Abstract
BackgroundTo describe quantitative data quality monitoring and performance metrics adopted by the Global Network’s (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs).MethodsOngoing prospective, population-based data on all pregnancy outcomes within defined geographical locations participating in the GN have been collected since 2008. Data quality metrics were defined and are implemented at the cluster, site and the central level to ensure data quality. Quantitative performance metrics are described for data collected between 2010 and 2013.ResultsDelivery outcome rates over 95% illustrate that all sites are successful in following patients from pregnancy through delivery. Examples of specific performance metric reports illustrate how both the metrics and reporting process are used to identify cluster-level and site-level quality issues and illustrate how those metrics track over time. Other summary reports (e.g. the increasing proportion of measured birth weight compared to estimated and missing birth weight) illustrate how a site has improved quality over time.ConclusionHigh quality MPPBRs such as the MNHR provide key information on pregnancy outcomes to local and international health officials where civil registration systems are lacking. The MNHR has measures in place to monitor data collection procedures and improve the quality of data collected. Sites have increasingly achieved acceptable values of performance metrics over time, indicating improvements in data quality, but the quality control program must continue to evolve to optimize the use of the MNHR to assess the impact of community interventions in research protocols in pregnancy and perinatal health.Trial registration numberNCT01073475
Highlights
Neonatal mortality, defined as deaths in the first 28 days of life, has dropped significantly in the last two decades, from 33 deaths per 1,000 live births in 1990 to 20 deaths per 1,000 live births in 2013 [1]
In 2013 there were an estimated 289,000 maternal deaths, with sub-Saharan Africa accounting for 62% (179,000) and South Asia accounting for 24% (69,000) of those deaths [2]
The World Health Organization (WHO) estimates that less than 40% of all countries have an adequate civil registration system for collecting information on births and deaths and that less than half of births are registered in some developing countries, where vital registration systems are inaccurate and incomplete [2,3,4]
Summary
Neonatal mortality, defined as deaths in the first 28 days of life, has dropped significantly in the last two decades, from 33 deaths per 1,000 live births in 1990 to 20 deaths per 1,000 live births in 2013 [1]. Rates in sub-Saharan Africa and South Asia were still high in 2013, at 31 and 30 deaths per 1,000 live births respectively. In 2013 there were an estimated 289,000 maternal deaths, with sub-Saharan Africa accounting for 62% (179,000) and South Asia accounting for 24% (69,000) of those deaths [2]. Regions with high rates of unregistered births likely have disproportionately high neonatal mortality rates and stillbirths are not recorded in many existing systems [3]. This disparity results in unreported perinatal and neonatal mortality and potentially decreases the ability to develop effective interventions to improve newborn and child survival. To describe quantitative data quality monitoring and performance metrics adopted by the Global Network’s (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs)
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