Sunita Kishor’s research while affiliated with Loyola University Maryland and other places

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Publications (18)


Figure 1: Five Health and Demographic Surveillance System sites with summary statistics from the Every Newborn-INDEPTH study FBH+=full birth history module with additional questions on pregnancy losses. FPH=full pregnancy history module. NMR=neonatal mortality rate. SBR=stillbirth rate.
Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study
  • Article
  • Full-text available

April 2020

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229 Reads

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39 Citations

The Lancet Global Health

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Background: An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires: a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths. Methods: Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by stillbirth rate [SBR] and neonatal mortality rate [NMR]) and mean time taken to complete the maternity history section of the questionnaire. We also assessed between-site heterogeneity. This study is registered with the Research Registry, 4720. Findings: 69 176 women were allocated to be interviewed by either FBH+ (n=34 805) or FPH (n=34 371). The mean time taken to complete FPH (10·5 min) was longer than for FBH+ (9·1 min; p<0·0001). Using FPH, the estimated SBR was 17·4 per 1000 total births, 21% (95% CI -10 to 62) higher than with FBH+ (15·2 per 1000 total births; p=0·20) in the 5 years preceding the survey interview. There was strong evidence of between-site heterogeneity (I2=80·9%; p<0·0001), with SBR higher for FPH than for FBH+ in four of five sites. The estimated NMR did not differ between modules (FPH 25·1 per 1000 livebirths vs FBH+ 25·4 per 1000 livebirths), with no evidence of between-site heterogeneity (I2=0·7%; p=0·40). Interpretation: FPH takes an average of 1·4 min longer to complete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality. Funding: Children's Investment Fund Foundation.

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“Every Newborn-INDEPTH” (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites

February 2019

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287 Reads

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38 Citations

Journal of Global Health

Background: Under-five and maternal mortality were halved in the Millennium Development Goals (MDG) era, with slower reductions for 2.6 million neonatal deaths and 2.6 million stillbirths. The Every Newborn Action Plan aims to accelerate progress towards national targets, and includes an ambitious Measurement Improvement Roadmap. Population-based household surveys, notably Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys, are major sources of population-level data on child mortality in countries with weaker civil registration and vital statistics systems, where over two-thirds of global child deaths occur. To estimate neonatal/child mortality and pregnancy outcomes (stillbirths, miscarriages, birthweight, gestational age) the most common direct methods are: (1) the standard DHS-7 with Full Birth History with additional questions on pregnancy losses in the past 5 years (FBH+) or (2) a Full Pregnancy History (FPH). No direct comparison of these two methods has been undertaken, although descriptive analyses suggest that the FBH+ may underestimate mortality rates particularly for stillbirths. Methods: This is the protocol paper for the Every Newborn-INDEPTH study (INDEPTH Network, International Network for the Demographic Evaluation of Populations and their Health Every Newborn, Every Newborn Action Plan), aiming to undertake a randomised comparison of FBH+ and FPH to measure pregnancy outcomes in a household survey in five selected INDEPTH Network sites in Africa and South Asia (Bandim in urban and rural Guinea-Bissau; Dabat in Ethiopia; IgangaMayuge in Uganda; Kintampo in Ghana; Matlab in Bangladesh). The survey will reach >68 000 pregnancies to assess if there is ≥15% difference in stillbirth rates. Additional questions will capture birthweight, gestational age, birth/death certification, termination of pregnancy and fertility intentions. The World Bank's Survey Solutions platform will be tailored for data collection, including recording paradata to evaluate timing. A mixed methods assessment of barriers and enablers to reporting of pregnancy and adverse pregnancy outcomes will be undertaken. Conclusions: This large-scale study is the first randomised comparison of these two methods to capture pregnancy outcomes. Results are expected to inform the evidence base for survey methodology, especially in DHS, regarding capture of stillbirths and other outcomes, notably neonatal deaths, abortions (spontaneous and induced), birthweight and gestational age. In addition, this study will inform strategies to improve health and demographic surveillance capture of neonatal/child mortality and pregnancy outcomes.




NATIONAL FAMILY HEALTH SURVEY (NFHS-3) INDIA 2005-06, Goa

January 2009

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471 Reads

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33 Citations






Citations (16)


... The Matlab HDSS has been treated as the gold standard of vital registration, and global health researchers have undertaken studies to test survey data collection tools that collect data on births, deaths, pregnancy wastage, perinatal mortality and others. [12][13][14] Currently, a number of studies on the validation of adult deaths completeness in surveys using recent household death module and sibling survival history, and accuracy of age and time of death are being undertaken in Matlab HDSS areas. 15 16 Adult mortality findings based on Matlab HDSS data have been widely disseminated. ...

Reference:

Adult mortality trends in Matlab, Bangladesh: an analysis of cause-specific risks
Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study

The Lancet Global Health

... 29 Acknowledging the cultural influences and the potential misunderstanding of classification, underreporting of neonatal deaths is not unexpected, yet efforts to improve methods and enhance the capacity of health workers to reliable ascertainment of these crucial events is vital from a health system perspective. 30 A further challenge seen in this assessment is the accuracy with which aggregated HMIS data reflect communitybased events registered in FFs. Although in principle the HMIS monthly reports should reflect both facility and community numbers, it appears that child health services are substantially under-reported in the HMIS, and live births receiving first-dose PVV fairly consistently exceed the number of births. ...

“Every Newborn-INDEPTH” (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites

Journal of Global Health

... They take the value of 3 if the subject is bothered by the expression for more than 1 week and take the value of 4 if the subject is bothered by the expression almost every day. All the information regarding the mental health indicators is self-reported by the individuals.Socio-demographic factors in this study that could affect the likelihood of tobacco consumption are based on previous studies that construct the smoking model with socio-demographic factors.2,9,31,32 These studies examined tobacco consumption with variables as age, marital status, education, employment status which are similar to the socio-demographic factors of this study. ...

Tobacco Use by Men and Women in 49 Countries with Demographic and Health Surveys
  • Citing Technical Report
  • July 2013

... According the National Family health Survey (NFHS) 2015-16, 79% of childbirths toot place in a health facility, while the rest were conducted in homes by untrained birth attendants. [2] Thus, seeing the figures it implies that the number of unsupervised obstetric deliveries in India is still huge resulting in obstetric complications and resulting in perinatal asphyxia. Also, there is an increasing survival rate of very low birth weight babies and premature babies with improvement in neonatal care services in India. ...

National Family Health Survey (NFHS-4), 2015-16: India

... PRI constitutes the bedrock for the implementation of most of rural development programmes. [19] It has been described by an author as just a formal institution with no role in various tasks. Most of the respondents are not satisfied with the functioning of AWCs and the work of the panchayat since they have failed to provide them even the basic amenities like roads, electricity and employment through MNREGA. ...

NATIONAL FAMILY HEALTH SURVEY (NFHS-3) KERALA

... As a result, the tribal people drink a lot to harmful level, which is the root of much deadly disease. According to the National Family Health Survey (NFHS3) 21 , 72% of the tribal male population uses tobacco, compared to 56% of the male population aged 15-54. On the other hand, when it comes to consumption of alcohol, this proportion was found to be 30% higher than that of the nontribal male population. ...

NATIONAL FAMILY HEALTH SURVEY (NFHS-3) 2005–06 INDIA REPORT

... Further, the demographic transition of U.P. has been slow. Among all the major Indian states, Uttar Pradesh has the highest birth rate and the highest fertility rate (Arnold et al., 2009). The problems of education system are exacting. ...

NATIONAL FAMILY HEALTH SURVEY (NFHS-3) INDIA 2005-06, Goa

... The intersection of economics and gender within patrilocal residence also provides the grounds for the paradoxical observation that while men were expected to be providers, women's responsibility for producing children was not expected to impose any extra economic burden on their husbands. The influence of in-laws in upholding these expectations is not surprising given that while the study participants shared the same household with their-in-laws, they occupied a subordinate position [30], which undermined their ability to act on their choices and decisions [31,32]. ...

Fertility, Dimensions of Patriarchy, and Development in India
  • Citing Article
  • June 1995

Population and Development Review

... Conversely, other caste-categorized women display minimal changes from 24.4% to 24.6%. These variations likely stem from differences in socioeconomic status, access to healthcare services, and cultural attitudes toward family planning within different social groups (Raj & Raj, 2004;Kishor & Gupta, 2004). Additionally, lack of information, cultural beliefs, and traditional practices regarding family planning within different caste and tribal communities may influence contraceptive decisionmaking (Singh et al., 2021). ...

Women's Empowerment in India and Its States: Evidence from the NFHS
  • Citing Article
  • January 2004

Economic and Political Weekly

... Nonetheless, research in sub-Saharan countries showed that disadvantaged communities and poor households could be protective or risk causes of violence against wives despite the use of similar indicators of economic status or household income levels [33]. Also, studies in three Asian societies found a significant correlation between spousal violence and this factor [34]. Nevertheless, the direction and magnitude of the relationship was different across those societies. ...

WOMEN AT THE NEXUS OF POVERTY AND VIOLENCE: HOW UNIQUE IS THEIR DISADVANTAGE?
  • Citing Article