“Every Newborn-INDEPTH” (EN-INDEPTH): A randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites
Introduction
The Every Newborn-INDEPTH Network (EN-INDEPTH) study is part of the Every Newborn Measurement Improvement Roadmap which aims to improve household survey capture of stillbirths and neonatal deaths by assessing whether Full Pregnancy History (FPH) leads to increased capture of selected pregnancy outcomes compared to the standard DHS-7 Full Birth History (FBH+)
The EN-INDEPTH 3-year study begun in 2016, and is taking place across 5 Health and Demographic Surveillance System (HDSS) sites that are members of the INDEPTH Network. These are Bandim in Guinea Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Kintampo in Ghana, and Matlab in Bangladesh.
The research objectives for the study are:
To undertake a randomised comparison of the reproductive module used in the latest version of FBH+ versus a FPH module to examine the variation in capture of stillbirths and neonatal deaths.
To evaluate the use of existing/modified survey questions to capture the fertility intentions and selected pregnancy outcomes (TOP, miscarriage, birthweight, gestational age), as well as birth and death certification.
To compare the capture of pregnancy outcomes in the survey to that in the routine HDSS data collection.
To identify barriers and enablers to the reporting of pregnancy and adverse pregnancy outcomes during the survey and HDSS data collection, and particularly if these differ for the two survey questionnaire methods (FBH+ and FPH).
This multi-site study is using a retrospective survey to compare two methods of recording pregnancy outcomes (FBH+ versus FPH methods), with random allocation at the individual woman level. Quantitative and qualitative data is being collected.
Progress
Quantitative
Data collection in 5 HDSS sites completed, with 69,110 household interviews with women and 77,001 births recorded
Data preparations including anonymization and transfer/sharing by sites and cleaning by core team is complete
Analysis plans for the different quantitative specific objectives developed and finalized
Preliminary results for objective one (randomised comparison) completed
Preparations for analysis of other objectives is underway
Discussion of manuscripts and supplements from the specific objectives is ongoing
One PhD student doing a methodological PhD at LSHTM
Qualitative
35 Focus Group Discussions (FGDS) have been conducted across the 5 HDSS sites (in addition to 5 others during the pre-testing of tools). These FGDs were held with women, interviewers of the EN-INDEPTH survey and interviewers of the regular HDSS survey.
Analysis of the data is currently under way in each HDSS site. Coding of Bandim data has been completed, and preliminary themes identified.
Discussion on manuscripts to be written from study findings is ongoing.
One PhD student doing a Joint Makerere-Uppsala Universities
Future activities
Completion of both quantitative and qualitative data analyses
Face-to-face analysis and writing meeting in Uganda in February 2019
Completion of papers from study results
Dissemination of final report
Study team (Makerere University)
Principal Investigator: Assoc. Prof. Peter Waiswa
Technical Coordinator: Mr. Joseph Akuze
Researcher: Ms. Doris Kwesiga
Sponsor
Children’s Investment Fund Foundation, through a grant run by the London School of Hygiene and Tropical Medicine (Principal Investigator: Prof. Joy Lawn)