Summary of current data availability

There were 41 countries with national CRVS data classified as ‘higher quality’ across all three outcomes (Table 6-1). An additional four countries had higher quality national CRVS data for stillbirth and low birthweight, and a further 27 countries had such data for low birthweight along. Whilst acknowledging that these data are not perfect, with some limitations that will be discussed later in this chapter, they provide a good starting point for further data improvements to increase data comparability. In contrast there are 47 countries with no national data meeting inclusion criteria for any of the outcomes.

Table 6-1 Data availability for stillbirth, preterm birth and low birthweight estimates

Data type Stillbirth Data Preterm Birth Low birthweight

National CRVS: higher quality 45 countries (23%) 41 countries (22%) 72 countries (37%) National CRVS: lower quality 65 countries (33%) 9 countries (5%) 15 countries (8%) Nationally representative survey 57 countries (29%) 8 countries (4%) 61 countries (31%)

No national data 51 countries

(26%)

126 countries (68%)

47 countries (24%)

Subnational data only 13 countries (7%)

41 countries (22%)

Not applicablea

For low birthweight and stillbirth estimates data were collated for 195 countries. For preterm birth outcome data were collated for 184 countries; 11 countries small nations with fewer than 1,000 births in 2010 were excluded. a_{Subnational data were not considered as part of the estimation process for low birthweight}

Figure 6-1, Figure 6-2 and Figure 6-3 show the geographical distribution of national data availability. These figures need to be interpreted in light of the different inclusion criteria used for administrative type national routine data (CRVS, HMIS, national birth registry or other routine administrative data source) between the estimates. The LBW estimates have the most stringent criteria, by including only those data sources capturing data on >80% of all estimated live births in the country in any given year. However, similar patterns are seen across the three outcomes, with widespread availability of administrative data across Europe, the Americas and Australia and New Zealand, and large data gaps in sub-Saharan African, and North African and Eastern Mediterranean regions. In many countries in sub-Saharan Africa and South Asia these data gaps for stillbirth and LBW are filled by household survey data. Eastern Mediterranean region countries have fewer surveys and frequently weaker administrative data sources, coupled with recent and ongoing conflict and weaker accountability structures, contributing to data gaps in the region. Data gaps are largest for data on preterm birth, as these data are not reliably collected within standard household surveys such as DHS.

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Figure 6-1 Empirically-measured data available as input to stillbirth estimates

Administrative data refer to CRVS (higher and lower quality) and HMIS combined

Figure 6-2 Empirically-measured data available as input to preterm birth estimates

Administrative data refer to CRVS (higher and lower quality) and HMIS combined

Figure 6-3 Empirically-measured data available as input to low birthweight estimates

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Sub-national data are very useful for planning purposes for an individual country, especially in large and heterogeneous countries such as India, Brazil and China. Moreover, subnational data from one region in a country may provide useful information to inform estimates for another country with similar demographic, health and economic profiles. However, as discussed before, ideally, high quality national or nationally representative data would be used to generate estimated national rates for a given country. Overall fewer than a quarter of all countries globally have higher quality administrative data for all three outcomes. In the highest-burden settings, much of the national data available comes from household surveys where the quality of the data captured is variable.

Some improvement in coverage of national data in high mortality burden regions has been seen in recent years. In the case of stillbirths, a larger proportion of countries in the high burden regions of South Asia, East Asia, sub-Saharan Africa and South-East Asia have at least one national data point, from survey or administrative sources, around the year 2010 compared to 2000 (Figure 6-4). Some predominantly middle-income regions show a slight decrease in coverage over time, this is in part due to a reduction in nationally representative surveys over this time period, and whilst administrative data systems are improving in some countries in these regions, they are not yet nationally representative.

Figure 6-4 National data availability for stillbirth rate data 2000 and 2010 by MDG region

Light green bars show % of countries in region with at least one national data point around the year 2000. Dark green bars show for the year 2010.

Changes in stillbirth rate data availability over time are shown in Figure 2 in Chapter 3. Outside of HIC regions, much of the increase in data availability is due to an increase in routine administrative national data from the predominantly middle income regions of Latin America, North Africa and West Asia and Caucasus and Central Asia. Much of the increase is due to increased availability of HMIS data, with some increase in CRVS data. Notable increases are also

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observed in South-eastern Asia, predominantly due to an increase in data availability from studies and sub-Saharan Africa where both the contribution of study data and HMIS data have been important. Similar patterns are seen for preterm and low birthweight data.

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