Quality of vital event data for infant mortality estimation in prospective, population-based studies: An analysis of secondary data from Asia, Africa, and Latin America

Daniel J. Erchick, Seema Subedi, Andrea Verhulst, Michel Guillot, Linda S. Adair, Aluísio J.D. Barros, Bernard Chasekwa, Parul Christian, Bruna Gonçalves C. da Silva, Mariângela F. Silveira, Pedro C. Hallal, Jean H. Humphrey, Lieven Huybregts, Simon Kariuki, Subarna K. Khatry, Carl Lachat, Alicia Matijasevich, Peter D. McElroy, Ana Maria B. Menezes, Luke C. MullanyTita Lorna L. Perez, Penelope Phillips-Howard, Dominique Roberfroid, Iná S. Santos, Feiko Ter Kuile, Thulasiraj D. Ravilla, James M. Tielsch, Lee S.F. Wu, Joanne Katz

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Infant and neonatal mortality estimates are typically derived from retrospective birth histories collected through surveys in countries with unreliable civil registration and vital statistics systems. Yet such data are subject to biases, including under-reporting of deaths and age misreporting, which impact mortality estimates. Prospective pPopulation-based cohort studies are an under-utilized data source for mortality estimation that may offer strengths that avoid biases.

Methods: We conducted a secondary analysis of data from the Child Health Epidemiology Reference Group, including 11 11 population-based pregnancy or birth cohort studies, to evaluate the appropriateness of vital event data for mortality estimation. Analyses were descriptive, summarizing study designs, populations, protocols, and internal checks to assess their impact on data quality. We calculated infant and neonatal morality rates and compared patterns with Demographic and Health Survey (DHS) data.

Results: Studies yielded 71,760 pregnant women and 85,095 live births. Specific field protocols, especially pregnancy enrollment, limited exclusion criteria, and frequent follow-up visits after delivery, led to higher birth outcome ascertainment and fewer missing deaths. Most studies achieved had low follow-up loss in pregnancy and the first month with little evidence of date heaping. Among studies in Asia and Latin America, nNeonatal mortality rates (NMR) between the cohorts and DHS appeared similar in Asia and Latin Americawere similar to DHS, while several studies in and lower in Sub-Saharan Africa Africahad lower NMRs than DHS. Infant mortality varied by study and region between sources.

Conclusions: Prospective, pPopulation-based cohort studies following rigorous protocols can yield high-quality vital event data to improve characterization of detailed mortality patterns of infants in low- and middle-income countriesLMICs, especially in the early neonatal period where mortality risk is highest and changes rapidly.

Original languageEnglish
Article number10
Pages (from-to)e10
JournalPopulation Health Metrics
Volume21
Issue number1
DOIs
Publication statusPublished - 28 Jul 2023

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