Final Report_Verbal Autopsy_MaMoni_Habiganj_2010 2010 Evaluation of the MAMONI, Bangladesh Program Final Report of verbal Autopsy, Habiganj 2010 Report prepared by: Child Health Unit of Public Health Sciences Division ICDDR,B 1 | P a g e Final Report_Verbal Autopsy_MaMoni_Habiganj_2010 2010 Acknowledgements We would like to acknowledge the large number of individuals and organizations whose contribution help us successfully complete the verbal autopsy survey in the “MaMoni” areas of Habiganj. To begin with, we express our profound appreciation to the women and household members who took time out of their busy daily routines to respond to the survey questions. We thank them for their patience and openness. We express our deep gratitude to the members of the two local NGOs engaged in the implementation of the MaMoni project (Shimantik and FIVDB) for their support. We extend our appreciation and gratitude to the members of Save the Children USA and USAID mission in Dhaka for their great collaboration and support to implement the verbal autopsy survey. 2 | P a g e Final Report_Verbal Autopsy_MaMoni_Habiganj_2010 2010 Contents Page # List of tables ........................................................................................................................... 4 List of figures ........................................................................................................................... 5 Executive Summary ........................................................................................................................... 6 Chapter-1: Background ....................................................................................................... 9 1.1 MaMoni project in Habiganj ............................................................................. 9 1.2 Causes of neonatal deaths.................................................................................. 9 1.3 Chapter References ........................................................................................... 12 Chapter-2: Methodology of the survey................................................................................ 13 2.1 Are and population ............................................................................................ 13 2.2 Objective of verbal autopsy ............................................................................... 14 2.3 Implementation of verbal autopsy ..................................................................... 14 2.4 Sample design.................................................................................................... 14 2.5 Data collection tool ........................................................................................... 15 2.6 Training of data collectors ................................................................................. 15 2.7 Data collection ................................................................................................... 15 2.8 Data entry and Analysis .................................................................................... 16 2.9 Reference ........................................................................................................... 16 Chapter-3: Interview results & characteristic of respondents ............................................. 17 3.1 Interview result .................................................................................................. 17 3.2 Relationship of respondents to the deceased ..................................................... 18 3.3 Age and education level of the respondent ...................................................... 18 Chapter – 4: Maternal & delivery care and conditions .......................................................... 20 4.1 Tetanus Toxoid vaccination of mother .............................................................. 20 4.2 Delivery conditions ........................................................................................... 23 Chapter -5: Causes of neonatal deaths.................................................................................. 25 5.1 Causes of neonatal death in the MaMoni area ................................................. 26 5.2 Key maternal characteristics of and intervention coverage............................... 29 5.3 Age at death of neonatal deaths ......................................................................... 33 5.4 Chapter references ............................................................................................. 35 Chapter- 6 Health care seeking prior to neonatal death ..................................................... 39 6.1 Perception and care seeking .............................................................................. 39 6.2 Reasons of not seeking care .............................................................................. 45 6.3 Place of death .................................................................................................... 47 Chapter -7: Discussions ........................................................................................................ 49 Chapter -8: Annexure 51 A Hierarchy of different order to assign cause of death ....................................... 51 B Graphs ............................................................................................................... 52 C Questionnaire..................................................................................................... 54 3 | P a g e Final Report_Verbal Autopsy_MaMoni_Habiganj_2010 2010 List of Tables Page # Chapter-2: Methodology of the survey ............................................................................................ 13 Table 2.1.1 Population by upazila ...................................................................................................... 13 Table 2.2.1 Distribution of role and responsibility of verbal autopsy interview ................................ 14 Table 2.3.1 Distribution of samples of neonatal deaths & still-births by upazila .............................. 14 Chapter-3: Interview results & characteristic of respondents ...................................................... 17 Percent Distribution of sampled neonatal deaths and still-births by interview results and by Table 3.1.1 17 upazila.............................................................................................................................. Percent Distribution of neonatal deaths and still-births by relationship of the respondent to Table 3.2.1 18 the deceased by upazila ................................................................................................... Percent Distribution of neonatal deaths and still-births by age category & level of education Table 3.3.1 19 of the respondent by upazila. ........................................................................................... Chapter-4: Maternal & delivery care and conditions .................................................................... 20 Percent Distribution of neonatal deaths and still-births by TT immunization status of the Table 4.1.1 21 mother of the deceased for index pregnancy and lifetime by upazila ............................. Percent Distribution of lifetime TT immunization status of women those did not receive TT Table 4.1.2 22 during index pregnancy by upazila.................................................................................. Percent distribution of women (part) received valid doses of TT (from card and history) Table 4.1.3 22 during their lifetime by upazila ....................................................................................... Percentage of children born protected from neonatal tetanus among live-births in the last Table 4.1.4 23 pregnancies by upazila .................................................................................................... Percent Distribution of neonatal deaths and still-births by duration of pregnancy, timing of Table 4.2.1 24 rupture of membrane and by duration of labour pain during delivery by upazila ........... Chapter-5: Causes of neonatal death............................................................................................... 25 Table 5.1.1 Proportion of cases with overlap between causes of death ............................................. 28 Table 5.1.2 Percent distribution of neonatal deaths by cause and still-births by type by upazila ...... 29 Proportion of neonates died from neonatal tetanus and other causes by status of TT Table 5.2.1 29 immunization of the mother of the deceased ................................................................... Percent distribution of cause specific neonatal deaths and still-births by maternal age & Table 5.2.2 education, place of delivery, type of birth attendant, mode of delivery, size of the newborn at 30 birth, timing of neonatal death and whether multiple/single birth .................................. Percent distribution of cause of neonatal deaths and still births by maternal and delivery Table 5.2.3 32 complications ................................................................................................................... Table 5.3.1 Percent distribution of cause of neonatal deaths by age at death ................................... 34 Table 5.3.2 Percent distribution of age at death by sex and by cause of death .................................. 35 Chapter-6: Health care seeking prior to neonatal death .............................................................. 39