Search

Your search keyword '"Blencowe H"' showing total 16 results
Start Over Author "Blencowe H" Publication Type Electronic Resources
16 results on '"Blencowe H"'

1. Counting the smallest : data to estimate global stillbirth, preterm birth and low birthweight rates

Author

Blencowe, H. and Blencowe, H.

Subjects
362.1983
Abstract

Background: Stillbirth, preterm birth and low birthweight are important indicators of global burden of disease, status of maternal health and healthcare, and predictors of health throughout the life-course. Data are available through Civil Registration and Vital Statistics (CRVS), Health Management Information Systems (HMIS) and household surveys. Comparisons of data by country or over time requires standard definitions and comparable data quality. Data gaps and inconsistencies necessitate adjustments and use of modelled estimates in many settings. Methods: Systematic data searches were undertaken to compile available data on these outcomes for 195 countries. Where no reliable data were available, statistical models were used to generate national estimates. Data quantity and quality were summarised for each outcome, with implications for improvement and research. Results: The estimated burden remains large: 2.6 million stillbirths (2015), 14.9 million preterm births (2010) and 20.5 million low birthweight babies (2015) based on 4,392 data-points from 148 countries. Common data quality challenges include use of non-standard definitions, omission, and misclassification. Targeted data quality assessments are required to detect these. Five data gaps identified to address are: (1) coverage of data systems (2) accurate assessment of vital status at birth, birthweight and gestational age for every birth, (3) accurate recording of these key data elements (4) comparable collation within and across data systems and (5) use of data to inform programmes and policy. Evidence exists across all data platforms of examples of solutions to close these gaps. Systematic data linkage could increase efficiency. Conclusion: Data availability has increased over the last decade, even in the poorest countries. Data quality issues currently hamper the use of these data to improve outcomes in many settings, but could be addressed with political will and targeted investment. Ending preventable deaths among the world's smallest babies requires that these data are accurate, available and used.

Published
2020
Full Text
View/download PDF

2. A Review Of Key Terminology And Definitions Used For Birth Defects Globally

Author

Malherbe, HL, Modell, B, Blencowe, H, Strong, KL, Malherbe, HL, Modell, B, Blencowe, H, and Strong, KL

Abstract

Birth defects, also known as congenital disorders, are a signifcant health issue impacting at least fve million births annually worldwide. For policymakers to mount a relevant healthcare response to care for those afected, the burden of disease of these conditions must be quantifed. Estimates of the contribution of birth defects to under-5 child mortality and morbidity are generated by several groups globally. These estimates often difer, causing confusion for policymakers. While some differences may be attributed to the data sources and methods used, much is due to a lack of clarity in the terminology used for the group of disorders classed as “congenital”. This study aimed to gain insight into the diversity of terms and defnitions for birth defects, including those used routinely by relevant international/national organisations and in the peer-reviewed literature. This two-part study included (1) scoping review of peer-reviewed literature to identify terms and defnitions in use for birth defects and (2) review of key websites and grey literature to identify terms and defnitions used. The results of this study indicate a wide variety of terms being used, often interchangeably and undefned, in peer-reviewed publications, on institutional websites and related literature. This suggests a lack of clarity related to terminology and sets the scene for further discussion, recommending that the community of practice working on birth defects comes to a consensus on standard terminology and defnitions for global uptake and implementation. Such standardisation will facilitate a common understanding of the burden of these disorders globally, regionally and within countries so that action can be taken to support afected children and their families

Published
2023

3. Global research priorities on COVID-19 for maternal, newborn, child and adolescent health

Author

Ahmed, ASMNU, Maamri, A, Falade, AG, Ayede, AI, Bhutta, A, Gambhir, A, Tagarro, A, Abdelmegeid, A, Ahmadi, AR, Barros, AJD, Mekasha, A, Srinivasaiyer, AK, Araujo da Silva, AR, Schultz, A, Fatima, B, Dhar, B, Magowan, B, Wills, B, Raynes-Greenow, C, Homer, C, Maclennan, C, Ward, C, Garcia, DM, Ross, D, Murdoch, D, Wilson, DJ, Adejuyigbe, E, Stasii, E, Scudder, E, Sacks, E, McCollum, ED, Althabe, F, Russell, F, Kumar, GS, Sommerfelt, H, Graham, H, Blencowe, H, Tappis, H, Saloojee, H, Ben Masaud, HA, Tiwary, H, Asiodu, I, Newton, JB, Bourdaire, J, Adze, JA, Martines, J, Lozano, JM, Walson, J, Rankin, J, Allegaert, K, Pelle, KG, Edmond, K, Rabiei, K, Rasmussen, KM, Yunis, K, Ferguson, L, Greenslade, L, Kiapi, L, Noguchi, L, Bont, L, Day, LT, Mofenson, L, Aboumayaleh, M, Aquzouz, M, Wahba, M, Nagai, M, Knight, M, Melkumova, M, Jenyfa, M, Neuman, MI, Meremikwu, M, Kinney, M, Gravett, M, Hawkes, MT, Pacque, M, Walsh, M, McGuire, MK, AlShawafi, NA, Khuri-Bulos, N, Thacker, N, Rollins, N, Kissoon, N, Starets, O, Picone, O, Oladapo, OT, Erdeve, O, Smith, PB, Van de Perre, P, Kumar, P, Mangtani, P, Abbas, Q, Khatoon, R, Bahl, R, Lodha, R, Grais, R, Richards-Kortum, R, Rasaily, R, Aryeetey, R, Pattinson, R, Petrucci, R, Rossi, R, Pace, RM, Yoshida, S, Walani, SR, Godakandage, SSP, Bauler, S, Comstock, SS, Basu, S, Kebede, S, Saha, S, Bhatnagar, S, Lee, SK, Gupta, S, Antara, SN, Downe, S, Freedman, S, Lye, SJ, Miller, S, Sulimani, S, Ley, SH, Mangal, TD, Lavin, T, Shi, T, Florin, TA, Sundekilde, UK, Baltag, V, Valdes, V, Cherniak, W, Bin Nisar, Y, Shamszai, ZZ, Navabi, ZS, Ahmed, ASMNU, Maamri, A, Falade, AG, Ayede, AI, Bhutta, A, Gambhir, A, Tagarro, A, Abdelmegeid, A, Ahmadi, AR, Barros, AJD, Mekasha, A, Srinivasaiyer, AK, Araujo da Silva, AR, Schultz, A, Fatima, B, Dhar, B, Magowan, B, Wills, B, Raynes-Greenow, C, Homer, C, Maclennan, C, Ward, C, Garcia, DM, Ross, D, Murdoch, D, Wilson, DJ, Adejuyigbe, E, Stasii, E, Scudder, E, Sacks, E, McCollum, ED, Althabe, F, Russell, F, Kumar, GS, Sommerfelt, H, Graham, H, Blencowe, H, Tappis, H, Saloojee, H, Ben Masaud, HA, Tiwary, H, Asiodu, I, Newton, JB, Bourdaire, J, Adze, JA, Martines, J, Lozano, JM, Walson, J, Rankin, J, Allegaert, K, Pelle, KG, Edmond, K, Rabiei, K, Rasmussen, KM, Yunis, K, Ferguson, L, Greenslade, L, Kiapi, L, Noguchi, L, Bont, L, Day, LT, Mofenson, L, Aboumayaleh, M, Aquzouz, M, Wahba, M, Nagai, M, Knight, M, Melkumova, M, Jenyfa, M, Neuman, MI, Meremikwu, M, Kinney, M, Gravett, M, Hawkes, MT, Pacque, M, Walsh, M, McGuire, MK, AlShawafi, NA, Khuri-Bulos, N, Thacker, N, Rollins, N, Kissoon, N, Starets, O, Picone, O, Oladapo, OT, Erdeve, O, Smith, PB, Van de Perre, P, Kumar, P, Mangtani, P, Abbas, Q, Khatoon, R, Bahl, R, Lodha, R, Grais, R, Richards-Kortum, R, Rasaily, R, Aryeetey, R, Pattinson, R, Petrucci, R, Rossi, R, Pace, RM, Yoshida, S, Walani, SR, Godakandage, SSP, Bauler, S, Comstock, SS, Basu, S, Kebede, S, Saha, S, Bhatnagar, S, Lee, SK, Gupta, S, Antara, SN, Downe, S, Freedman, S, Lye, SJ, Miller, S, Sulimani, S, Ley, SH, Mangal, TD, Lavin, T, Shi, T, Florin, TA, Sundekilde, UK, Baltag, V, Valdes, V, Cherniak, W, Bin Nisar, Y, Shamszai, ZZ, and Navabi, ZS

Abstract

BACKGROUND: This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. METHODS: We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. RESULTS: We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. CONCLUSIONS: We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

Published
2021

4. Counting stillbirths and COVID 19-there has never been a more urgent time

Author

Homer, CSE, Leisher, SH, Aggarwal, N, Akuze, J, Babona, D, Blencowe, H, Bolgna, J, Chawana, R, Christou, A, Davies-Tuck, M, Dandona, R, Gordijn, S, Gordon, A, Jan, R, Korteweg, F, Maswime, S, Murphy, MM, Quigley, P, Storey, C, Vallely, LM, Waiswa, P, Whitehead, C, Zeitlin, J, Flenady, V, Homer, CSE, Leisher, SH, Aggarwal, N, Akuze, J, Babona, D, Blencowe, H, Bolgna, J, Chawana, R, Christou, A, Davies-Tuck, M, Dandona, R, Gordijn, S, Gordon, A, Jan, R, Korteweg, F, Maswime, S, Murphy, MM, Quigley, P, Storey, C, Vallely, LM, Waiswa, P, Whitehead, C, Zeitlin, J, and Flenady, V

Published
2021

5. Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia

Author

Flenady VJ, Middleton P, Wallace E, Morris J, Gordon A, Boyle FM, Homer C, Henry S, Brezler L, Wojcieszek AM, Davies-Tuck M, Coory M, Callander E, Kumar S, Clifton V, Leisher SH, Blencowe H, Forbes M, Sexton J, Ellwood D, Flenady VJ, Middleton P, Wallace E, Morris J, Gordon A, Boyle FM, Homer C, Henry S, Brezler L, Wojcieszek AM, Davies-Tuck M, Coory M, Callander E, Kumar S, Clifton V, Leisher SH, Blencowe H, Forbes M, Sexton J, and Ellwood D

Abstract

© 2020 Australian College of Midwives Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia's late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia's NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.

Published
2020

6. The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network's first protocol: deep phenotyping in three sub-Saharan African countries.

Author

von Dadelszen, P, Flint-O'Kane, M, Poston, L, Craik, R, Russell, D, Tribe, RM, d'Alessandro, U, Roca, A, Jah, H, Temmerman, M, Koech Etyang, A, Sevene, E, Chin, P, Lawn, JE, Blencowe, H, Sandall, J, Salisbury, TT, Barratt, B, Shennan, AH, Makanga, PT, Magee, LA, PRECISE Network, von Dadelszen, P, Flint-O'Kane, M, Poston, L, Craik, R, Russell, D, Tribe, RM, d'Alessandro, U, Roca, A, Jah, H, Temmerman, M, Koech Etyang, A, Sevene, E, Chin, P, Lawn, JE, Blencowe, H, Sandall, J, Salisbury, TT, Barratt, B, Shennan, AH, Makanga, PT, Magee, LA, and PRECISE Network

Abstract

BACKGROUND:The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network is a new and broadly-based group of research scientists and health advocates based in the UK, Africa and North America. METHODS:This paper describes the protocol that underpins the clinical research activity of the Network, so that the investigators, and broader global health community, can have access to 'deep phenotyping' (social determinants of health, demographic and clinical parameters, placental biology and agnostic discovery biology) of women as they advance through pregnancy to the end of the puerperium, whether those pregnancies have normal outcomes or are complicated by one/more of the placental disorders of pregnancy (pregnancy hypertension, fetal growth restriction and stillbirth). Our clinical sites are in The Gambia (Farafenni), Kenya (Kilifi County), and Mozambique (Maputo Province). In each country, 50 non-pregnant women of reproductive age will be recruited each month for 1 year, to provide a final national sample size of 600; these women will provide culturally-, ethnically-, seasonally- and spatially-relevant control data with which to compare women with normal and complicated pregnancies. Between the three countries we will recruit ≈10,000 unselected pregnant women over 2 years. An estimated 1500 women will experience one/more placental complications over the same epoch. Importantly, as we will have accurate gestational age dating using the TraCer device, we will be able to discriminate between fetal growth restriction and preterm birth. Recruitment and follow-up will be primarily facility-based and will include women booking for antenatal care, subsequent visits in the third trimester, at time-of-disease, when relevant, during/immediately after birth and 6 weeks after birth. CONCLUSIONS:To accelerate progress towards the women's and children's health-relevant Sustainable Development Goals, we need to understand how a variety of social, chronic disease

Published
2020

7. Rare single gene disorders: Estimating baseline prevalence and outcomes worldwide

Author

Blencowe, H., Moorthie, S., Petrou, M., Hamamy, H., Povey, S., Bittles, A., Gibbons, S., Darlison, M., Modell, B., Blencowe, H., Moorthie, S., Petrou, M., Hamamy, H., Povey, S., Bittles, A., Gibbons, S., Darlison, M., and Modell, B.

Abstract

As child mortality rates overall are decreasing, non-communicable conditions, such as genetic disorders, constitute an increasing proportion of child mortality, morbidity and disability. To date, policy and public health programmes have focused on common genetic disorders. Rare single gene disorders are an important source of morbidity and premature mortality for affected families. When considered collectively, they account for an important public health burden, which is frequently under-recognised. To document the collective frequency and health burden of rare single gene disorders, it is necessary to aggregate them into large manageable groupings and take account of their family implications, effective interventions and service needs. Here, we present an approach to estimate the burden of these conditions up to 5 years of age in settings without empirical data. This approaches uses population-level demographic data, combined with assumptions based on empirical data from settings with data available, to provide population-level estimates which programmes and policy-makers when planning services can use.

Published
2018

8. Making stillbirths visible: a systematic review of globally reported causes of stillbirth

Author

Reinebrant, HE, Leisher, SH, Coory, M, Henry, S, Wojcieszek, AM, Gardener, G, Lourie, R, Ellwood, D, Teoh, Z, Allanson, E, Blencowe, H, Draper, ES, Erwich, JJ, Froen, JF, Gardosi, J, Gold, K, Gordijn, S, Gordon, A, Heazell, AEP, Khong, TY, Korteweg, F, Lawn, JE, McClure, EM, Oats, J, Pattinson, R, Pettersson, K, Siassakos, D, Silver, RM, Smith, GCS, Tuncalp, OE, Flenady, V, Reinebrant, HE, Leisher, SH, Coory, M, Henry, S, Wojcieszek, AM, Gardener, G, Lourie, R, Ellwood, D, Teoh, Z, Allanson, E, Blencowe, H, Draper, ES, Erwich, JJ, Froen, JF, Gardosi, J, Gold, K, Gordijn, S, Gordon, A, Heazell, AEP, Khong, TY, Korteweg, F, Lawn, JE, McClure, EM, Oats, J, Pattinson, R, Pettersson, K, Siassakos, D, Silver, RM, Smith, GCS, Tuncalp, OE, and Flenady, V

Abstract

BACKGROUND: Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention. OBJECTIVES: To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM. SEARCH STRATEGY: We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. SELECTION CRITERIA: Reports of stillbirth causes in unselective cohorts. DATA COLLECTION AND ANALYSIS: Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). MAIN RESULTS: Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes. CONCLUSIONS: There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. FUNDING: HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). TWEETABLE ABSTRACT: Urgent need to improve data on causes of stillbirths across all settings to meet global targets. PLAIN LANGUAGE SUMMARY: Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parent

Published
2018

9. Stillbirths: Recall to action in high-income countries.

Author

Goldenberg R.L., Sadler L., Petersen S., Froen J.F., Sisassakos D., Kinney M.V., de Bernis L., Heazell A., Ruidiaz J., Carvalho A., Dahlstrom J., Fox J.P., Gibbons K., Ibiebele I., Kildea S., Gardener G., Lourie R., Wilson P., Gordon A., Kent A., McDonald S., Merchant K., Oats J., Walker S.P., Raven L., Schirmann A., de Montigny F., Guyon G., Blondel B., de Wall S., Bonham S., Corcoran P., Cregan M., Meaney S., Murphy M., Fukui S., Gordijn S., Korteweg F., Cronin R., Masson V., Culling V., Usynina A., Pettersson K., Radestad I., van Gogh S., Bichara B., Bradley S., Ellis A., Downe S., Draper E., Manktelow B., Scott J., Smith L., Stones W., Lavender T., Cacciatore J., Duke W., Fretts R.C., Gold K.J., McClure E., Reddy U., East C., Jennings B., Flenady V., Wojcieszek A.M., Middleton P., Ellwood D., Erwich J.J., Coory M., Khong T.Y., Silver R.M., Smith G.C.S., Boyle F.M., Lawn J.E., Blencowe H., Hopkins Leisher S., Gross M.M., Horey D., Farrales L., Bloomfield F., McCowan L., Brown S.J., Joseph K.S., Zeitlin J., Reinebrant H.E., Ravaldi C., Vannacci A., Cassidy J., Cassidy P., Farquhar C., Wallace E., Siassakos D., Heazell A.E.P., Storey C., Goldenberg R.L., Sadler L., Petersen S., Froen J.F., Sisassakos D., Kinney M.V., de Bernis L., Heazell A., Ruidiaz J., Carvalho A., Dahlstrom J., Fox J.P., Gibbons K., Ibiebele I., Kildea S., Gardener G., Lourie R., Wilson P., Gordon A., Kent A., McDonald S., Merchant K., Oats J., Walker S.P., Raven L., Schirmann A., de Montigny F., Guyon G., Blondel B., de Wall S., Bonham S., Corcoran P., Cregan M., Meaney S., Murphy M., Fukui S., Gordijn S., Korteweg F., Cronin R., Masson V., Culling V., Usynina A., Pettersson K., Radestad I., van Gogh S., Bichara B., Bradley S., Ellis A., Downe S., Draper E., Manktelow B., Scott J., Smith L., Stones W., Lavender T., Cacciatore J., Duke W., Fretts R.C., Gold K.J., McClure E., Reddy U., East C., Jennings B., Flenady V., Wojcieszek A.M., Middleton P., Ellwood D., Erwich J.J., Coory M., Khong T.Y., Silver R.M., Smith G.C.S., Boyle F.M., Lawn J.E., Blencowe H., Hopkins Leisher S., Gross M.M., Horey D., Farrales L., Bloomfield F., McCowan L., Brown S.J., Joseph K.S., Zeitlin J., Reinebrant H.E., Ravaldi C., Vannacci A., Cassidy J., Cassidy P., Farquhar C., Wallace E., Siassakos D., Heazell A.E.P., and Storey C.

Abstract

Summary Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.Copyright © 2016 Elsevier Ltd.

Published
2016

10. Stillbirths: economic and psychosocial consequences.

Author

Heazell, Alex, Siassakos, D, Blencowe, H, Burden, C, Bhutta, ZA, Cacciatore, J, Danq, N, Das, J, Flenady, V, Gold, KJ, Mensah, OK, Millum, J, Nuzum, D, O'Donaghue, K, Redshaw, M, Rizvi, A, Roberts, T, Saraki, HE, Storey, C, Wojcieszek, AM, Downe, Soo, Heazell, Alex, Siassakos, D, Blencowe, H, Burden, C, Bhutta, ZA, Cacciatore, J, Danq, N, Das, J, Flenady, V, Gold, KJ, Mensah, OK, Millum, J, Nuzum, D, O'Donaghue, K, Redshaw, M, Rizvi, A, Roberts, T, Saraki, HE, Storey, C, Wojcieszek, AM, and Downe, Soo

Abstract

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.

Published
2016

11. Setting research priorities to improve global newborn health and prevent stillbirths by 2025

Author

Yoshida, S, Martines, J, Lawn, JE, Wall, S, Souza, JP, Rudan, I, Cousens, S, Aaby, P, Adam, I, Adhikari, RK, Ambalavanan, N, El Arifeen, S, Aryal, DR, Asiruddin, S, Baqui, A, Barros, AJD, Benn, CS, Bhandari, V, Bhatnagar, S, Bhattacharya, S, Bhutta, ZA, Black, RE, Blencowe, H, Bose, C, Brown, J, Buehrer, C, Carlo, W, Cecatti, JG, Cheung, P-Y, Clark, R, Colbourn, T, Conde-Agudelo, A, Corbett, E, Czeizel, AE, Das, A, Day, LT, Deal, C, Deorari, A, Dilmen, U, English, M, Engmann, C, Esamai, F, Fall, C, Ferriero, DM, Gisore, P, Hazir, T, Higgins, RD, Homer, CSE, Hoque, DE, Irgens, L, Islam, MT, de Graft-Johnson, J, Joshua, MA, Keenan, W, Khatoon, S, Kieler, H, Kramer, MS, Lackritz, EM, Lavender, T, Lawintono, L, Luhanga, R, Marsh, D, McMillan, D, McNamara, PJ, Mol, BWJ, Molyneux, E, Mukasa, GK, Mutabazi, M, Nacul, LC, Nakakeeto, M, Narayanan, I, Olusanya, B, Osrin, D, Paul, V, Poets, C, Reddy, UM, Santosham, M, Sayed, R, Schlabritz-Loutsevitch, NE, Singhal, N, Smith, MA, Smith, PG, Soofi, S, Spong, CY, Sultana, S, Tshefu, A, van Bel, F, Gray, LV, Waiswa, P, Wang, W, Williams, SLA, Wright, L, Zaidi, A, Zhang, Y, Zhong, N, Zuniga, I, Bahl, R, Yoshida, S, Martines, J, Lawn, JE, Wall, S, Souza, JP, Rudan, I, Cousens, S, Aaby, P, Adam, I, Adhikari, RK, Ambalavanan, N, El Arifeen, S, Aryal, DR, Asiruddin, S, Baqui, A, Barros, AJD, Benn, CS, Bhandari, V, Bhatnagar, S, Bhattacharya, S, Bhutta, ZA, Black, RE, Blencowe, H, Bose, C, Brown, J, Buehrer, C, Carlo, W, Cecatti, JG, Cheung, P-Y, Clark, R, Colbourn, T, Conde-Agudelo, A, Corbett, E, Czeizel, AE, Das, A, Day, LT, Deal, C, Deorari, A, Dilmen, U, English, M, Engmann, C, Esamai, F, Fall, C, Ferriero, DM, Gisore, P, Hazir, T, Higgins, RD, Homer, CSE, Hoque, DE, Irgens, L, Islam, MT, de Graft-Johnson, J, Joshua, MA, Keenan, W, Khatoon, S, Kieler, H, Kramer, MS, Lackritz, EM, Lavender, T, Lawintono, L, Luhanga, R, Marsh, D, McMillan, D, McNamara, PJ, Mol, BWJ, Molyneux, E, Mukasa, GK, Mutabazi, M, Nacul, LC, Nakakeeto, M, Narayanan, I, Olusanya, B, Osrin, D, Paul, V, Poets, C, Reddy, UM, Santosham, M, Sayed, R, Schlabritz-Loutsevitch, NE, Singhal, N, Smith, MA, Smith, PG, Soofi, S, Spong, CY, Sultana, S, Tshefu, A, van Bel, F, Gray, LV, Waiswa, P, Wang, W, Williams, SLA, Wright, L, Zaidi, A, Zhang, Y, Zhong, N, Zuniga, I, and Bahl, R

Abstract

BACKGROUND: In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013-2025. METHODS: We used adapted Child Health and Nutrition Research Initiative (CHNRI) methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions online. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and were assessed and scored by 91 experts. RESULTS: Nine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how to improve the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour. CONCLUSION: These findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment. WHO, SNL and other partners will work to gen

Published
2016

12. Stillbirth: Why invest?

Author

Heazell, A, Siassakos, D, Blencowe, H, Bhutta, Z, Cacciatore, J, Dang, N, Das, J, Flenady, V, Gold, K, Mensah, O, Millum, J, Nuzum, D, O’Donoghue, K, Redshaw, M, Rizvi, A, Roberts, T, Toyin Saraki, H E, Storey, C, Wojcieszek, A, Downe, Soo, Heazell, A, Siassakos, D, Blencowe, H, Bhutta, Z, Cacciatore, J, Dang, N, Das, J, Flenady, V, Gold, K, Mensah, O, Millum, J, Nuzum, D, O’Donoghue, K, Redshaw, M, Rizvi, A, Roberts, T, Toyin Saraki, H E, Storey, C, Wojcieszek, A, and Downe, Soo

Abstract

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.

Published
2015

13. Count every newborn; a measurement improvement roadmap for coverage data

Author

Moxon, SG, Ruysen, H, Kerber, KJ, Amouzou, A, Fournier, S, Grove, J, Moran, AC, Vaz, LME, Blencowe, H, Conroy, N, Gulmezoglu, AM, Vogel, JP, Rawlins, B, Sayed, R, Hill, K, Vivio, D, Qazi, SA, Sitrin, D, Seale, AC, Wall, S, Jacobs, T, Ruiz Pelaez, JG, Guenther, T, Coffey, PS, Dawson, P, Marchant, T, Waiswa, P, Deorari, A, Enweronu-Laryea, C, El Arifeen, S, Lee, ACC, Mathai, M, Lawn, JE, Moxon, SG, Ruysen, H, Kerber, KJ, Amouzou, A, Fournier, S, Grove, J, Moran, AC, Vaz, LME, Blencowe, H, Conroy, N, Gulmezoglu, AM, Vogel, JP, Rawlins, B, Sayed, R, Hill, K, Vivio, D, Qazi, SA, Sitrin, D, Seale, AC, Wall, S, Jacobs, T, Ruiz Pelaez, JG, Guenther, T, Coffey, PS, Dawson, P, Marchant, T, Waiswa, P, Deorari, A, Enweronu-Laryea, C, El Arifeen, S, Lee, ACC, Mathai, M, and Lawn, JE

Abstract

BACKGROUND: The Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularly to track coverage, quality and equity. METHODS: In a multistage process, a matrix of 70 indicators were assessed by the Every Newborn steering group. Indicators were graded based on their availability and importance to ENAP, resulting in 10 core and 10 additional indicators. A consultation process was undertaken to assess the status of each ENAP core indicator definition, data availability and measurement feasibility. Coverage indicators for the specific ENAP treatment interventions were assigned task teams and given priority as they were identified as requiring the most technical work. Consultations were held throughout. RESULTS: ENAP published 10 core indicators plus 10 additional indicators. Three core impact indicators (neonatal mortality rate, maternal mortality ratio, stillbirth rate) are well defined, with future efforts needed to focus on improving data quantity and quality. Three core indicators on coverage of care for all mothers and newborns (intrapartum/skilled birth attendance, early postnatal care, essential newborn care) have defined contact points, but gaps exist in measuring content and quality of the interventions. Four core (antenatal corticosteroids, neonatal resuscitation, treatment of serious neonatal infections, kangaroo mother care) and one additional coverage indicator for newborns at risk or with complications (chlorhexidine cord cleansing) lack indicator definitions or data, especially for denominators (population in need). To address these gaps, feasible coverage indicator definitions are presented for validity testing. Measurable process indicators to help monitor health service readiness are

Published
2015

14. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Author

Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basanez, M-G, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabe, E, Bhalla, K, Bhandari, B, Bikbov, B, Bin Abdulhak, A, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, SA, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, GR, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, AT-A, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, de Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Dharmaratne, SD, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fevre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gosselin, R, Grainger, R, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Halasa, YA, Hall, W, Haring, D, Maria Haro, J, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, J-P, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Ma, J, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Elena Medina-Mora, M, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, A-C, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Perez Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leon, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JRA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, van der Werf, MJ, van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, P-H, Zaidi, AKM, Zheng, Z-J, Zonies, D, Lopez, AD, Murray, CJL, Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basanez, M-G, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabe, E, Bhalla, K, Bhandari, B, Bikbov, B, Bin Abdulhak, A, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, SA, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, GR, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, AT-A, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, de Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Dharmaratne, SD, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fevre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Franklin, R, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gosselin, R, Grainger, R, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Halasa, YA, Hall, W, Haring, D, Maria Haro, J, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, J-P, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Ma, J, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Elena Medina-Mora, M, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, A-C, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Perez Padilla, R, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leon, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JRA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, van der Werf, MJ, van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, P-H, Zaidi, AKM, Zheng, Z-J, Zonies, D, Lopez, AD, and Murray, CJL

Abstract

BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly cor

Published
2012

15. Measurement of stillbirths and neonatal deaths in standardised population-based surveys

Author

Akuze Waiswa, J., Blencowe, H., Cousens, S., and Waiswa, P.

Abstract

Background: Worldwide, 4.4 million stillbirths and neonatal deaths (SB&NND) are estimated to occur annually. Household surveys, notably the Demographic and Health Surveys (DHS), are an important source of SB&NND data. This PhD aimed to review the DHS's evolution for SB&NND data capture and compare the full birth history with additional questions on pregnancy losses (FBH+) and full pregnancy history (FPH) approaches in terms of data quality and potential measurement errors. Methods: A literature and programmatic review of the DHS programme and HDSS pregnancy surveillance system was conducted. A randomised comparison of FBH+ versus FPH modules (the EveryNewborn-INDEPTH (EN-INDEPTH) survey) was undertaken in five health and demographic surveillance sites (HDSS). Reported stillbirth rates (SBR) and neonatal mortality rates (NMR); time for completion of survey modules; evidence for heterogeneity between sites; patterns of corrections between question types and structures, and modules were assessed. Survey data were compared to and HDSS data in four sites. Results: Both FPH and FBH+ modules have been used within the DHS programme, but there is limited evidence concerning their accuracy for SB&NND. The FBH+ was the core model questionnaire between DHS-phases I-VII. A total of 69,176 women consented. 34,805 (50·3%) were randomised to FBH+ and 34,371 (49·7%) to FPH. There was little difference between the average time to administer questions in FBH+ (9.1 minutes) and FPH (10.5 minutes). The SBR was 15.2/1000 and 17.4/1000 total births for FBH+ and FPH, respectively. SBR was 21% (95% CI (-10% - 62%)) higher in FPH than in FBH+ with strong evidence of heterogeneity across the sites (I-squared=80·9% (p < 0.001)). The NMR was similar in FPH (25.1/1000 births) and FBH+ (25.4/1000 births) with no evidence of heterogeneity between the sites (I-squared=0.0% (p=0.48)). Corrections were similar by survey module and occurred in 84% of survey interviews. Single corrections were the most common, multiple-select, and free-text questions increased response time by two minutes on average and had the most corrections. Pregnancy surveillance systems differed between sites (frequency of surveillance visits, main respondent reporting pregnancy outcomes, pregnancy testing, and data capture and surveillance modes). In three of the four sites, both arms of the EN-INDEPTH survey reported more pregnancies than the HDSS Matlab being the exception. Overall, the survey data produced higher estimated SBRs (FBH+: RR=1.13, 95%CI (0.79, 1.63), p=0.519; FPH: RR=1.20, 95%CI (0.76, 1.90), p=0.444) and NMRs (FBH+: RR=1.19, 95%CI (0.98, 1.43), p=0.071; FPH: RR=1.15, 95%CI (1.01, 1.30), p=0.030) than the HDSS data. In Matlab, the HDSS recorded more stillbirths and miscarriages than the survey in the FPH arm only. In Kintampo, the HDSS recorded more stillbirths than the survey, even though the HDSS recorded fewer pregnancies. Conclusions: Evidence from this PhD of improved capture of stillbirths using the FPH influenced the DHS's switch to the FPH module in its eighth phase; however, limited evidence concerning SB&NND data accuracy and quality in standardised surveys is available. Therefore, additional efforts towards improved survey implementation of the FPH approach, including training, interviewer prompts, translations, and developing and testing standard data quality criteria for SB&NND in surveys and routine data, are warranted.

Published
2022

16. Service readiness for inpatient care of small and sick newborns : improving measurement in low- and middle-income settings

Author

Moxon, Sarah, Lawn, J., and Blencowe, H.

Subjects
362.19892
Abstract

Background: In 2018, 2.5 million newborns died; mainly from prematurity, infections, and intrapartum events. Preventing these deaths requires health systems to provide routine and emergency care at birth, and quality inpatient care for small and sick newborns. Despite high potential impact, inpatient newborn care is not consistently measured. Methods: For this PhD, I conducted a bottleneck analysis using data from 12 national workshops regarding delivery of inpatient newborn care in low- and middle-income countries (LMIC). Using WHO guidelines, grey literature and expert consultation, I mapped the components required to deliver inpatient care and reviewed these against three health facility assessment tools. Finally, I carried out an online survey to elicit global practitioner opinions regarding levels of newborn care, paralleling those used for monitoring emergency obstetric care in LMIC. Results: In 12 high-burden countries in sub-Saharan Africa and Asia, health financing and workforce were identified as the greatest bottlenecks to scaling up quality inpatient care, followed by community ownership. My review identified 654 components required to deliver inpatient care. These are inconsistently measured by existing health facility assessments. The 262 survey respondents agreed on 12 interventions to comprise a package of care for small and sick newborns; selected levels of care varied by clinical background and experience in LMIC. Conclusion: Inpatient newborn care faces multiple health system challenges, particularly to ensure funding and skilled staffing. Standard facility numbers and staffing ratios by defined levels of care are important for countries to benchmark service delivery progress. Due to the large number of components required for delivering quality care, newborn “signal functions” could be selected by level of care to parallel emergency obstetric care indicators. Improved measurement of service readiness requires sustained focus on interoperability of routine measurement systems, and further research to better capture the experience of newborn inpatient care for families.

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results