scholarly journals Assessment of neonatal mortalities and stillbirths data quality in Offinso North District of Ghana

2022 ◽  
Vol 10 (01) ◽  
pp. 508-518
Author(s):  
Richmond Nsiah ◽  
Wisdom Takramah ◽  
Solomon Anum-Doku ◽  
Richard Avagu ◽  
Dominic Nyarko

Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect the quality of decision and interventions. This study sought to assess the quality of routine neonatal mortalities and stillbirth records in health facilities and propose interventions to improve the data quality gaps. Method: Descriptive cross-sectional study was employed. This study was carried out at three (3) purposively selected health facilities in Offinso North district. Stillbirths and neonatal deaths recorded in registers from 2015 to 2017, were recounted and compared with monthly aggregated data and District Health Information Management System 2 (DHIMS 2) data using a self-developed Excel Data Quality Assessment Tool (DQS).  An observational checklist was used to collect primary data on completeness and availability. Accuracy ratio (verification factor), discrepancy rate, percentage availability and completeness of stillbirths and neonatal mortality data were computed using the DQS tool. Findings: The results showed high discrepancy rate of stillbirth data recorded in registers compared with monthly aggregated reports (12.5%), and monthly aggregated reports compared with DHIMS 2 (13.5%). Neonatal mortalities data were under-reported in monthly aggregated reports, but over-reported in DHIMS 2. Overall data completeness was about 84.6%, but only 68.5% of submitted reports were supervised by facility in-charges. Delivery and admission registers availability were 100% and 83.3% respectively. Conclusion: Quality of stillbirths and neonatal mortality data in the district is generally encouraging, but are not reliable for decision-making. Routine data quality audit is needed to reduce high discrepancies in stillbirth and neonatal mortality data in the district.

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0239049
Author(s):  
Dora Dadzie ◽  
Richard Okyere Boadu ◽  
Cyril Mark Engmann ◽  
Nana Amma Yeboaa Twum-Danso

Background Cause-specific mortality data are required to set interventions to reduce neonatal mortality. However, in many developing countries, these data are either lacking or of low quality. We assessed the completeness and accuracy of cause of death (COD) data for neonates in Ghana to assess their usability for monitoring the effectiveness of health system interventions aimed at improving neonatal survival. Methods A lot quality assurance sampling survey was conducted in 20 hospitals in the public sector across four regions of Ghana. Institutional neonatal deaths (IND) occurring from 2014 through 2017 were divided into lots, defined as neonatal deaths occurring in a selected facility in a calendar year. A total of 52 eligible lots were selected: 10 from Ashanti region, and 14 each from Brong Ahafo, Eastern and Volta region. Nine lots were from 2014, 11 from 2015 and 16 each were from 2016 and 2017. The cause of death (COD) of 20 IND per lot were abstracted from admission and discharge (A&D) registers and validated against the COD recorded in death certificates, clinician’s notes or neonatal death audit reports for consistency. With the error threshold set at 5%, ≥ 17 correctly matched diagnoses in a sample of 20 deaths would make the lot accurate for COD diagnosis. Completeness of COD data was measured by calculating the proportion of IND that had death certificates completed. Results Nineteen out of 52 eligible (36.5%) lots had accurate COD diagnoses recorded in their A&D registers. The regional distribution of lots with accurate COD data is as follows: Ashanti (4, 21.2%), Brong Ahafo (7, 36.8%), Eastern (4, 21.1%) and Volta (4, 21.1%). Majority (9, 47.4%) of lots with accurate data were from 2016, followed by 2015 and 2017 with four (21.1%) lots. Two (10.5%) lots had accurate COD data in 2014. Only 22% (239/1040) of sampled IND had completed death certificates. Conclusion Death certificates were not reliably completed for IND in a sample of health facilities in Ghana from 2014 through 2017. The accuracy of cause-specific mortality data recorded in A&D registers was also below the desired target. Thus, recorded IND data in public sector health facilities in Ghana are not valid enough for decision-making or planning. Periodic data quality assessments can determine the magnitude of the data quality concerns and guide site-specific improvements in mortality data management.


2020 ◽  
Author(s):  
Livingstone Asem ◽  
Sorengmen Amos Ziema

Abstract Background: Immunization has been an important public health intervention for preventing and reducing child morbidity and mortality over the years and coverage has increased in the past decades. However, the validity of the data from immunization coverages is usually disputed. Immunization data from health facilities show poor concordance between tallied registers and monthly reports as they are reported to higher levels of the health system. The study assessed the quality of data from routine immunization of some health facilities in the Ho central municipality in the Volta region of Ghana.Methods: A descriptive cross-sectional study was used to review routine immunization data in tallied registers and reports submitted to the Municipal Health Directorate (MHD) from January to December, 2015. Simple random sampling was used to select three health facilities in Ho central municipality. The Data Quality Self-assessment tool (DQS) was the main instrument used to present and analyze data for accuracy and discrepancy level between the tallied registers and reports. A template was created in Microsoft excel which automatically presented accuracy and discrepancy levels when data was entered. Ethical approval for the study was obtained from Ghana Health Service Ethics Review Committee. Results: The result showed discrepancies between recounted tallies at the facilities and reports submitted to the MHD. Accuracy ratios of 102%, 64% and 94% for Bacillus Calmette Guerin (BCG), Pentavalent (Penta) vaccine dose 3 and Measles 2 respectively indicating underreporting for BCG and over reporting for the rest were obtained. There was 460 over reported data to the municipal level representing accuracy ratio of 80% and discrepancy level of 20%. Conclusions: Immunization data was characterized by underreporting and overreporting, hence not accurate and lacked quality. Immunization data quality should be a priority among health staff at health facilities.


Author(s):  
Kuppan Balamurugan ◽  
Rajangam Ponprabha ◽  
Veeramani Sivashankari

Background: Infant mortality is the most important indicator which reflect country growth standards and development. This study was aimed to assess the risk factors and clinical profile of post neonatal deaths, admitted in PICU, government Villupuram medical college.Methods: A retrospective analysis was done on post neonatal mortality data by pediatric department of government Villupuram medical college, Mundiyambakkam from January 2019 to December 2020, referral and LAMA patients were excluded from study. Data was analyzed using SPSS 18.0Results: Overall post neonatal mortality was 7.3%. Mortality amongst boys were 28 (41.1%) and girls were 40 (58.8%). Mortality of female babies were higher than male babies.Among the 68 post neonatal deaths, maximum number of mortalities was seen in 1-3 months (61.9%), maximum within 24 hours of hospital stay (54.4%), 37 cases (54.4%) were referred from GHPHC and private practitioners of the nearby districts, 28 babies (41.1%) had previous admissions, 22 babies had SNCU admissions and 6 babies had pediatric admissions. Three most common causes of mortality were bronchopneumonia, sepsis and acute CNS infections. Congenital malformations and heart disease along with failure to thrive are other causes of morbidity.Conclusions: Analysis reflects the disease occurrence, treatment modalities and quality of treatment available. Treatment at primary level can prevent postnatal deaths from infections. The preventive and primary health care system should be strengthened. All special newborn care units (SNCU) discharged babies should have both community and district early intervention centre (DEIC) follow up, immunization practices, explaining danger signs to the parents, improving the quality of life has got great impact on the post neonatal outcome.


2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.


2021 ◽  
Author(s):  
Adisu Tafari Shama ◽  
Hirbo Shore Roba ◽  
Admas Abera ◽  
Negga Baraki

Abstract Background: Despite the improvements in the knowledge and understanding of the role of health information in the global health system, the quality of data generated by a routine health information system is still very poor in low and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, this study was aimed to assess the quality of routine health information system data and associated factors in public health facilities of Harari region, Ethiopia.Methods: A cross-sectional study was conducted in all public health facilities in Harari region of Ethiopia. The department-level data were collected from respective department heads through document reviews, interviews, and observation check-lists. Descriptive statistics were used to data quality and multivariate logistic regression was run to identify factors influencing data quality. The level of significance was declared at P-value <0.05. Result: The study found a good quality data in 51.35% (95% CI, 44.6-58.1) of the departments in public health facilities in Harari Region. Departments found in the health centers were 2.5 times more likely to have good quality data as compared to departments found in the health posts. The presence of trained staffs able to fill reporting formats (AOR=2.474; 95%CI: 1.124-5.445) and provision of feedback (AOR=3.083; 95%CI: 1.549-6.135) were also significantly associated with data quality. Conclusion: The level of good data quality in the public health facilities was less than the expected national level. Training should be provided to increase the knowledge and skills of the health workers.


2005 ◽  
Vol 24 (S1) ◽  
pp. 153-170 ◽  
Author(s):  
Leslie L. Roos ◽  
Sumit Gupta ◽  
Ruth-Ann Soodeen ◽  
Laurel Jebamani

ABSTRACTThis review evaluates the quality of available administrative data in the Canadian provinces, emphasizing the information needed to create integrated systems. We explicitly compare approaches to quality measurement, indicating where record linkage can and cannot substitute for more expensive record re-abstraction. Forty-nine original studies evaluating Canadian administrative data (registries, hospital abstracts, physician claims, and prescription drugs) are summarized in a structured manner. Registries, hospital abstracts, and physician files appear to be generally of satisfactory quality, though much work remains to be done. Data quality did not vary systematically among provinces. Primary data collection to check place of residence and longitudinal follow-up in provincial registries is needed. Promising initial checks of pharmaceutical data should be expanded. Because record linkage studies were “conservative” in reporting reliability, the reduction of time-consuming record re-abstraction appears feasible in many cases. Finally, expanding the scope of administrative data to study health, as well as health care, seems possible for some chronic conditions. The research potential of the information-rich environments being created highlights the importance of data quality.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256515
Author(s):  
Adobea Yaa Owusu ◽  
Sandra Boatemaa Kushitor ◽  
Anthony Adofo Ofosu ◽  
Mawuli Komla Kushitor ◽  
Atsu Ayi ◽  
...  

Background The epidemiological transition, touted as occurring in Ghana, requires research that tracks the changing patterns of diseases in order to capture the trend and improve healthcare delivery. This study examines national trends in mortality rate and cause of death at health facilities in Ghana between 2014 and 2018. Methods Institutional mortality data and cause of death from 2014–2018 were sourced from the Ghana Health Service’s District Health Information Management System. The latter collates healthcare service data routinely from government and non-governmental health institutions in Ghana yearly. The institutional mortality rate was estimated using guidelines from the Ghana Health Service. Percent change in mortality was examined for 2014 and 2018. In addition, cause of death data were available for 2017 and 2018. The World Health Organisation’s 11th International Classification for Diseases (ICD-11) was used to group the cause of death. Results Institutional mortality decreased by 7% nationally over the study period. However, four out of ten regions (Greater Accra, Volta, Upper East, and Upper West) recorded increases in institutional mortality. The Upper East (17%) and Volta regions (13%) recorded the highest increase. Chronic non-communicable diseases (NCDs) were the leading cause of death in 2017 (25%) and 2018 (20%). This was followed by certain infectious and parasitic diseases (15% for both years) and respiratory infections (10% in 2017 and 13% in 2018). Among the NCDs, hypertension was the leading cause of death with 2,243 and 2,472 cases in 2017 and 2018. Other (non-ischemic) heart diseases and diabetes were the second and third leading NCDs. Septicaemia, tuberculosis and pneumonia were the predominant infectious diseases. Regional variations existed in the cause of death. NCDs showed more urban-region bias while infectious diseases presented more rural-region bias. Conclusions This study examined national trends in mortality rate and cause of death at health facilities in Ghana. Ghana recorded a decrease in institutional mortality throughout the study. NCDs and infections were the leading causes of death, giving a double-burden of diseases. There is a need to enhance efforts towards healthcare and health promotion programmes for NCDs and infectious diseases at facility and community levels as outlined in the 2020 National Health Policy of Ghana.


2020 ◽  
Author(s):  
Lauren Ann Snell

Abstract Background Over the last two decades, globally, the number of neonatal deaths declined from 5.0 million in 1990 to 2.5 million in 2018. The residual neonatal mortality rate is seen as problematic and indicative of possible poor services or failings in the provision of quality care to neonates. The aim of this study was to analyse nurses’ perception related to the quality of the neonatal continuum of care, using Donabedian model as an evaluative framework.Methods A qualitative study design was utilised. Primary data was collected via semi-structured interviews from a purposive sample of nurses (n = 21), observations and document analysis. Thematic analysis was used to analyse data.Results Two categories of criteria relating to structure and process were identified by nurses. Structure criteria included Human resources and resources; and process criteria included technical quality, interpersonal development and nurse-patient relationship.Conclusion To ensure quality care, a variety of infrastructure, an adequate supply of equipment, supplies and an adequate staff capacity that are trained and skilled healthcare professionals are required.


2020 ◽  
Author(s):  
Livingstone Asem ◽  
Sorengmen Amos Ziema

Abstract Background: Immunization has been an important public health intervention for preventing and reducing child morbidity and mortality over the years and coverage has increased in the past decades. However, the validity of the data from immunization coverages is usually disputed. Immunization data from health facilities show poor concordance between tallied registers and monthly reports as they are reported to higher levels of the health system. The study assessed the quality of data from routine immunization of some health facilities in the Ho central municipality in the Volta region of Ghana.Methods: A descriptive cross-sectional study was used to review routine immunization data in tallied registers and reports submitted to the Municipal Health Directorate (MHD) from January to December, 2015. Simple random sampling was used to select three health facilities in Ho central municipality. The World Health Organization (WHO) Data Quality Self-assessment (DQS) tool was the main instrument used to present and analyze data for accuracy and discrepancy level between the tallied registers and reports. A template was created in Microsoft excel which automatically presented accuracy and discrepancy levels when data was entered. Ethical approval for the study was obtained from Ghana Health Service Ethics Review Committee. Results: The result showed discrepancies between recounted tallies at the facilities and reports submitted to the MHD. Accuracy ratios of 102%, 64% and 94% for Bacillus Calmette Guerin (BCG), Pentavalent (Penta) vaccine dose 3 and Measles 2 respectively indicating underreporting for BCG and over reporting for the rest were obtained. There was 460 over reported data to the municipal level representing accuracy ratio of 80% and discrepancy level of 20%. Conclusions: Immunization data was characterized by underreporting and overreporting, hence not accurate and lacked quality. Immunization data quality should be a priority among health staff at health facilities.


Author(s):  
Chacha D Mangu ◽  
Susan F Rumisha ◽  
Emanuel P Lyimo ◽  
Irene R Mremi ◽  
Isolide S Massawe ◽  
...  

Abstract Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care.


Sign in / Sign up

Export Citation Format

Share Document