Provider-Mother Communication and the Misclassification of Neonatal Death in Guinea-Bissau

Wan Hua Yeung , Johns Hopkins University
Alex Mickler, Johns Hopkins University
Yue Chu, The Ohio State University
Andreea Creanga, Johns Hopkins University
Stephane Helleringer, Johns Hopkins University
Ane Fisker, Statens Serum Institut
Li Liu, Johns Hopkins University

Accurate estimates of neonatal mortality rate (NMR) are essential for tracking countries’ progress toward achieving Sustainable Development Goal 3 of reducing NMR to no more than 12 per 1000 livebirths by 2030 (UN, 2018). In low-and-middle-income countries where 98.4% of neonatal deaths occur, population survey-based self-reports are the primary source of data for estimation. However, such self-reports are subject to measurement error due to misclassifications between stillbirths and early neonatal deaths (UN IGME, 2018; Liu, 2016; Liu, 2019). We implement a mixed-methods study in Guinea Bissau to explore the association of provider-mother communication on correctly classified and misclassified newborn vital statuses using direct observation, case-control, in-depth interviews, and focus group discussions. We use an inductive thematic iterative analysis approach to analyze the presence of communication, its selected dimensions, and its facilitators and barriers in the event of SB/ENND. We also use logistic regressions to investigate the association between presence of communication and misclassification, and multinomial regressions to examine how different dimensions of communication and demographic and birth factors are associated with misclassification. We anticipate that these findings will demonstrate how the presence and quality of provider-mother communications about vital status may affect the odds of misclassification, thus identifying opportunities for patient care and reporting interventions, and eventually improving the measurement of neonatal mortality in population-based surveys.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality