Factors Influencing Measurement of Pregnancy and Adverse Pregnancy Outcomes in Population-Based Surveys in Africa and Asia

Doris Kwesiga, Makerere University School of Public Health
Yeetey A. Enuameh, Kintampo Health Research Centre (KHRC)
Ali Imam, IcddrB, Matlab, Bangladesh
Adane Kebede, Dabat HDSS, Ethiopia
Tryphena Nareeba, Iganga-Mayuge Health Demographic Surveillance Site
Charlotte Tawiah, Kintampo Health Research Centre (KHRC)
Joy Lawn, London School of Hygiene & Tropical Medicine
Hannah Blencowe, London School of Hygiene & Tropical Medicine
B. Ane Fisker, Bandim Health Project

Introduction Neonatal deaths and stillbirths remain high, especially in sub-Saharan Africa and Asia, with under reporting and inaccurate data. This information, used for planning, could lead to under investment. We explored factors influencing reporting of pregnancy and Adverse Pregnancy Outcomes (APOs) in Africa and Asia. Methods Twenty eight focus group discussions across five countries with women and survey interviewers, combined with thematic analysis with QSR NViVo 12 and an a priori codebook were used. Results Socio-cultural beliefs and interview processes impacted reporting. Women did not report pregnancy because bad people could harm the baby. People did not understand why interviewers wanted to know about dead children, APOs resurrected sad memories, and interviewers required skills to encourage women to talk. Conclusion Clear explanation of the survey purpose is needed, so respondents can understand importance of reporting. Interviewers require good skills in probing, building rapport, empathy and a deep understanding of cultures.