INTRODUCTION: In low-resource settings, a social autopsy tool has been proposed to measure the effect of delays in access to healthcare on deaths, complementing verbal autopsy questionnaires routinely used to determine cause of death. This study estimates the contribution of various delays in maternal healthcare to subsequent neonatal mortality using a social autopsy case-control design. METHODS: This study was conducted at the Child Health and Mortality Prevention Surveillance (CHAMPS) Sierra Leone site (Makeni City and surrounding rural areas). Cases were neonatal deaths in the catchment area, and controls were sex- and area-matched living neonates. Odds ratios for maternal barriers to care and neonatal death were estimated, and stratified models examined this association by neonatal age and medical complications. RESULTS: Of 53 neonatal deaths, 26.4% of mothers experienced at least one delay during pregnancy or delivery compared to 46.9% of mothers of stillbirths and 18.6% of control mothers. The most commonly reported delay among neonatal deaths was receiving care at the facility (18.9%). Experiencing any barrier was weakly associated (OR 1.68, CI 0.77, 3.67) and a delay in receiving care at the facility was strongly associated (OR 19.15, CI 3.90, 94.19) with neonatal death. DISCUSSION: Delays in healthcare are associated with neonatal death, particularly delays experienced at the healthcare facility. Heterogeneity exists in the prevalence of specific delays, which has implications for local public health policy. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
INTRODUCTION: In low-resource settings, a social autopsy tool has been proposed to measure the effect of delays in access to healthcare on deaths, complementing verbal autopsy questionnaires routinely used to determine cause of death. This study estimates the contribution of various delays in maternal healthcare to subsequent neonatal mortality using a social autopsy case-control design. METHODS: This study was conducted at the Child Health and Mortality Prevention Surveillance (CHAMPS) Sierra Leone site (Makeni City and surrounding rural areas). Cases were neonatal deaths in the catchment area, and controls were sex- and area-matched living neonates. Odds ratios for maternal barriers to care and neonatal death were estimated, and stratified models examined this association by neonatal age and medical complications. RESULTS: Of 53 neonatal deaths, 26.4% of mothers experienced at least one delay during pregnancy or delivery compared to 46.9% of mothers of stillbirths and 18.6% of control mothers. The most commonly reported delay among neonatal deaths was receiving care at the facility (18.9%). Experiencing any barrier was weakly associated (OR 1.68, CI 0.77, 3.67) and a delay in receiving care at the facility was strongly associated (OR 19.15, CI 3.90, 94.19) with neonatal death. DISCUSSION: Delays in healthcare are associated with neonatal death, particularly delays experienced at the healthcare facility. Heterogeneity exists in the prevalence of specific delays, which has implications for local public health policy. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Authors: Bareng As Nonyane; Narjis Kazmi; Alain K Koffi; Nazma Begum; Salahuddin Ahmed; Abdullah H Baqui; Henry D Kalter Journal: J Glob Health Date: 2016-06 Impact factor: 4.413
Authors: Jordana Leitao; Daniel Chandramohan; Peter Byass; Robert Jakob; Kanitta Bundhamcharoen; Chanpen Choprapawon; Don de Savigny; Edward Fottrell; Elizabeth França; Frederik Frøen; Gihan Gewaifel; Abraham Hodgson; Sennen Hounton; Kathleen Kahn; Anand Krishnan; Vishwajeet Kumar; Honorati Masanja; Erin Nichols; Francis Notzon; Mohammad Hafiz Rasooly; Osman Sankoh; Paul Spiegel; Carla AbouZahr; Marc Amexo; Derege Kebede; William Soumbey Alley; Fatima Marinho; Mohamed Ali; Enrique Loyola; Jyotsna Chikersal; Jun Gao; Giuseppe Annunziata; Rajiv Bahl; Kidist Bartolomeus; Ties Boerma; Bedirhan Ustun; Doris Chou; Lulu Muhe; Matthews Mathai Journal: Glob Health Action Date: 2013-09-13 Impact factor: 2.640
Authors: Henry D Kalter; Asma Gali Yaroh; Abdou Maina; Alain K Koffi; Khaled Bensaïd; Agbessi Amouzou; Robert E Black Journal: J Glob Health Date: 2016-06 Impact factor: 4.413
Authors: Alain K Koffi; Henry D Kalter; Ezenwa N Loveth; John Quinley; Joseph Monehin; Robert E Black Journal: PLoS One Date: 2017-05-31 Impact factor: 3.240