Browsing by Author "Seifu, Abiy (BSc. MPH)"

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    Level and Reasons for Misclassification of Very Early Neonatal Death into Stillbirth in Public Hospitals of Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-01) Gebremicheal, Hanna Feleke; Mekonnen, Wubegzier (PhD, Associate professor); Seifu, Abiy (BSc. MPH)
    Background- Report on stillbirth and early neonatal deaths are susceptible for misreporting, misclassification and omission. The distinction between the two events is that the presence of faint sign of life after delivery. The accuracy and reliability of intrapartum mortality data is very essential for preventing deaths. There is evidence gap in knowing the exact magnitude and reason behind misclassification of very early neonatal death. Objective- To assess Level of and reasons for misclassification of very early neonatal death into stillbirth from March, 2018 to March, 2019 in public hospitals of Addis Ababa, Ethiopia. Method- Cross sectional study with qualitative and quantitative method was conducted among stillbirths and health care providers. 410 still births datawere collected from selected hospitals registration. Verbal autopsy was conducted among mothers who had stillbirth through household visits. The collected data was reviewed by three coders. Disagreement on cause of death among two initials coders were resolved by third physician’s independent assessment. In depth interview was conducted among health care providers. The magnitude of misclassification was defined as percentage of stillbirth reported in HMIS registration book that was later classified as early neonatal death in verbal autopsy data. Frequency distribution and cross tabulation was done to measure the level of misclassification. Bivariate and multivariate analysis was done to see the association between misclassification status and health care provider characteristic. Qualitative data was analyzed using thematic analysis. Result: The level of misclassification of very early neonatal death into still birth was 8.54% (35/410). Denial of safe traditional practice was significantly associated with misclassification of very early neonatal deaths, [AOR =0.21; 95% CI =0.05-0.93]. We found that confusion in understanding of the exact definition of perinatal loss, fear of blame, work load and medico legal issues drive health care providers to misclassify very early neonatal death into stillbirth at health facility level. Conclusion and recommendation: This study shows significant number of very early neonatal death are misclassified into stillbirth. It also describes driving factors for misclassification such as personal, health facility and system related factor. Standard cause of death classification training, creating culture of accountability and favorable working environment are essential to prevent misclassification of very early neonatal death which occur immediately after birth.