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Byass, Peter
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Coates, M. M., Kamanda, M., Kintuc, A., Arikpo, I., Chauque, A., Mengesha, M. M., . . . Bukhman, G. (2019). A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa. Global Health Action, 12(1), Article ID 1608013.
Åpne denne publikasjonen i ny fane eller vindu >>A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa
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2019 (engelsk)Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikkel-id 1608013Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Understanding socioeconomic disparities in all-cause and cause-specific mortality can help inform prevention and treatment strategies.

Objectives: To quantify cause-specific mortality rates by socioeconomic status across seven health and demographic surveillance systems (HDSS) in five countries (Ethiopia, Kenya, Malawi, Mozambique, and Nigeria) in the INDEPTH Network in sub-Saharan Africa.

Methods: We linked demographic residence data with household survey data containing living standards and education information we used to create a poverty index. Person-years lived and deaths between 2003 and 2016 (periods varied by HDSS) were stratified in each HDSS by age, sex, year, and number of deprivations on the poverty index (0-8). Causes of death were assigned to each death using the InterVA-4 model based on responses to verbal autopsy questionnaires. We estimated rate ratios between socioeconomic groups (2-4 and 5-8 deprivations on our poverty index compared to 0-2 deprivations) for specific causes of death and calculated life expectancy for the deprivation groups.

Results: Our pooled data contained almost 3.5 million person-years of observation and 25,038 deaths. All-cause mortality rates were higher among people in households with 5-8 deprivations on our poverty index compared to 0-2 deprivations, controlling for age, sex, and year (rate ratios ranged 1.42 to 2.06 across HDSS sites). The poorest group had consistently higher death rates in communicable, maternal, neonatal, and nutritional conditions (rate ratios ranged 1.34-4.05) and for non-communicable diseases in several sites (1.14-1.93). The disparities in mortality between 5-8 deprivation groups and 0-2 deprivation groups led to lower life expectancy in the higher-deprivation groups by six years in all sites and more than 10 years in five sites.

Conclusions: We show large disparities in mortality on the basis of socioeconomic status across seven HDSS in sub-Saharan Africa due to disparities in communicable disease mortality and from non-communicable diseases in some sites. Life expectancy gaps between socioeconomic groups within sites were similar to the gaps between high-income and lower-middle-income countries. Prevention and treatment efforts can benefit from understanding subpopulations facing higher mortality from specific conditions.

sted, utgiver, år, opplag, sider
Taylor & Francis Group, 2019
Emneord
Cause of death, verbal autopsy, non-communicable disease, life expectancy
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-159639 (URN)10.1080/16549716.2019.1608013 (DOI)000468041100001 ()31092155 (PubMedID)
Tilgjengelig fra: 2019-06-03 Laget: 2019-06-03 Sist oppdatert: 2019-06-03bibliografisk kontrollert
Byass, P., Hussain-Alkhateeb, L., D'Ambruoso, L., Clark, S., Davies, J., Fottrell, E., . . . Petzold, M. (2019). An integrated approach to processing WHO-2016 verbal autopsy data: the InterVA-5 model. BMC Medicine, 17, Article ID 102.
Åpne denne publikasjonen i ny fane eller vindu >>An integrated approach to processing WHO-2016 verbal autopsy data: the InterVA-5 model
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2019 (engelsk)Inngår i: BMC Medicine, ISSN 1741-7015, E-ISSN 1741-7015, Vol. 17, artikkel-id 102Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Verbal autopsy is an increasingly important methodology for assigning causes to otherwise uncertified deaths, which amount to around 50% of global mortality and cause much uncertainty for health planning. The World Health Organization sets international standards for the structure of verbal autopsy interviews and for cause categories that can reasonably be derived from verbal autopsy data. In addition, computer models are needed to efficiently process large quantities of verbal autopsy interviews to assign causes of death in a standardised manner. Here, we present the InterVA-5 model, developed to align with the WHO-2016 verbal autopsy standard. This is a harmonising model that can process input data from WHO-2016, as well as earlier WHO-2012 and Tariff-2 formats, to generate standardised cause-specific mortality profiles for diverse contexts.

The software development involved building on the earlier InterVA-4 model, and the expanded knowledge base required for InterVA-5 was informed by analyses from a training dataset drawn from the Population Health Metrics Research Collaboration verbal autopsy reference dataset, as well as expert input.

Results: The new model was evaluated against a test dataset of 6130 cases from the Population Health Metrics Research Collaboration and 4009 cases from the Afghanistan National Mortality Survey dataset. Both of these sources contained around three quarters of the input items from the WHO-2016, WHO-2012 and Tariff-2 formats. Cause-specific mortality fractions across all applicable WHO cause categories were compared between causes assigned in participating tertiary hospitals and InterVA-5 in the test dataset, with concordance correlation coefficients of 0.92 for children and 0.86 for adults.

The InterVA-5 model’s capacity to handle different input formats was evaluated in the Afghanistan dataset, with concordance correlation coefficients of 0.97 and 0.96 between the WHO-2016 and the WHO-2012 format for children and adults respectively, and 0.92 and 0.87 between the WHO-2016 and the Tariff-2 format respectively.

Conclusions: Despite the inherent difficulties of determining “truth” in assigning cause of death, these findings suggest that the InterVA-5 model performs well and succeeds in harmonising across a range of input formats. As more primary data collected under WHO-2016 become available, it is likely that InterVA-5 will undergo minor re-versioning in the light of practical experience. The model is an important resource for measuring and evaluating cause-specific mortality globally.

sted, utgiver, år, opplag, sider
BioMed Central, 2019
Emneord
Verbal autopsy, Mortality surveillance, Civil registration, InterVA, Cause of death, World Health Organization
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-160291 (URN)10.1186/s12916-019-1333-6 (DOI)000469778700001 ()31146736 (PubMedID)
Tilgjengelig fra: 2019-06-17 Laget: 2019-06-17 Sist oppdatert: 2019-06-17bibliografisk kontrollert
Baschieri, A., Gordeev, V. S., Akuze, J., Kwesiga, D., Blencowe, H., Cousens, S., . . . Lawn, J. E. (2019). "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, 9(1), 1-15, Article ID 010901.
Åpne denne publikasjonen i ny fane eller vindu >>"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
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2019 (engelsk)Inngår i: Journal of Global Health, ISSN 2047-2978, E-ISSN 2047-2986, Vol. 9, nr 1, s. 1-15, artikkel-id 010901Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

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.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158204 (URN)10.7189/jogh.09.010901 (DOI)000476640500084 ()30820319 (PubMedID)2-s2.0-85062435467 (Scopus ID)
Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-08-14bibliografisk kontrollert
Edem, I. J., Dare, A. J., Byass, P., D'Ambruoso, L., Kahn, K., Leather, A. J. M., . . . Davies, J. (2019). External injuries, trauma and avoidable deaths in Agincourt, South Africa: a retrospective observational and qualitative study. Paper presented at CNIS Bethune Round Table, 2018, Toronto, CANADA. BMJ Open, 9(6), Article ID e027576.
Åpne denne publikasjonen i ny fane eller vindu >>External injuries, trauma and avoidable deaths in Agincourt, South Africa: a retrospective observational and qualitative study
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2019 (engelsk)Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 6, artikkel-id e027576Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: Injury burden is highest in low-income and middle-income countries. To reduce avoidable deaths, it is necessary to identify health system deficiencies preventing timely, quality care. We developed criteria to use verbal autopsy (VA) data to identify avoidable deaths and associated health system deficiencies.

Setting: Agincourt, a rural Bushbuckridge municipality, Mpumalanga Province, South Africa.

Participants: Agincourt Health and Socio-Demographic Surveillance System and healthcare providers (HCPs) from local hospitals.

Methods: A literature review to explore definitions of avoidable deaths after trauma and barriers to access to care using the ‘three delays framework’ (seeking, reaching and receiving care) was performed. Based on these definitions, this study developed criteria, applicable for use with VA data, for identifying avoidable death and which of the three delays contributed to avoidable deaths. These criteria were then applied retrospectively to the VA-defined category external injury deaths (EIDs—a subset of which are trauma deaths) from 2012 to 2015. The findings were validated by external expert review. Key informant interviews (KIIs) with HCPs were performed to further explore delays to care.

Results: Using VA data, avoidable death was defined with a focus on survivability, using level of consciousness at the scene and ability to seek care as indicators. Of 260 EIDs (189 trauma deaths), there were 104 (40%) avoidable EIDs and 78 (30%) avoidable trauma deaths (41% of trauma deaths). Delay in receiving care was the largest contributor to avoidable EIDs (61%) and trauma deaths (59%), followed by delay in seeking care (24% and 23%) and in reaching care (15% and 18%). KIIs revealed context-specific factors contributing to the third delay, including difficult referral systems.

Conclusions: A substantial proportion of EIDs and trauma deaths were avoidable, mainly occurring due to facility-based delays in care. Interventions, including strengthening referral networks, may substantially reduce trauma deaths.

sted, utgiver, år, opplag, sider
BMJ Publishing Group Ltd, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-161456 (URN)10.1136/bmjopen-2018-027576 (DOI)000471197000071 ()31167869 (PubMedID)
Konferanse
CNIS Bethune Round Table, 2018, Toronto, CANADA
Tilgjengelig fra: 2019-07-09 Laget: 2019-07-09 Sist oppdatert: 2019-07-09bibliografisk kontrollert
Byass, P., Ng, N. & Wall, S. (2019). Nurturing Global Health Action through its first decade. Global Health Action, 12(1), Article ID 1569847.
Åpne denne publikasjonen i ny fane eller vindu >>Nurturing Global Health Action through its first decade
2019 (engelsk)Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikkel-id 1569847Artikkel i tidsskrift, Editorial material (Fagfellevurdert) Published
sted, utgiver, år, opplag, sider
Taylor & Francis Group, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158193 (URN)10.1080/16549716.2019.1569847 (DOI)000457989300001 ()30727852 (PubMedID)
Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-04-24bibliografisk kontrollert
Nyirenda, M. J. & Byass, P. (2019). Pregnancy, programming, and predisposition. The Lancet Global Health, 7(4), e404-e405
Åpne denne publikasjonen i ny fane eller vindu >>Pregnancy, programming, and predisposition
2019 (engelsk)Inngår i: The Lancet Global Health, E-ISSN 2214-109X, Vol. 7, nr 4, s. e404-e405Artikkel i tidsskrift, Editorial material (Annet (populærvitenskap, debatt, mm)) Published
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-158206 (URN)10.1016/S2214-109X(19)30051-8 (DOI)30799145 (PubMedID)2-s2.0-85062812117 (Scopus ID)
Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-04-18bibliografisk kontrollert
Abraha, A., Myléus, A., Byass, P., Kahsay, A. & Kinsman, J. (2019). Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia. PLoS ONE, 14(6), Article ID e0218101.
Åpne denne publikasjonen i ny fane eller vindu >>Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia
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2019 (engelsk)Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 6, artikkel-id e0218101Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Despite the significant reductions seen in under-5 child mortality in Ethiopia over the last two decades, more than 10,000 children still die each year in Tigray Region alone, of whom 75% die from preventable diseases. Using an equity lens, this study aimed to investigate the social determinants of child health in one particularly vulnerable district as a means of informing the health policy decision-making process. An exploratory qualitative study design was adopted, combining focus group discussions and qualitative interviews. Seven Focus Group Discussions with mothers of young children, and 21 qualitative interviews with health workers were conducted in Wolkayit district in May-June 2015. Data were subjected to thematic analysis. Mothers’ knowledge regarding the major causes of child mortality appeared to be good, and they also knew about and trusted the available child health interventions. However, utilization and practice of these interventions was limited by a range of issues, including cultural factors, financial shortages, limited female autonomy on financial resources, seasonal mobility, and inaccessible or unaffordable health services. Our findings pointed to the importance of a multi-sectoral strategy to improve child health equity and reduce under-5 mortality in Wolkayit. Recommendations include further decentralizing child health services to local-level Health Posts, and increasing the number of Health Facilities based on local topography and living conditions.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-160500 (URN)10.1371/journal.pone.0218101 (DOI)000471238300048 ()31194787 (PubMedID)
Forskningsfinansiär
Swedish Research Council, C0615601
Tilgjengelig fra: 2019-06-19 Laget: 2019-06-19 Sist oppdatert: 2019-07-11bibliografisk kontrollert
Hove, J., D'Ambruoso, L., Mabetha, D., van der Merwe, M., Byass, P., Kahn, K., . . . Twine, R. (2019). 'Water is life': developing community participation for clean water in rural South Africa. BMJ Global Health, 4(3), Article ID e001377.
Åpne denne publikasjonen i ny fane eller vindu >>'Water is life': developing community participation for clean water in rural South Africa
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2019 (engelsk)Inngår i: BMJ Global Health, ISSN 2059-7908, Vol. 4, nr 3, artikkel-id e001377Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background South Africa is a semiarid country where 5 million people, mainly in rural areas, lack access to water. Despite legislative and policy commitments to the right to water, cooperative governance and public participation, many authorities lack the means to engage with and respond to community needs. The objectives were to develop local knowledge on health priorities in a rural province as part of a programme developing community evidence for policy and planning. Methods We engaged 24 participants across three villages in the Agincourt Health and Socio-Demographic Surveillance System and codesigned the study. This paper reports on lack of clean, safe water, which was nominated in one village (n=8 participants) and in which women of reproductive age were nominated as a group whose voices are excluded from attention to the issue. On this basis, additional participants were recruited (n=8). We then held a series of consensus-building workshops to develop accounts of the problem and actions to address it using Photovoice to document lived realities. Thematic analysis of narrative and visual data was performed. Results Repeated and prolonged periods when piped water is unavailable were reported, as was unreliable infrastructure, inadequate service delivery, empty reservoirs and poor supply exacerbated by droughts. Interconnected social, behavioural and health impacts were documented combined with lack of understanding, cooperation and trust between communities and authorities. There was unanimity among participants for taps in houses as an overarching goal and strategies to build an evidence base for planning and advocacy were developed. Conclusion In this setting, there is willingness among community stakeholders to improve water security and there are existing community assemblies to support this. Health and Socio-Demographic Surveillance Systems provide important opportunities to routinely connect communities to resource management and service delivery. Developing learning platforms with government and non-government organisations may offer a means to enable more effective public participation in decentralised water governance.

sted, utgiver, år, opplag, sider
BMJ Publishing Group Ltd, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-161545 (URN)10.1136/bmjgh-2018-001377 (DOI)000471834400020 ()31263583 (PubMedID)
Tilgjengelig fra: 2019-07-10 Laget: 2019-07-10 Sist oppdatert: 2019-07-10bibliografisk kontrollert
Byass, P., Jackson Cole, C., Davies, J. I., Geldsetzer, P., Witham, M. D. & Wu, Y. (2018). Collaboration for impact in global health [Letter to the editor]. The Lancet Global Health, 6(8), e836-e837
Åpne denne publikasjonen i ny fane eller vindu >>Collaboration for impact in global health
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2018 (engelsk)Inngår i: The Lancet Global Health, E-ISSN 2214-109X, Vol. 6, nr 8, s. e836-e837Artikkel i tidsskrift, Letter (Fagfellevurdert) Published
sted, utgiver, år, opplag, sider
Elsevier, 2018
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-150560 (URN)10.1016/S2214-109X(18)30296-1 (DOI)000438821600014 ()30012262 (PubMedID)2-s2.0-85049729744 (Scopus ID)
Tilgjengelig fra: 2018-08-13 Laget: 2018-08-13 Sist oppdatert: 2018-08-13bibliografisk kontrollert
Davies, J. I., Macnab, A. J., Byass, P., Norris, S. A., Nyirenda, M., Singhal, A., . . . Daar, A. S. (2018). Developmental origins of health and disease in Africa: influencing early life. The Lancet Global Health, 6(3), E244-E245
Åpne denne publikasjonen i ny fane eller vindu >>Developmental origins of health and disease in Africa: influencing early life
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2018 (engelsk)Inngår i: The Lancet Global Health, E-ISSN 2214-109X, Vol. 6, nr 3, s. E244-E245Artikkel i tidsskrift, Editorial material (Annet vitenskapelig) Published
sted, utgiver, år, opplag, sider
Elsevier, 2018
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-145363 (URN)10.1016/S2214-109X(18)30036-6 (DOI)000424738900009 ()29433658 (PubMedID)
Tilgjengelig fra: 2018-03-13 Laget: 2018-03-13 Sist oppdatert: 2018-06-09bibliografisk kontrollert
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