Community surveillance and response to maternal and child deaths in low- and middle-income countries: A scoping review

Basera, Tariro; Schmitz, Kathrin; Price, Jessica; Willcox, Merlin; Bosire, Edna N; Ajuwon, Ademola J.; Mbule, Marjorie; Ronan, Agnes; Burtt, Fiona; Scheepers, Esca; Igumbor, Jude

doi:10.1371/journal.pone.0248143

Cited by 20 publications

(21 citation statements)

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“…Priority setting in health requires robust and timely knowledge on the burden of diseases and mortality to enable efficient resource allocation. While many low- and middle-income countries (LMICs) have built well-functioning civil registration and vital statistics (CRVS) system with good coverage, in many countries, comprehensive systems do not exist [ 1 , 2 ]. There is a drive towards better civil registration system availability and quality globally to ensure better informed decision-making.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are fewer voices advocating for the involvement of the community in priority setting. Community members have limited roles in setting local health priorities or even being recognised as active agents who should be consulted in setting the agenda [ 2–4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Verbal autopsy (VA) is currently the only realistic alternative to medical certification of deaths in settings where the CRVS system is incomplete or absent. VA is a pragmatic tool to determine the probable cause(s) of death [ 2 , 9–11 ]. Its use has proved sensitive and efficient, providing a valuable method filling the gap in mortality data [ 10 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Burden of mortality linked to community-nominated priorities in rural South Africa

Mattila

Davies

Mabetha

et al. 2022

Global Health Action

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Background Community knowledge is a critical input for relevant health programmes and strategies. How community perceptions of risk reflect the burden of mortality is poorly understood. Objective To determine the burden of mortality reflecting community-nominated health risk factors in rural South Africa, where a complex health transition is underway. Methods Three discussion groups (total 48 participants) representing a cross-section of the community nominated health priorities through a Participatory Action Research process. A secondary analysis of Verbal Autopsy (VA) data was performed for deaths in the same community from 1993 to 2015 (n = 14,430). Using population attributable fractions (PAFs) extracted from Global Burden of Disease data for South Africa, deaths were categorised as ‘attributable at least in part’ to community-nominated risk factors if the PAF of the risk factor to the cause of death was >0. We also calculated ‘reducible mortality fractions’ (RMFs), defined as the proportions of each and all community-nominated risk factor(s) relative to all possible risk factors for deaths in the population . Results Three risk factors were nominated as the most important health concerns locally: alcohol abuse , drug abuse , and lack of safe water . Of all causes of deaths 1993–2015, over 77% (n = 11,143) were attributable at least in part to at least one community-nominated risk factor. Causes of attributable deaths, at least in part, to alcohol abuse were most common (52.6%, n = 7,591), followed by drug abuse (29.3%, n = 4,223), and lack of safe water (11.4%, n = 1,652). In terms of the RMF, alcohol use contributed the largest percentage of all possible risk factors leading to death (13.6%), then lack of safe water (7.0%), and drug abuse (1.3%) . Conclusion A substantial proportion of deaths are linked to community-nominated risk factors. Community knowledge is a critical input to understand local health risks.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Burden of mortality linked to community-nominated priorities in rural South Africa

Mattila

Davies

Mabetha

et al. 2022

Global Health Action

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“…Despite the potential of engaging CHWs in timely local data collection and response in LMICs, there have been questions about the quality and completeness of data reported by them for effectively evaluating program and health outcomes. A recent scoping review suggests that community-based vital events reporting is promising but tends to be sub-optimal in data quality and completeness [ 14 ]. Studies in Mali, Ethiopia, and Malawi, conducted by the ‘Real-Time Monitoring of Under-Five Mortality’ group, found that vital events data collected routinely by CHWs varied in quality and completeness to accurately assess mortality rates at scale.…”

Section: Introductionmentioning

confidence: 99%

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Choudhury

Tiwari²,

Wu³

et al. 2022

Popul Health Metrics

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Background Timely tracking of health outcomes is difficult in low- and middle-income countries without comprehensive vital registration systems. Community health workers (CHWs) are increasingly collecting vital events data while delivering routine care in low-resource settings. It is necessary, however, to assess whether routine programmatic data collected by CHWs are sufficiently reliable for timely monitoring and evaluation of health interventions. To study this, we assessed the consistency of vital events data recorded by CHWs using two methodologies—routine data collected while delivering an integrated maternal and child health intervention, and data from a birth history census approach at the same site in rural Nepal. Methods We linked individual records from routine programmatic data from June 2017 to May 2018 with those from census data, both collected by CHWs at the same site using a mobile platform. We categorized each vital event over a one-year period as ‘recorded by both methods,’ ‘census alone,’ or ‘programmatic alone.’ We further assessed whether vital events data recorded by both methods were classified consistently. Results From June 2017 to May 2018, we identified a total of 713 unique births collectively from the census (birth history) and programmatic maternal ‘post-delivery’ data. Three-fourths of these births (n = 526) were identified by both. There was high consistency in birth location classification among the 526 births identified by both methods. Upon including additional programmatic ‘child registry’ data, we identified 746 total births, of which 572 births were identified by both census and programmatic methods. Programmatic data (maternal ‘post-delivery’ and ‘child registry’ combined) captured more births than census data (723 vs. 595). Both methods consistently classified most infants as ‘living,’ while infant deaths and stillbirths were largely classified inconsistently or recorded by only one method. Programmatic data identified five infant deaths and five stillbirths not recorded in census data. Conclusions Our findings suggest that data collected by CHWs from routinely tracking pregnancies, births, and deaths are promising for timely program monitoring and evaluation. Despite some limitations, programmatic data may be more sensitive in detecting vital events than cross-sectional census surveys asking women to recall these events.

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“…Despite the potential of engaging CHWs in timely local data collection and response in LMICs, there have been questions about the quality and completeness of data reported by them for effectively evaluating program and health outcomes. A recent scoping review suggests that community-based vital events reporting is promising but tends to be sub-optimal in data quality and completeness (13). Studies in Mali, Ethiopia, and Malawi, conducted by the 'Real-Time Monitoring of Under-Five Mortality' group, found that vital events data collected routinely by CHWs varied in quality and completeness to assess mortality rates accurately at scale.…”

Section: Introductionmentioning

confidence: 99%

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Choudhury¹,

Tiwari²,

Wu³

et al. 2021

Preprint

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Background: Timely tracking of health outcomes is difficult in low- and middle-income countries without comprehensive vital registration systems. Community health workers (CHWs) are increasingly collecting vital events data while routinely delivering care in communities in low-resource settings. It is necessary, however, to assess whether routine programmatic data collected by CHWs are sufficiently reliable for timely monitoring and evaluation of health interventions. To study this, we assessed the consistency of vital events data recorded by CHWs using two methodologies – routine data collected while delivering an integrated maternal and child health intervention, and data from a birth history census approach at the same site in rural Nepal. Methods: We linked individual records from routine programmatic data from June 2017 to May 2018 with those from census data, both collected by CHWs at the same site using a mobile platform. We categorized each vital event over a one-year period as “recorded by both methods,” “census alone,” or “programmatic alone.” We further assessed whether vital events data recorded by both methods were classified consistently. Results: We identified a total of 713 unique births (from maternal records only) and 746 births (collectively from maternal and child records) from June 2017 to May 2018 in one or both data collection methods. About three-fourths (n=526) of total births (from maternal records only), and (n=572) of total births (collectively from maternal and child records) were identified by both methods. Among births from maternal records identified by both methods, there was high consistency in birth location classification. Programmatic data captured more births (from mothers and children combined) than census data (723 versus 595). Most infants were consistently classified as “living” in both methods, while infant deaths and stillbirths were largely classified inconsistently or recorded by only one method. Programmatic data identified five infant deaths and five stillbirths not recorded in census data. Conclusions: Our findings suggest that data collected by CHWs from routinely tracking pregnancies, births, and deaths over time are promising for timely program monitoring and evaluation despite some limitations, and may be more effective than cross-sectional census surveys asking women to recall these events.

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Community surveillance and response to maternal and child deaths in low- and middle-income countries: A scoping review

Cited by 20 publications

References 62 publications

Burden of mortality linked to community-nominated priorities in rural South Africa

Burden of mortality linked to community-nominated priorities in rural South Africa

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

Comparing two data collection methods to track vital events in maternal and child health via community health workers in rural Nepal

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