Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study
Abstract Background Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. “Every Newborn Birth Indicators Research Tracking in Hospitals” (EN...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-020-03421-w |
| _version_ | 1818415587809820672 |
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| author | Tazeen Tahsina Aniqa Tasnim Hossain Harriet Ruysen Ahmed Ehsanur Rahman Louise T. Day Kimberly Peven Qazi Sadeq-ur Rahman Jasmin Khan Josephine Shabani Ashish KC Tapas Mazumder Sojib Bin Zaman Shafiqul Ameen Stefanie Kong Agbessi Amouzou Ornella Lincetto Shams El Arifeen Joy E. Lawn EN-BIRTH Study Group |
| author_facet | Tazeen Tahsina Aniqa Tasnim Hossain Harriet Ruysen Ahmed Ehsanur Rahman Louise T. Day Kimberly Peven Qazi Sadeq-ur Rahman Jasmin Khan Josephine Shabani Ashish KC Tapas Mazumder Sojib Bin Zaman Shafiqul Ameen Stefanie Kong Agbessi Amouzou Ornella Lincetto Shams El Arifeen Joy E. Lawn EN-BIRTH Study Group |
| author_sort | Tazeen Tahsina |
| collection | DOAJ |
| description | Abstract Background Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. “Every Newborn Birth Indicators Research Tracking in Hospitals” (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF. Methods The EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women’s exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording. Results Coverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8–21.0). Survey-reported (53.2, 95% CI 39.4–66.8) and register-recorded results (85.9, 95% CI 58.1–99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5–93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3–73.5%) and drying (7.3–29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5–3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting. Conclusions Our study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement. |
| first_indexed | 2024-12-14T11:37:22Z |
| format | Article |
| id | doaj.art-e9408de49f3e44c6ada9cd8379523302 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-14T11:37:22Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-e9408de49f3e44c6ada9cd83795233022022-12-21T23:02:58ZengBMCBMC Pregnancy and Childbirth1471-23932021-03-0121S111710.1186/s12884-020-03421-wImmediate newborn care and breastfeeding: EN-BIRTH multi-country validation studyTazeen Tahsina0Aniqa Tasnim Hossain1Harriet Ruysen2Ahmed Ehsanur Rahman3Louise T. Day4Kimberly Peven5Qazi Sadeq-ur Rahman6Jasmin Khan7Josephine Shabani8Ashish KC9Tapas Mazumder10Sojib Bin Zaman11Shafiqul Ameen12Stefanie Kong13Agbessi Amouzou14Ornella Lincetto15Shams El Arifeen16Joy E. Lawn17EN-BIRTH Study GroupMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical MedicineMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical MedicineMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical MedicineMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute (IHI)Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala UniversityMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical MedicineJohns Hopkins University, Bloomberg School of Public HealthWorld Health OrganizationMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, (icddr,b)Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical MedicineAbstract Background Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. “Every Newborn Birth Indicators Research Tracking in Hospitals” (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF. Methods The EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women’s exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording. Results Coverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8–21.0). Survey-reported (53.2, 95% CI 39.4–66.8) and register-recorded results (85.9, 95% CI 58.1–99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5–93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3–73.5%) and drying (7.3–29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5–3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting. Conclusions Our study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.https://doi.org/10.1186/s12884-020-03421-wBirthMaternalNewbornValiditySurveyHospital records |
| spellingShingle | Tazeen Tahsina Aniqa Tasnim Hossain Harriet Ruysen Ahmed Ehsanur Rahman Louise T. Day Kimberly Peven Qazi Sadeq-ur Rahman Jasmin Khan Josephine Shabani Ashish KC Tapas Mazumder Sojib Bin Zaman Shafiqul Ameen Stefanie Kong Agbessi Amouzou Ornella Lincetto Shams El Arifeen Joy E. Lawn EN-BIRTH Study Group Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study BMC Pregnancy and Childbirth Birth Maternal Newborn Validity Survey Hospital records |
| title | Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study |
| title_full | Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study |
| title_fullStr | Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study |
| title_full_unstemmed | Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study |
| title_short | Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study |
| title_sort | immediate newborn care and breastfeeding en birth multi country validation study |
| topic | Birth Maternal Newborn Validity Survey Hospital records |
| url | https://doi.org/10.1186/s12884-020-03421-w |
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