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

Citation

Erchick, Daniel J.; Subedi, Seema; Verhulst, Andrea; Guillot, Michel; Adair, Linda S.; Barros, Aluísio J. D.; Chasekwa, Bernard; Christian, Parul; da Silva, Bruna Gonçalves C.; & Silveira, Mariângela F., et al. (2023). 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. Population Health Metrics, 21(1), 10. PMCID: PMC10375772

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 population-based cohort studies are an underutilized 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 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 had low follow-up loss in pregnancy and the first month with little evidence of date heaping. Among studies in Asia and Latin America, neonatal mortality rates (NMR) were similar to DHS, while several studies in Sub-Saharan Africa had lower NMRs than DHS. Infant mortality varied by study and region between sources.
CONCLUSIONS: Prospective, population-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 countries, especially in the early neonatal period where mortality risk is highest and changes rapidly.

URL

http://dx.doi.org/10.1186/s12963-023-00309-7

Reference Type

Journal Article

Year Published

2023

Journal Title

Population Health Metrics

Author(s)

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

Article Type

Regular

PMCID

PMC10375772

Data Set/Study

Child Health Epidemiology Reference Group
Demographic and Health Surveys (DHS)

Continent/Country

Asia
Africa
Latin America

ORCiD

Adair - 0000-0002-3670-8073