TY - JOUR
T1 - "Every Newborn-BIRTH" protocol
T2 - Observational study validating indicators for coverage and quality of maternal and newborn health care in Bangladesh, Nepal and Tanzania
AU - Day, Louise T.
AU - Ruysen, Harriet
AU - Gordeev, Vladimir S.
AU - Gore-Langton, Georgia R.
AU - Boggs, Dorothy
AU - Cousens, Simon
AU - Moxon, Sarah G.
AU - Blencowe, Hannah
AU - Baschieri, Angela
AU - Rahman, Ahmed Ehsanur
AU - Tahsina, Tazeen
AU - Zaman, Sojib Bin
AU - Hossain, Tanvir
AU - Rahman, Qazi Sadeq Ur
AU - Ameen, Shafiqul
AU - Arifeen, Shams El
AU - Ashish, K. C.
AU - Shrestha, Shree Krishna
AU - Naresh, P. K.C.
AU - Singh, Dela
AU - Jha, Anjani Kumar
AU - Jha, Bijay
AU - Rana, Nisha
AU - Basnet, Omkar
AU - Joshi, Elisha
AU - Paudel, Asmita
AU - Shrestha, Parashu Ram
AU - Jha, Deepak
AU - Bastola, Ram Chandra
AU - Ghimire, Jagat Jeevan
AU - Paudel, Rajendra
AU - Salim, Nahya
AU - Shamba, Donat
AU - Manji, Karim
AU - Shabani, Josephine
AU - Shirima, Kizito
AU - Mkopi, Namala
AU - Mrisho, Mwifadhi
AU - Manzi, Fatuma
AU - Jaribu, Jennie
AU - Kija, Edward
AU - Assenga, Evelyne
AU - Kisenge, Rodrick
AU - Pembe, Andrea
AU - Hanson, Claudia
AU - Mbaruku, Godfrey
AU - Masanja, Honorati
AU - Amouzou, Agbessi
AU - Azim, Tariq
AU - Jackson, Debra
AU - Kabuteni, Theopista John
AU - Mathai, Matthews
AU - Monet, Jean Pierre
AU - Moran, Allisyn
AU - Ram, Pavani
AU - Rawlins, Barbara
AU - Sæbø, Johan Ivar
AU - Serbanescu, Florina
AU - Vaz, Lara
AU - Zaka, Nabila
AU - Lawn, Joy E.
N1 - Funding Information:
Acknowledgements: We credit the inspiration of the late Godfrey Mbaruku. Many thanks to Claudia DaSilva, Fion Hay, Alegria Perez, Sadie Sareen, Adeline Herman, Veronica Ulay, Mohammad Raisul Islam and Ziaul Haque Shaikh, Susheel Karki and Bhula Rai for their administrative support. We thank Sabrina Jabeen, Tamatun Islam Tanha, Goutom Banik and Md Moshiur Rahman for their support in providing training to data collectors in the Bangladesh sites. We would also like to thank Ann Blanc, Liliana Carvajal, Doris Chou, Kim Dickson, Tanya Marchant, Claire-Helene Mershon, Natalie Roos, Anna Seale, Theresa Shaver, Deborah Sitrin, Kate Somers, and Cindy Stanton for sharing relevant technical inputs and expertise. We acknowledge the National Advisory Groups: Tanzania: Muhammad Bakari Kambi, Georgina Msemo, Asia Hu-sein, Talhiya Yahya, Claud Kumalija, Eliakim Eliud, Mary Azayo, Onest Kimaro. Bangladesh: Mohammad Sha-hidullah, Khaleda Islam, Md Jahurul Islam (joining the EN-BIRTH Expert Advisory Group in 2018). Nepal: Tara Pokharel, Uwe Ewald. Finally, and most importantly we thank the women, their families, the health workers and the hundreds of data collectors involved in the EN-BIRTH study. Ethics and consent to participate: This study was granted ethical approval by institutional review boards in all operating counties including the London School of Hygiene & Tropical Medicine (Appendix S3 of Online Supplementary Document). Availability of data and material: All collaborating partners have signed data sharing and transfer agreements. Funding: The Children’s Investment Fund Foundation (CIFF) are the main funder of this research which is administered via The London School of Hygiene & Tropical Medicine. The Swedish Research Council specifically funded the Nepal site through UNICEF and Lifeline Nepal. The main funding for the Windsor research design workshop was provided by CIFF and in addition, the United States Agency for International Development, Saving Newborn Lives/Save the Children, WHO and Bill & Melinda Gates Foundation through the United States Fund for UNICEF funded many participants’ travel and accommodation for attendance. Authorship contributions: The study was conceptualized by JEL in 2014, and the initial protocol was coordinated by HR with JEL during 2016, with inputs from SC, SM, HB, the EN-BIRTH advisory group (names listed above), and during a multi-stakeholder Windsor research design workshop (names listed above). From mid-2016 VSG, GGL, DB and AB, with LTD joining in 2017. GGL and HR led inputs to observation checklists and led development of training materials with country coordinators (Bangladesh, TT and AER, Nepal, NR, Tanzania, NS). DB led development of the maternal recall survey and coordinated the health facility assessments. Each of the three country research teams input to all the data collection tools and review processes. The iccdr,b team from Bangladesh (notably AER, TT, TH, QSR, SA and SBZ) led the development of the software application, data dashboards and database development with VSG and the LSHTM team. iccdr,b (AER) also led the development of the verification form for infection case management and the data variable dictionary. The IHI and MUHAS in Tanzania hosted the study implementation workshop, input to data collection tools and training materials and are leading work on objective 4 (barriers and enablers for data collection and use). The Nepal team input to data collection tools and training materials, and led on use of video filming. The manuscript was drafted by HR, JEL and LTD with further review of the analysis sections by VSG and SC, in addition to major inputs particularly from GM, AER and TT. All authors reviewed and helped to revise the manuscript. Competing interests: The authors completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available upon request from the corresponding author), and declare no conflicts of interest. Additional material Online Supplementary Document
Publisher Copyright:
© 2019 The Author(s).
PY - 2019
Y1 - 2019
N2 - Background To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and > 80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone, to content of care. As facility births increase, monitoring using routine facility data in DHIS2 has potential, yet validation research has mainly focussed on maternal recall surveys. The Every Newborn - Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study aims to validate selected newborn and maternal indicators for routine tracking of coverage and quality of facility-based care for use at district, national and global levels. Methods EN-BIRTH is an observational study including > 20 000 facility births in three countries (Tanzania, Bangladesh and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, immediate newborn care, neonatal resuscitation and Kangaroo mother care. Indicators including neonatal infection management and antenatal corticosteroid administration, which cannot be easily observed, will be validated using inpatient records. Trained clinical observers in Labour/Delivery ward, Operation theatre, and Kangaroo mother care ward/areas will collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerators with adequate information. Other objectives include comparison of denominator options (ie, true target population or surrogates) and quality of care analyses, especially regarding intervention timing. Barriers and enablers to routine recording and data usage will be assessed by data flow assessments, quantitative and qualitative analyses. Conclusions To our knowledge, this is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths.
AB - Background To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and > 80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone, to content of care. As facility births increase, monitoring using routine facility data in DHIS2 has potential, yet validation research has mainly focussed on maternal recall surveys. The Every Newborn - Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study aims to validate selected newborn and maternal indicators for routine tracking of coverage and quality of facility-based care for use at district, national and global levels. Methods EN-BIRTH is an observational study including > 20 000 facility births in three countries (Tanzania, Bangladesh and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, immediate newborn care, neonatal resuscitation and Kangaroo mother care. Indicators including neonatal infection management and antenatal corticosteroid administration, which cannot be easily observed, will be validated using inpatient records. Trained clinical observers in Labour/Delivery ward, Operation theatre, and Kangaroo mother care ward/areas will collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerators with adequate information. Other objectives include comparison of denominator options (ie, true target population or surrogates) and quality of care analyses, especially regarding intervention timing. Barriers and enablers to routine recording and data usage will be assessed by data flow assessments, quantitative and qualitative analyses. Conclusions To our knowledge, this is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths.
UR - http://www.scopus.com/inward/record.url?scp=85062859088&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062859088&partnerID=8YFLogxK
U2 - 10.7189/jogh.09.010902
DO - 10.7189/jogh.09.010902
M3 - Article
C2 - 30863542
AN - SCOPUS:85062859088
VL - 9
JO - Journal of Global Health
JF - Journal of Global Health
SN - 2047-2978
IS - 1
M1 - 010902
ER -