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Population Health Metrics Feb 2021Birth registration is a child's first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth...
BACKGROUND
Birth registration is a child's first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth registration for live births in low- and middle-income countries is measured through population-based surveys which do not currently include completeness of stillbirth or death registration.
METHODS
The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017-2018). In four African sites, we included new/modified questions regarding registration for 1177 stillbirths and 11,881 livebirths (1333 neonatal deaths and 10,548 surviving the neonatal period). Questions were evaluated for completeness of responses, data quality, time to administer and estimates of registration completeness using descriptive statistics. Timing of birth registration, factors associated with non-registration and reported barriers were assessed using descriptive statistics and logistic regression.
RESULTS
Almost all women, irrespective of their baby's survival, responded to registration questions, taking an average of < 1 min. Reported completeness of birth registration was 30.7% (6.1-53.5%) for babies surviving the neonatal period, compared to 1.7% for neonatal deaths (0.4-5.7%). Women were able to report age at birth registration for 93.6% of babies. Non-registration of babies surviving the neonatal period was significantly higher for home-born children (aOR 1.43 (95% CI 1.27-1.60)) and in Dabat (Ethiopia) (aOR 4.11 (95% CI 3.37-5.01)). Other socio-demographic factors associated with non-registration included younger age of mother, more prior births, little or no education, and lower socio-economic status. Neonatal death registration questions were feasible (100% women responded; only 1% did not know), revealing extremely low completeness with only 1.2% of neonatal deaths reported as registered. Despite > 70% of stillbirths occurring in facilities, only 2.5% were reported as registered.
CONCLUSIONS
Questions on birth, stillbirth and death registration were feasible in a household survey. Completeness of birth registration is low in all four sites, but stillbirth and neonatal death registration was very low. Closing the registration gap amongst facility births could increase registration of both livebirths and facility deaths, including stillbirths, but will require co-ordination between civil registration systems and the often over-stretched health sector. Investment and innovation is required to capture birth and especially deaths in both facility and community systems.
Topics: Child; Data Accuracy; Data Collection; Educational Status; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Perinatal Death; Pregnancy; Stillbirth
PubMed: 33557862
DOI: 10.1186/s12963-020-00231-2 -
Journal of Perinatology : Official... May 2022To characterize literature that describes infant mode of death and to clarify how limitation of life-sustaining treatment (LST) is defined and rationalized. (Review)
Review
OBJECTIVE
To characterize literature that describes infant mode of death and to clarify how limitation of life-sustaining treatment (LST) is defined and rationalized.
STUDY DESIGN
Eligible studies were peer-reviewed, English-language, and included number of infant deaths by mode out of all infant deaths in the NICU and/or delivery room.
RESULT
58 included studies were primarily published in the last two decades from North American and European centers. There was variation in rates of infant mode of death by study, with some showing an increase in deaths following limitation of LST over time. Limitation of LST was defined by the intervention withheld/withdrawn, the relationship between the two practices, and prior frameworks. Themes for limiting LST included diagnoses, low predicted survival and/or quality of life, futility, and suffering.
CONCLUSION
Limitation of LST is a common infant mode of death, although rates, study definitions, and clinical rationale for this practice are variable.
Topics: Decision Making; Humans; Infant; Infant Death; Infant, Newborn; Intensive Care Units, Neonatal; Quality of Life; Withholding Treatment
PubMed: 35058594
DOI: 10.1038/s41372-022-01319-3 -
Comprehensive Child and Adolescent... Mar 2023
Topics: Child; Humans; Social Media; Death
PubMed: 36971887
DOI: 10.1080/24694193.2023.2172291 -
Medecine Sciences : M/S Dec 2020
Topics: Attitude to Death; Brain Death; Coma; Death; Functional Neuroimaging; Heart Arrest; Humans; Postmortem Changes; Religion; Time Factors; Transcription, Genetic
PubMed: 33296637
DOI: 10.1051/medsci/2020227 -
The American Journal of Cardiology Sep 2023
Topics: Pregnancy; Female; Humans; Pre-Eclampsia; Death, Sudden; Death, Sudden, Cardiac
PubMed: 37454636
DOI: 10.1016/j.amjcard.2023.06.089 -
The American Journal of Bioethics : AJOB Jun 2020
Topics: Apnea; Brain Death; Death; Humans; Informed Consent; Morals
PubMed: 32441607
DOI: 10.1080/15265161.2020.1754514 -
Forensic Science, Medicine, and... Jun 2022Sudden unexpected death in the young (SUDY) is a tragic event resulting in the fatality of seemingly healthy individuals between the ages of one and 40 years. Whilst... (Review)
Review
Sudden unexpected death in the young (SUDY) is a tragic event resulting in the fatality of seemingly healthy individuals between the ages of one and 40 years. Whilst studies have been performed on sudden unexpected death in infants, children, and adults respectively, little is known about trends in risk factors and causes of death of SUDY cases. Understanding the factors surrounding these deaths could lead to targeted interventions for at-risk individuals. Hence, a systematic approach to investigate the reported possible causes of SUDY was employed using three major databases and Primo, wherein 67 relevant articles were identified and 2 additional guidelines were read. Sudden unexpected death in epilepsy and sudden cardiac events were well-established causes of death with risk factors such as male predominance, substance use and a familial history identified. It was acknowledged that while the cause of death is established following post-mortem examination in many cases, some remain non-specific or undetermined. Considering the genetic etiology, these cases would be ideal candidates for molecular autopsies in the future. Thus, this review emphasized the significance of acquiring the relevant information to aid in resolving cause of death of these SUDY cases and subsequently highlighted the potential for further studies on risk factors and the value of molecular autopsies.
Topics: Adolescent; Adult; Autopsy; Cause of Death; Child; Child, Preschool; Death, Sudden; Death, Sudden, Cardiac; Female; Humans; Infant; Male; Risk Factors; Young Adult
PubMed: 35133622
DOI: 10.1007/s12024-021-00444-3 -
International Journal of Environmental... Jun 2020Maternal deaths remain a major public health concern in low- and middle-income countries. Implementation of maternal and perinatal deaths surveillance and response...
Maternal deaths remain a major public health concern in low- and middle-income countries. Implementation of maternal and perinatal deaths surveillance and response (MPDSR) is vital to reduce preventable deaths. The study aimed to assess implementation of MPDSR in Rwanda. We applied mixed methods following the six-step audit cycle for MPDSR to determine the level of implementation at 10 hospitals and three health centers. Results showed various stages of implementation of MPDSR across facilities. Maternal death audits were conducted regularly, and facilities had action plans to address modifiable factors. However, perinatal death audits were not formally done. Implementation was challenged by lack of enough motivated staff, heavy workload, lack of community engagement, no linkages with existing quality improvement efforts, no guidelines for review of stillbirths, incomplete medical records, poor classification of cause of death, and no sharing of feedback among others. Implementation of MPDSR varied from facility to facility indicating varying capacity gaps. There is need to integrate perinatal death audits with maternal death audits and ensure the process is part of other quality improvement initiatives at the facility level. More efforts are needed to support health facilities to improve implementation of MPDSR and contribute to achieving sustainable development goal (SDG) 3.
Topics: Female; Humans; Maternal Death; Maternal Mortality; Perinatal Death; Population Surveillance; Pregnancy; Rwanda; Stillbirth
PubMed: 32570817
DOI: 10.3390/ijerph17124376 -
Cardiac Electrophysiology Clinics Sep 2023
Topics: Humans; Heart Diseases; Death, Sudden; Heart; Death, Sudden, Cardiac
PubMed: 37558311
DOI: 10.1016/j.ccep.2023.07.002 -
International Journal of Gynaecology... Aug 2022To analyze implementation of the maternal death surveillance and response (MDSR) strategy in Chad.
OBJECTIVE
To analyze implementation of the maternal death surveillance and response (MDSR) strategy in Chad.
METHODS
Secondary data analysis of results from a cross-sectional study involving semistructured interviews with decision-makers at central, regional, and district levels, health providers, and technical and financial partners, and a document review. Data collection took place from June-July 2017.
RESULTS
Maternal death reporting was incorporated into the Integrated Disease Surveillance and Response system but did not include neonatal deaths nor maternal and neonatal deaths in communities. Underreporting of maternal deaths owing to fear of repercussions was evident, likely associated with maternal deaths reported at monthly meetings held by the country's President with stakeholders in the health sector. Maternal death reviews were only undertaken between 2015 and 2016 in four regions of Chad and ceased in mid-August 2016. Reasons include the departure of foreign obstetricians, lack of motivation among health workers, weak accountability at all levels of the health system, organizational issues, and nonimplementation of review recommendations.
CONCLUSION
Strong action is needed by the Ministry of Health to revive implementation of the MDSR system.
Topics: Chad; Cross-Sectional Studies; Female; Humans; Infant, Newborn; Maternal Death; Maternal Mortality; Perinatal Death
PubMed: 35322874
DOI: 10.1002/ijgo.14150