A Regional Approach to Standardize Neonatal Deaths Surveillance in Latin America and the Caribbean

Presentation at the Global Maternal Newborn Health Conference, October 21, 2015

Background: The gold standard for neonatal mortality data collection is a good civil registration system. Nevertheless, about 30% of babies lack birth certificates by their first birthday, with more than 1 million children unregistered in LAC. The most common data source for neonatal mortality is household surveys, which rely on birth histories without reporting neonatal outcomes. Evidence indicates this process results in under-reporting of neonatal deaths and misclassification of stillbirths. Important information for policymaking, planning, and evaluation for newborn health is lacking.   In 1990, a PAHO resolution recommended the establishment of a death surveillance system in LAC; some countries have developed various approaches since, but few have such systems in place. One priority activity of the LAC Regional Neonatal Alliance’s Action Plan is the promotion of peri-neonatal morbidity and mortality surveillance initiatives.

Methodology: Building upon maternal mortality surveillance systems well established in the region, LAC is enhancing surveillance regionally, by providing: open access to new software packages and implementation manuals in Spanish and English; south-to-south technical assistance in updating surveillance systems; and communications through collaboration with national newborn networks. The LAC Neonatal Alliance is working to enhance newborn deaths surveillance through a) standardization of definitions and their use to improve data robustness and comparability; b) improvement of user-friendly software packages adaptable to paper and computer systems; and, c) linking analysis to action for real-time quality of care improvement.

Results and Conclusions: Activities initiated and led by the LAC Neonatal Alliance include: literature review of systems in developing countries; partnership with the Regional Task Force on Maternal Mortality Reduction to understand current status of maternal and newborn surveillance in countries in the LAC region; two-day experts consultation to share success stories and discuss the way forward; and formation of a working group to address definition consensus and strengthening of national surveillance systems.