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A comparative analysis of pregnancy reporting and differentials in under-five mortality in HDSS

Hallie Eilerts-Spinelli, Johns Hopkins Bloomberg School of Public Health
Julio E. Romero-Prieto, London School of Hygiene and Tropical Medicine (LSHTM)
Kobus Herbst, Africa Health Research Institute (AHRI) and DSI-MRC South African Population Research Infrastructure (SAPRIN)
Dickman Gareta, Africa Health Research Institute (AHRI)
Sammy Khagayi, Kenya Medical Research Institute (KEMRI)/CDC Research and Public Health Collaboration
Momodou Jasseh, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine (LSHTM)
Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)

In 2019, 5.2 million children under age five died from mostly preventable causes. Accurate measurement of levels, trends, and age patterns of under-five mortality is essential to tracking and accelerating progress towards its reduction. Civil registration and vital statistics systems are the preferred sources for this information, but in the region with the highest under-five mortality in the world, sub-Saharan Africa, they are either incomplete or non-existent. Health and Demographic Surveillance Systems (HDSS) are important sources of mortality data in low-resource settings. The prospective nature of HDSS data collection is powerful for monitoring the vital status of established residents, but births followed by early deaths often escape surveillance, creating downward bias in mortality estimates. Registering pregnancies can improve follow-up on the vital events of newborns, and mortality estimates for cohorts of births with prior pregnancy registrations (pregnancy cohorts) appear to be less affected by the omission of early deaths. However, HDSS pregnancy registration is often incomplete, and it is not clear that under-five mortality estimates for pregnancy cohorts are representative of the site as a whole. We investigated these issues through a comparative analysis of pregnancy reporting and differentials in under-five mortality in three African HDSS sites.

Keywords: Mortality, Children and youth, Cross-country comparative analyses, Comparative methods

See paper.

  Presented in Session 136. Data Quality: From Pregnancy to Death