality worldwide. In low-income settings, the quality of birthweight data suffers from measurement and recording errors, inconsistent data reporting systems, and missing data from non-facility births. This paper describes birthweight data quality and the prevalence of LBW before and after implementation of a birthweight quality improvement (QI) initiative in Amhara region, Ethiopia. Methods: A comparative pre-post study was performed in selected rural health facilities located in West Gojjam and South Gondar zones. At baseline, a retrospective review of delivery records from February to May 2018 was performed in 14 health centers to collect birthweight data. A birthweight QI initiative was introduced in August 2019, which included provision of high-quality digital infant weight scales (precision 5 g), routine calibration, training in birth weighing and data recording, and routine field supervision. After the QI implementation, birthweight data were prospectively collected from late August to early September 2019, and December 2019 to June 2020. Data quality, as measured by heaping (weights at exact multiples of 500 g) and rounding to the nearest 100 g, and the prevalence of LBW were calculated before and after QI implementation. Results: We retrospectively reviewed 1383 delivery records before the QI implementation and prospectively measured 1371 newborn weights after QI implementation. Heaping was most frequently observed at 3000 g and declined from 26% pre-initiative to 6.7% post-initiative. Heaping at 2500 g decreased from 5.4% pre-QI to 2.2% post-QI. The percentage of rounding to the nearest 100 g was reduced from 100% pre-initiative to 36.5% post-initiative. Before the QI initiative, the prevalence of recognized LBW was 2.2% (95% confidence interval [CI]: 1.5–3.1) and after the QI initiative increased to 11.7% (95% CI: 10.1–13.5). Conclusions: A QI intervention can improve the quality of birthweight measurements, and data measurement quality may substantially affect estimates of LBW prevalence.
KW - Birthweight heaping
KW - Data quality improvement initiative
KW - Delivery registers
KW - Ethiopia
KW - Low birthweight
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U2 - 10.1186/s12963-021-00265-0
DO - 10.1186/s12963-021-00265-0
M3 - Article
C2 - 34551768
AN - SCOPUS:85115333989
SN - 1478-7954
VL - 19
JO - Population Health Metrics
JF - Population Health Metrics
IS - 1
M1 - 35
ER -