SEARCHCOHORTpediatrics, obstetrics and gynecology

cohort·pediatrics, obstetrics and gynecology, public health, epidemiology, observational study·PMC10173481

Improving birth weight measurement and recording practices in Kenya and Tanzania: a prospective intervention study with historical controls

Population Health Metrics · 17 authors, 9 centres

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TL;DR

This historically controlled intervention study compared low birth weight (LBW) prevalence estimates from routine practices to those obtained after an intervention using digital scales and nurse training.

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The intervention involved providing digital scales, training nurses in accurate measurement and recording, and adding supervision and feedback. This prospective arm was compared to historical data from the same facilities and months from the prior year, collected via routine practices and manual scales. Results showed LBW prevalence was 12.6% in Kenya and 18.2% in Tanzania prospectively, versus 7.8% and 10.0% historically. The absolute differences were 4.8 and 8.2 percentage points, with risk ratios of 1.61 and 1.81. The intervention led to a lower mean birth weight in both countries. Limitations include the samples not being nationally representative and potential referral bias in Tanzania. The findings indicate that routine data significantly underestimate LBW prevalence and that a simple, low-cost intervention can improve data accuracy.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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AI pipeline

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ORIGINAL PAPER

PMC10173481

Improving birth weight measurement and recording practices in Kenya and Tanzania: a prospective intervention study with historical controls

Population Health Metrics

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ABSTRACT

Abstract Background Low birth weight (LBW) is a significant public health concern given its association with early-life mortality and other adverse health consequences that can impact the entire life cycle. In many countries, accurate estimates of LBW prevalence are lacking due to inaccuracies in collection and gaps in available data. Our study aimed to determine LBW prevalence among facility-born infants in selected areas of Kenya and Tanzania and to assess whether the introduction of an intervention to improve the accuracy of birth weight measurement would result in a meaningfully different estimate of LBW prevalence than current practice. Methods We carried out a historically controlled intervention study in 22 health facilities in Kenya and three health facilities in Tanzania. The intervention included: provision of high-quality digital scales, training of nursing staff on accurate birth weight measurement, recording and scale calibration practices, and quality maintenance support that consisted of enhanced supervision and feedback (prospective arm). The historically controlled data were birth weights from the same facilities recorded in maternity registers for the same calendar months from the previous year measured using routine practices and manual scales. We calculated mean birth weight (95% confidence interval CI), mean difference in LBW prevalence, and respective risk ratio (95% CI) between study arms. Results Between October 2019 and February 2020, we prospectively collected birth weights from 8441 newborns in Kenya and 4294 in Tanzania. Historical data were available from 9318 newborns in Kenya and 12,007 in Tanzania. In the prospective sample, the prevalence of LBW was 12.6% (95% confidence intervals [CI]: 10.9%–14.4%) in Kenya and 18.2% (12.2%–24.2%) in Tanzania. In the historical sample, the corresponding prevalence estimates were 7.8% (6.5%–9.2%) and 10.0% (8.6%–11.4%). Compared to the retrospective sample, the LBW prevalence in the prospective sample was 4.8% points (3.2%–6.4%) higher in Kenya and 8.2% points (2.3%–14.0%) higher in Tanzania, corresponding to a risk ratio of 1.61 (1.38–1.88) in Kenya and 1.81 (1.30–2.52) in Tanzania. Conclusion Routine birth weight records underestimate the risk of LBW among facility-born infants in Kenya and Tanzania. The quality of birth weight data can be improved by a simple intervention consisting of provision of digital scales and supportive training. Keywords: Low birth weight (LBW), Measurement, Accuracy, Digital scales, Data quality, Low- and middle-income countries (LMIC)

CITATION EXPORT

Alloys K’Oloo, Evance Godfrey, Annariina M Koivu et al.. Improving birth weight measurement and recording practices in Kenya and Tanzania: a prospective intervention study with historical controls. Population Health Metrics. (2023). https://doi.org/10.1186/s12963-023-00305-x

AUTHORS

17 · 9 CENTRES

Alloys K’Oloo, Evance Godfrey, Annariina M Koivu, Hellen C Barsosio, Karim Manji, Veneranda Ndesangia, Fredrick Omiti, Mohamed Bakari Khery, Everlyne D Ondieki, Simon Kariuki, Feiko O ter Kuile, R Matthew Chico, Nigel Klein, Otto Heimonen, Per Ashorn, Ulla Ashorn, Pieta Näsänen-Gilmore

1Kenya Medical Research Institute, Centre for Global Health Research, P.O. Box 1578-40100, Kisumu, Kenya
2Muhimbili National Hospital, Malik/Kalenga Road, P.O. Box 65000, Dar es Salaam, Tanzania
3Muhimbili University of Health and Allied Sciences, United Nations Rd, P.O. Box 65001, Dar es Salaam, Tanzania
4Faculty of Medicine and Health Technology, Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Arvo Ylpön katu 34, 33014 Tampere, Finland
5Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
6Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT UK
7UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK
8Department of Paediatrics, Tampere University Hospital, PO BOX 2000, 33521 Tampere, Finland
9Department for Public Health and Welfare, Public Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland