Using community-based reporting of vital events to monitor child mortality: Lessons from rural Ghana
Reducing neonatal and child mortality is a key component of the health-related sustainable development goal (SDG), but most low and middle income countries lack data to monitor child mortality on an annual basis. We tested a mortality monitoring system based on the continuous recording of pregnancie...
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| creator | Helleringer, Stephane Arhinful, Daniel Abuaku, Benjamin Humes, Michael Wilson, Emily Marsh, Andrew Clermont, Adrienne Black, Robert E Bryce, Jennifer Amouzou, Agbessi |
| description | Reducing neonatal and child mortality is a key component of the health-related sustainable development goal (SDG), but most low and middle income countries lack data to monitor child mortality on an annual basis. We tested a mortality monitoring system based on the continuous recording of pregnancies, births and deaths by trained community-based volunteers (CBV).
This project was implemented in 96 clusters located in three districts of the Northern Region of Ghana. Community-based volunteers (CBVs) were selected from these clusters and were trained in recording all pregnancies, births, and deaths among children under 5 in their catchment areas. Data collection lasted from January 2012 through September 2013. All CBVs transmitted tallies of recorded births and deaths to the Ghana Birth and deaths registry each month, except in one of the study districts (approximately 80% reporting). Some events were reported only several months after they had occurred. We assessed the completeness and accuracy of CBV data by comparing them to retrospective full pregnancy histories (FPH) collected during a census of the same clusters conducted in October-December 2013. We conducted all analyses separately by district, as well as for the combined sample of all districts. During the 21-month implementation period, the CBVs reported a total of 2,819 births and 137 under-five deaths. Among the latter, there were 84 infant deaths (55 neonatal deaths and 29 post-neonatal deaths). Comparison of the CBV data with FPH data suggested that CBVs significantly under-estimated child mortality: the estimated under-5 mortality rate according to CBV data was only 2/3 of the rate estimated from FPH data (95% Confidence Interval for the ratio of the two rates = 51.7 to 81.4). The discrepancies between the CBV and FPH estimates of infant and neonatal mortality were more limited, but varied significantly across districts.
In northern Ghana, a community-based data collection systems relying on volunteers did not yield accurate estimates of child mortality rates. Additional implementation research is needed to improve the timeliness, completeness and accuracy of such systems. Enhancing pregnancy monitoring, in particular, may be an essential step to improve the measurement of neonatal mortality. |
| doi_str_mv | 10.1371/journal.pone.0192034 |
| format | Article |
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This project was implemented in 96 clusters located in three districts of the Northern Region of Ghana. Community-based volunteers (CBVs) were selected from these clusters and were trained in recording all pregnancies, births, and deaths among children under 5 in their catchment areas. Data collection lasted from January 2012 through September 2013. All CBVs transmitted tallies of recorded births and deaths to the Ghana Birth and deaths registry each month, except in one of the study districts (approximately 80% reporting). Some events were reported only several months after they had occurred. We assessed the completeness and accuracy of CBV data by comparing them to retrospective full pregnancy histories (FPH) collected during a census of the same clusters conducted in October-December 2013. We conducted all analyses separately by district, as well as for the combined sample of all districts. During the 21-month implementation period, the CBVs reported a total of 2,819 births and 137 under-five deaths. Among the latter, there were 84 infant deaths (55 neonatal deaths and 29 post-neonatal deaths). Comparison of the CBV data with FPH data suggested that CBVs significantly under-estimated child mortality: the estimated under-5 mortality rate according to CBV data was only 2/3 of the rate estimated from FPH data (95% Confidence Interval for the ratio of the two rates = 51.7 to 81.4). The discrepancies between the CBV and FPH estimates of infant and neonatal mortality were more limited, but varied significantly across districts.
In northern Ghana, a community-based data collection systems relying on volunteers did not yield accurate estimates of child mortality rates. Additional implementation research is needed to improve the timeliness, completeness and accuracy of such systems. Enhancing pregnancy monitoring, in particular, may be an essential step to improve the measurement of neonatal mortality.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0192034</identifier><identifier>PMID: 29381745</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; Births ; Catchment areas ; Catchments ; Child ; Child Mortality ; Children ; Communities ; Completeness ; Confidence intervals ; Data collection ; Demography ; Estimates ; Fatalities ; Ghana - epidemiology ; Health aspects ; Health surveillance ; Households ; Humans ; Infant mortality ; Infants ; Maternal Health Services - organization & administration ; Medical research ; Medicine and Health Sciences ; Methods ; Monitoring ; Monitoring systems ; Mortality ; Neonates ; Newborn babies ; People and Places ; Pregnancy ; Public health ; Recording ; Registration ; Research and Analysis Methods ; Sustainable development ; Vital statistics</subject><ispartof>PloS one, 2018-01, Vol.13 (1), p.e0192034-e0192034</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Helleringer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Helleringer et al 2018 Helleringer et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c950f4323d87ed20cfdaf0c14fc07f1febea3b670fc7854dea784e9d178e17ce3</citedby><cites>FETCH-LOGICAL-c692t-c950f4323d87ed20cfdaf0c14fc07f1febea3b670fc7854dea784e9d178e17ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790256/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790256/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29381745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Deribe, Kebede</contributor><creatorcontrib>Helleringer, Stephane</creatorcontrib><creatorcontrib>Arhinful, Daniel</creatorcontrib><creatorcontrib>Abuaku, Benjamin</creatorcontrib><creatorcontrib>Humes, Michael</creatorcontrib><creatorcontrib>Wilson, Emily</creatorcontrib><creatorcontrib>Marsh, Andrew</creatorcontrib><creatorcontrib>Clermont, Adrienne</creatorcontrib><creatorcontrib>Black, Robert E</creatorcontrib><creatorcontrib>Bryce, Jennifer</creatorcontrib><creatorcontrib>Amouzou, Agbessi</creatorcontrib><title>Using community-based reporting of vital events to monitor child mortality: Lessons from rural Ghana</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Reducing neonatal and child mortality is a key component of the health-related sustainable development goal (SDG), but most low and middle income countries lack data to monitor child mortality on an annual basis. We tested a mortality monitoring system based on the continuous recording of pregnancies, births and deaths by trained community-based volunteers (CBV).
This project was implemented in 96 clusters located in three districts of the Northern Region of Ghana. Community-based volunteers (CBVs) were selected from these clusters and were trained in recording all pregnancies, births, and deaths among children under 5 in their catchment areas. Data collection lasted from January 2012 through September 2013. All CBVs transmitted tallies of recorded births and deaths to the Ghana Birth and deaths registry each month, except in one of the study districts (approximately 80% reporting). Some events were reported only several months after they had occurred. We assessed the completeness and accuracy of CBV data by comparing them to retrospective full pregnancy histories (FPH) collected during a census of the same clusters conducted in October-December 2013. We conducted all analyses separately by district, as well as for the combined sample of all districts. During the 21-month implementation period, the CBVs reported a total of 2,819 births and 137 under-five deaths. Among the latter, there were 84 infant deaths (55 neonatal deaths and 29 post-neonatal deaths). Comparison of the CBV data with FPH data suggested that CBVs significantly under-estimated child mortality: the estimated under-5 mortality rate according to CBV data was only 2/3 of the rate estimated from FPH data (95% Confidence Interval for the ratio of the two rates = 51.7 to 81.4). The discrepancies between the CBV and FPH estimates of infant and neonatal mortality were more limited, but varied significantly across districts.
In northern Ghana, a community-based data collection systems relying on volunteers did not yield accurate estimates of child mortality rates. Additional implementation research is needed to improve the timeliness, completeness and accuracy of such systems. Enhancing pregnancy monitoring, in particular, may be an essential step to improve the measurement of neonatal mortality.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Births</subject><subject>Catchment areas</subject><subject>Catchments</subject><subject>Child</subject><subject>Child Mortality</subject><subject>Children</subject><subject>Communities</subject><subject>Completeness</subject><subject>Confidence intervals</subject><subject>Data collection</subject><subject>Demography</subject><subject>Estimates</subject><subject>Fatalities</subject><subject>Ghana - epidemiology</subject><subject>Health aspects</subject><subject>Health surveillance</subject><subject>Households</subject><subject>Humans</subject><subject>Infant mortality</subject><subject>Infants</subject><subject>Maternal Health Services - organization & administration</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Monitoring</subject><subject>Monitoring systems</subject><subject>Mortality</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>People and Places</subject><subject>Pregnancy</subject><subject>Public health</subject><subject>Recording</subject><subject>Registration</subject><subject>Research and Analysis Methods</subject><subject>Sustainable development</subject><subject>Vital 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Helleringer, Stephane</au><au>Arhinful, Daniel</au><au>Abuaku, Benjamin</au><au>Humes, Michael</au><au>Wilson, Emily</au><au>Marsh, Andrew</au><au>Clermont, Adrienne</au><au>Black, Robert E</au><au>Bryce, Jennifer</au><au>Amouzou, Agbessi</au><au>Deribe, Kebede</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using community-based reporting of vital events to monitor child mortality: Lessons from rural Ghana</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-01-30</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>e0192034</spage><epage>e0192034</epage><pages>e0192034-e0192034</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Reducing neonatal and child mortality is a key component of the health-related sustainable development goal (SDG), but most low and middle income countries lack data to monitor child mortality on an annual basis. We tested a mortality monitoring system based on the continuous recording of pregnancies, births and deaths by trained community-based volunteers (CBV).
This project was implemented in 96 clusters located in three districts of the Northern Region of Ghana. Community-based volunteers (CBVs) were selected from these clusters and were trained in recording all pregnancies, births, and deaths among children under 5 in their catchment areas. Data collection lasted from January 2012 through September 2013. All CBVs transmitted tallies of recorded births and deaths to the Ghana Birth and deaths registry each month, except in one of the study districts (approximately 80% reporting). Some events were reported only several months after they had occurred. We assessed the completeness and accuracy of CBV data by comparing them to retrospective full pregnancy histories (FPH) collected during a census of the same clusters conducted in October-December 2013. We conducted all analyses separately by district, as well as for the combined sample of all districts. During the 21-month implementation period, the CBVs reported a total of 2,819 births and 137 under-five deaths. Among the latter, there were 84 infant deaths (55 neonatal deaths and 29 post-neonatal deaths). Comparison of the CBV data with FPH data suggested that CBVs significantly under-estimated child mortality: the estimated under-5 mortality rate according to CBV data was only 2/3 of the rate estimated from FPH data (95% Confidence Interval for the ratio of the two rates = 51.7 to 81.4). The discrepancies between the CBV and FPH estimates of infant and neonatal mortality were more limited, but varied significantly across districts.
In northern Ghana, a community-based data collection systems relying on volunteers did not yield accurate estimates of child mortality rates. Additional implementation research is needed to improve the timeliness, completeness and accuracy of such systems. Enhancing pregnancy monitoring, in particular, may be an essential step to improve the measurement of neonatal mortality.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29381745</pmid><doi>10.1371/journal.pone.0192034</doi><tpages>e0192034</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-01, Vol.13 (1), p.e0192034-e0192034 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1992661003 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Biology and Life Sciences Births Catchment areas Catchments Child Child Mortality Children Communities Completeness Confidence intervals Data collection Demography Estimates Fatalities Ghana - epidemiology Health aspects Health surveillance Households Humans Infant mortality Infants Maternal Health Services - organization & administration Medical research Medicine and Health Sciences Methods Monitoring Monitoring systems Mortality Neonates Newborn babies People and Places Pregnancy Public health Recording Registration Research and Analysis Methods Sustainable development Vital statistics |
| title | Using community-based reporting of vital events to monitor child mortality: Lessons from rural Ghana |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T02%3A03%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Using%20community-based%20reporting%20of%20vital%20events%20to%20monitor%20child%20mortality:%20Lessons%20from%20rural%20Ghana&rft.jtitle=PloS%20one&rft.au=Helleringer,%20Stephane&rft.date=2018-01-30&rft.volume=13&rft.issue=1&rft.spage=e0192034&rft.epage=e0192034&rft.pages=e0192034-e0192034&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0192034&rft_dat=%3Cgale_plos_%3EA525648531%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1992661003&rft_id=info:pmid/29381745&rft_galeid=A525648531&rft_doaj_id=oai_doaj_org_article_cc76b00979db4002b35ebd7afbdd235f&rfr_iscdi=true |