Birthweight data completeness and quality in population-based surveys: EN-INDEPTH study

• Published in: Population health metrics 2021-02, Vol.19 (Suppl 1), p.17-16, Article 17
• Main Authors: Biks, Gashaw Andargie, Blencowe, Hannah, Hardy, Victoria Ponce, Geremew, Bisrat Misganaw, Angaw, Dessie Abebaw, Wagnew, Alemakef, Abebe, Solomon Mekonnen, Guadu, Tadesse, Martins, Justiniano S D, Fisker, Ane Baerent, Imam, Md Ali, Nettey, Obed Ernest A, Kasasa, Simon, Di Stefano, Lydia, Akuze, Joseph, Kwesiga, Doris, Lawn, Joy E
• Format: Article
• Language: English
• Subjects: Babies; Birth size; Birth Weight; Births; Birthweight; Chronic illnesses; Data Accuracy; Data entry; Data quality; Demographics; Evaluation; Fatalities; Female; Gap analysis; Heaping; Heterogeneity; Household survey; Households; Humans; Infant; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Infants (Newborn); Information management; Management information systems; Measurement; Methods; Mothers; Neonates; Perceptions; Polls & surveys; Population; Population studies; Population-based studies; Pregnancy; Qualitative analysis; Questions; Stillbirth; Surveys and Questionnaires; Weighing; Womens health
• ISSN: 1478-7954; 1478-7954
• DOI: 10.1186/s12963-020-00229-w

Low birthweight (< 2500 g) is an important marker of maternal health and is associated with neonatal mortality, long-term development and chronic diseases. Household surveys remain an important source of population-based birthweight information, notably Demographic and Health Surveys (DHS) and UNICEF's Multiple Indicator Cluster Surveys (MICS); however, data quality concerns remain. Few studies have addressed how to close these gaps in surveys. The EN-INDEPTH population-based survey of 69,176 women was undertaken in five Health and Demographic Surveillance System sites (Matlab-Bangladesh, Dabat-Ethiopia, Kintampo-Ghana, Bandim-Guinea-Bissau, IgangaMayuge-Uganda). Responses to existing DHS/MICS birthweight questions on 14,411 livebirths were analysed and estimated adjusted odds ratios (aORs) associated with reporting weighing, birthweight and heaping reported. Twenty-eight focus group discussions with women and interviewers explored barriers and enablers to reporting birthweight. Almost all women provided responses to birthweight survey questions, taking on average 0.2 min to answer. Of all babies, 62.4% were weighed at birth, 53.8% reported birthweight and 21.1% provided health cards with recorded birthweight. High levels of heterogeneity were observed between sites. Home births and neonatal deaths were less likely to be weighed at birth (home births aOR 0.03(95%CI 0.02-0.03), neonatal deaths (aOR 0.19(95%CI 0.16-0.24)), and when weighed, actual birthweight was less likely to be known (aOR 0.44(95%CI 0.33-0.58), aOR 0.30(95%CI 0.22-0.41)) compared to facility births and post-neonatal survivors. Increased levels of maternal education were associated with increases in reporting weighing and knowing birthweight. Half of recorded birthweights were heaped on multiples of 500 g. Heaping was more common in IgangaMayuge (aOR 14.91(95%CI 11.37-19.55) and Dabat (aOR 14.25(95%CI 10.13-20.3) compared to Bandim. Recalled birthweights were more heaped than those recorded by card (aOR 2.59(95%CI 2.11-3.19)). A gap analysis showed large missed opportunity between facility birth and known birthweight, especially for neonatal deaths. Qualitative data suggested that knowing their baby's weight was perceived as valuable by women in all sites, but lack of measurement and poor communication, alongside social perceptions and spiritual beliefs surrounding birthweight, impacted women's ability to report birthweight. Substantial data gaps remain for birthweight data in household su