Neonatal mortality burden and trends in UNHCR refugee camps, 2006–2017: a retrospective analysis

Abstract Background More than 100 million people were forcibly displaced over the last decade, including millions of refugees displaced across international borders. Although refugee health and well-being has gained increasing attention from researchers in recent years, few studies have examined refugee birth outcomes or newborn health on a regional or global scale. This study uses routine health information system data to examine neonatal mortality burden and trends in refugee camps between 2006 and 2017. Methods Refugee population and mortality data were exported from the United Nations High Commissioner for Refugees (UNHCR) Health Information System (HIS) database. Tableau was used to export the data. Stata was used for data cleaning and statistical analysis. Neonatal mortality burdens and trends in refugee camps were analyzed and compared to national and subnational neonatal mortality rates captured by household surveys. Findings One hundred fifty refugee camps in 21 countries were included in this study, with an average population of 1,725,433 between 2006 and 2017. A total of 663,892 live births and 3382 neonatal deaths were captured during this period. Annual country-level refugee camp neonatal mortality rates (NMR) ranged from 12 to 56 neonatal deaths per 1000 live births. In most countries and years where national population-based surveys are available, refugee camp NMR as reported in the UNHCR HIS was lower than that of the immediate host community. Conclusion The UNHCR HIS provides insights into the neonatal mortality burden among refugees in camp settings and issues to consider in design and use of routine health information systems to monitor neonatal health in sub-national populations. Increased visibility of neonatal deaths and stillbirths among displaced populations can drive advocacy and inform decisions needed to strengthen health systems. Efforts to count every stillbirth and neonatal death are critical, as well as improvements to reporting systems and mechanisms for data review within broader efforts to improve the quality of neonatal care practices within and outside of health facilities.

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Neonatal Mortality Burden and Trends in UNHCR Refugee Camps, 2006-2017: A Retrospective Analysis

10.21203/rs.3.rs-40237/v1 ◽

2020 ◽

Author(s):

Hannah Tappis ◽

Marwa Ramadan ◽

Josep Vargas ◽

Vincent Kahi ◽

Heiko Hering ◽

...

Keyword(s):

Health Information ◽

Neonatal Mortality ◽

Refugee Camp ◽

Mortality Rates ◽

Host Community ◽

Mortality Data ◽

Refugee Camps ◽

Neonatal Deaths ◽

Live Births ◽

Mortality Burden

Abstract Objective: To examine neonatal mortality burden and trends in refugee camps between 2006 and 2017.Methods: Refugee population and mortality data were exported from the United Nations High Commissioner (UNHCR) Health Information System (HIS) database. Tableau was used to export the data. Stata was used for data cleaning and statistical analysis. Neonatal mortality burdens and trends in refugee camps were analyzed and compared to national and subnational neonatal mortality rates captured by household surveys.Findings: 150 refugee camps in 21 countries were included in this study, with an average population of 1,725,433 between 2006 and 2017. A total of 663,892 live births and 3,382 neonatal deaths were captured during this period. Annual country-level refugee camp neonatal mortality rates (NMR) ranged from 12 to 56 neonatal deaths per 1,000 live births. In most countries and years where national population-based surveys are available, refugee camp NMR as reported in the UNHCR HIS was lower than that of the immediate host community.Conclusion: The UNHCR HIS provides insights into the neonatal mortality burden among refugees in camp settings and issues to consider in design and use of routine health information systems to monitor neonatal health in sub-national populations. Increased visibility of neonatal deaths and stillbirths among displaced populations can drive advocacy and inform decisions needed to strengthen health systems. Efforts to count every stillbirth and neonatal death are critical, as well as improvements to reporting systems and mechanisms for data review within broader efforts to improve the quality of neonatal care practices within and outside of health facilities.

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United Nations High Commissioner for Refugees Feeding Program Performance in Kenya and Tanzania: A Retrospective Analysis of Routine Health Information System Data

Food and Nutrition Bulletin ◽

10.1177/156482651203300209 ◽

2012 ◽

Vol 33 (2) ◽

pp. 150-160 ◽

Cited By ~ 5

Author(s):

Hannah Tappis ◽

Shannon Doocy ◽

Christopher Haskew ◽

Caroline Wilkinson ◽

Allison Oman ◽

...

Keyword(s):

Information System ◽

United Nations ◽

Health Information ◽

Health Information System ◽

Mortality Rates ◽

Refugee Camps ◽

Selective Feeding ◽

Feeding Programs ◽

High Commissioner ◽

Program Data

Background The United Nations High Commissioner for Refugees (UNHCR) Health Information System is a primary source of routine nutrition program data and provides a comprehensive assessment of UNHCR selective feeding programs in more than 90 refugee camps in 18 countries worldwide. Objective To evaluate the coverage and effectiveness of UNHCR supplementary and therapeutic feeding programs for malnourished children under 5 years of age in Kenya and Tanzania refugee camps. Methods Analysis of Kenya and Tanzania refugee camp population, growth monitoring, and nutrition program data from the UNHCR Health Information System. Results UNHCR-supported implementing partners in Kenya and Tanzania admitted nearly 45,000 malnourished refugee children in selective feeding programs between January 2006 and May 2009. Average recovery rates of 77.1% and 84.6% in the therapeutic and supplementary programs, respectively, mortality rates of less than 1%, and average readmission below 5% suggest that feeding programs had a beneficial effect on enrolled children. Conclusions Increasing admission and enrollment in supplementary feeding programs was successful in preventing cases of severe malnutrition in some camps. Further attention to these camps would be likely to yield sizeable benefits in terms of absolute reductions in malnutrition prevalence and mortality rates.

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Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-319093 ◽

2020 ◽

pp. fetalneonatal-2020-319093

Author(s):

Godwin Oligbu ◽

Leila Ahmed ◽

Laura Ferraras-Antolin ◽

Shamez Ladhani

Keyword(s):

Mortality Rate ◽

Retrospective Analysis ◽

Neonatal Mortality ◽

Mortality Rates ◽

Neonatal Mortality Rate ◽

England And Wales ◽

Neonatal Deaths ◽

Live Births ◽

Extremely Preterm ◽

Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

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