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Beyond counting stillbirths to understanding their determinants in low‐ and middle‐income countries: a systematic assessment of stillbirth data availability in household surveys
Author(s) -
Christou Aliki,
Dibley Michael J.,
RaynesGreenow Camille
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12828
Subject(s) - medicine , demography , population , live birth , developing country , low and middle income countries , pregnancy , public health , environmental health , geography , economic growth , biology , nursing , sociology , economics , genetics
Objective To systematically map data availability for stillbirths from all countries with Demographic and Health Surveys (DHS) surveys to outline the limitations and challenges with using the data for understanding the determinants and causes of stillbirths, and for cross‐country comparisons. Methods We assessed data sources from the DHS programme website, including published DHS reports and their associated questionnaires for surveys completed between 2005 and 2015. Results Between 2005 and 2015, the DHS programme completed 114 surveys across 70 low‐ and middle‐income countries. Ninety‐eight (86.0%) surveys from 66 countries collected stillbirth data adequately to calculate a stillbirth rate, while 16 surveys from 12 countries did not. The method used to count stillbirths varied; 96 (84.2%) surveys used a live birth history with a reproductive calendar, while 16 (14.0%) surveys from 12 countries did a full pregnancy history. Based on assessment of questionnaires, antenatal and delivery care information for stillbirths was only available in 15 surveys (13.2%) from 12 countries (17.1%). Data on maternal conditions/complications were captured in 17 surveys (16.0%), but only in six could these be linked to stillbirths. Data on other recognised risk factors were scarce, varying considerably across surveys. Upon further examination of data sets from surveys with maternity care data on non‐live births, we found incomplete capture of these data; only two surveys had adequately and completely collected these for stillbirths. Conclusion Substantial variation exists in DHS surveys in the measurement of stillbirths, with limited scope to examine risk factors or causes. Without immediate improvements, our understanding of country‐specific trends and determinants for stillbirths will remain hampered, limiting the development and prioritisation of programmatic interventions to prevent these deaths.