Browsing by Author "Kinney, Mary"

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    Determining stillbirth data reporting systems in Africa
    (2025) Gumede, Simphiwe W; Maswime, Salome; Kinney, Mary; Pule, Mosonngwa
    Background Stillbirths are an important public health concern, with an estimated 1.9 million stillbirths occurring globally each year, more between 2020-2021 data. However, the recording, investigation, and classification of stillbirths vary across countries, leading to inconsistencies in data collection and analysis. This study aimed to assess the current data systems and practices regarding stillbirth recording, data collection, analysis, and utilization in African countries. Study design The study used a descriptive research design with a quantitative approach, involving the surveillance of national data systems and other existing systems in African countries. Method The study was undertaken in African countries by University of Cape Town in collaboration with the Africa Centres for Disease Control and UNICEF. The study involved a survey of the national data systems recording stillbirths in the African countries and other reporting systems that countries use. Results A survey of 55 African countries (34 respondents) revealed critical insights into stillbirth reporting and data management. Among responding countries, 76% defined stillbirth using a gestational age threshold of ≥28 weeks, while 48% used a birth weight criterion of ≥1000 grams. Significant policy gaps were identified: 47% lacked mandates for stillbirth classification, and only 57% integrated stillbirth targets into national health strategies. Despite 88% of countries routinely collecting stillbirth data, methods varied (paper-based vs. digital), and 54% reported no data quality assessments in the past decade. Classification systems for causes of death varied, with ICD-PM and ICD-10 each used by 35% of countries. Nurses/midwives were primarily responsible for data entry (73%), yet challenges persisted, including inadequate health worker capacity (53%) and poor infrastructure (42%). Only 42% of countries disseminated stillbirth reports publicly, often relying on aggregated tables rather than interactive formats. Regional disparities underscored systemic issues in healthcare access, data standardization, and governance, emphasizing the urgent need for policy harmonization and strengthened health information systems. Conclusion The persistent inconsistencies in the recording, investigation, and classification of stillbirths and perinatal deaths across African countries-evident in different gestational age (20-28 weeks) and birth weight thresholds (<500g to <1000g), ambiguous civil registration laws (82% of countries), and fragmented national policies (only 27% with stillbirth-specific targets) highlight an urgent need for standardised definitions and consistent legal frameworks. These gaps perpetuate unreliable data, obstructing targeted interventions and accountability mechanisms. To address this, governments must adopt WHO-aligned criteria, integrate stillbirth reduction into national health strategies, and strengthen cross-sector collaboration for robust civil registration systems. Prioritizing these steps, alongside research into context-specific barriers (e.g., stigma, resource limitations), will not only improve data accuracy but also catalyse actionable insights to reduce preventable stillbirths and advance maternal and newborn health outcomes globally.
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    The impact of foreign aid on the HIV/AIDS epidemic in sub-saharan Africa
    (2007) Kinney, Mary; Mattes, Robert; Strand, Per
    Includes abstract. Includes bibliographical references (leaves 70-79).
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    Niger's child survival success, contributing factors and challenges to sustainability: a retrospective analysis
    (Public Library of Science, 2016) Besada, Donela; Kerber, Kate; Leon, Natalie; Sanders, David; Daviaud, Emmanuelle; Rohde, Sarah; Rohde, Jon; Damme, Wim van; Kinney, Mary; Manda, Samuel; Oliphant, Nicholas P; Hachimou, Fatima; Ouedraogo, Adama; Ghali, Asma Yaroh; Doherty, Tanya
    BACKGROUND: Household surveys undertaken in Niger since 1998 have revealed steady declines in under-5 mortality which have placed the country 'on track' to reach the fourth Millennium Development goal (MDG). This paper explores Niger's mortality and health coverage data for children under-5 years of age up to 2012 to describe trends in high impact interventions and the resulting impact on childhood deaths averted. The sustainability of these trends are also considered. Methods and FINDINGS: Estimates of child mortality using the 2012 Demographic and Health Survey were developed and maternal and child health coverage indicators were calculated over four time periods. Child survival policies and programmes were documented through a review of documents and key informant interviews. The Lives Saved Tool (LiST) was used to estimate the number of child lives saved and identify which interventions had the largest impact on deaths averted. The national mortality rate in children under-5 decreased from 286 child deaths per 1000 live births (95% confidence interval 177 to 394) in the period 1989-1990 to 128 child deaths per 1000 live births in the period 2011-2012 (101 to 155), corresponding to an annual rate of decline of 3.6%, with significant declines taking place after 1998. Improvements in the coverage of maternal and child health interventions between 2006 and 2012 include one and four or more antenatal visits, maternal Fansidar and tetanus toxoid vaccination, measles and DPT3 vaccinations, early and exclusive breastfeeding, oral rehydration salts (ORS) and proportion of children sleeping under an insecticide-treated bed net (ITN). Approximately 26,000 deaths of children under-5 were averted in 2012 due to decreases in stunting rates (27%), increases in ORS (14%), the Hib vaccine (14%), and breastfeeding (11%). Increases in wasting and decreases in vitamin A supplementation negated some of those gains. Care seeking at the community level was responsible for an estimated 7,800 additional deaths averted in 2012. A major policy change occurred in 2006 enabling free health care provision for women and children, and in 2008 the establishment of a community health worker programme. CONCLUSION: Increases in access and coverage of care for mothers and children have averted a considerable number of childhood deaths. The 2006 free health care policy and health post expansion were paramount in reducing barriers to care. However the sustainability of this policy and health service provision is precarious in light of persistently high fertility rates, unpredictable GDP growth, a high dependence on donor support and increasing pressures on government funding.
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    Politics and policy outcomes on children affected by HIV/AIDS in Africa
    (IDS Bulletin, 2008) Strand, Per; Kinney, Mary; Mattes, Robert
    Global agencies working for children affected by AIDS have recently reported some progress (UNAIDS 2008). Year by year, more HIV-positive pregnant women receive medication to avoid infecting their unborn babies, increasing numbers of children in late stages of HIV infection receive antiretroviral treatment (ART), and a higher proportion of affected children enjoy some form of social protection and schooling. However, while all this is good news, countries still fail to provide basic services to the majority of orphans and vulnerable children (OVC) in the context of AIDS. Clearly, all stakeholders need to do more to protect children from the effects of AIDS. But how can this be done? A dominant discourse suggests that governance and politics can provide leverage to a more effective response.