Observational studyBMC pregnancy and childbirth2021
Survey of women's report for 33 maternal and newborn indicators: EN-BIRTH multi-country validation study.
Observational study in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparability of family planning quality of care measurement tools in low-and-middle income country settings: a systematic review.Reproductive health · 2021Pooled it
- Educational films for improving perinatal outcomes associated with gestational diabetes in Uganda and India: a cluster randomised trial.BMJ global health · 2026Trial
- Advancing maternal and newborn healthcare measurement: developing quality of care indices for postnatal and small and/or sick newborn care in low- and middle-income countries.Journal of global health · 2025Article
- Neonatal indicator data in Tanzania District Health Information System: evaluation of availability and quality of selected newborn indicators, 2015-2022.BMC pediatrics · 2025Article
- Introducing a standardised register for strengthening the inpatient management of newborns and sick children: Implementation research in selected health facilities of Bangladesh.Journal of global health · 2024Article
- Effect of the Mamás del Río programme on essential newborn care: a three-year before-and-after outcome evaluation of a community-based, maternal and neonatal health intervention in the Peruvian Amazon.Lancet regional health. Americas · 2023Article
- Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region.Lancet regional health. Americas · 2023Article
- How valid are women's reports of the antenatal health services they receive from Community Health Workers in Gombe State north-eastern Nigeria?BMC pregnancy and childbirth · 2022Article
- Measuring coverage and quality of supportive care for inpatient neonatal infections: EN-BIRTH multi-country validation study.Journal of global health · 2022Article
- Household Survey Measurement of Newborn Postnatal Care: Coverage, Quality Gaps, and Internal Inconsistencies in Responses.Global health, science and practice · 2021Article
- Equity in newborn care, evidence from national surveys in low- and middle-income countries.International journal for equity in health · 2021Article
- Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study.BMC pregnancy and childbirth · 2021Observational
- Neonatal resuscitation: EN-BIRTH multi-country validation study.BMC pregnancy and childbirth · 2021Observational
- Count every newborn: EN-BIRTH study improving facility-based coverage and quality measurement in routine information systems.BMC pregnancy and childbirth · 2021Article
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23 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPopulation-based household surveys, notably the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), remain the main source of maternal and newborn health data for many low- and middle-income countries. As part of the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study, this paper focuses on testing validity of measurement of maternal and newborn indicators around the time of birth (intrapartum and postnatal) in survey-report.
methodsEN-BIRTH was an observational study testing the validity of measurement for selected maternal and newborn indicators in five secondary/tertiary hospitals in Bangladesh, Nepal and Tanzania, conducted from July 2017 to July 2018. We compared women's report at exit survey with the gold standard of direct observation or verification from clinical records for women with vaginal births. Population-level validity was assessed by validity ratios (survey-reported coverage: observer-assessed coverage). Individual-level accuracy was assessed by sensitivity, specificity and percent agreement. We tested indicators already in DHS/MICS as well as indicators with potential to be included in population-based surveys, notably the first validation for small and sick newborn care indicators.
results33 maternal and newborn indicators were evaluated. Amongst nine indicators already present in DHS/MICS, validity ratios for baby dried or wiped, birthweight measured, low birthweight, and sex of baby (female) were between 0.90-1.10. Instrumental birth, skin-to-skin contact, and early initiation of breastfeeding were highly overestimated by survey-report (2.04-4.83) while umbilical cord care indicators were massively underestimated (0.14-0.22). Amongst 24 indicators not currently in DHS/MICS, two newborn contact indicators (kangaroo mother care 1.00, admission to neonatal unit 1.01) had high survey-reported coverage amongst admitted newborns and high sensitivity. The remaining indicators did not perform well and some had very high "don't know" responses.
conclusionsOur study revealed low validity for collecting many maternal and newborn indicators through an exit survey instrument, even with short recall periods among women with vaginal births. Household surveys are already at risk of overload, and some specific clinical care indicators do not perform well and may be under-powered. Given that approximately 80% of births worldwide occur in facilities, routine registers should also be explored to track coverage of key maternal and newborn health interventions, particularly for clinical care.
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