%0 Journal Article
%T Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study
%A Mats M£¿lqvist
%A Leif Eriksson
%A Nguyen Nga
%A Linn Fagerland
%A Dinh Hoa
%A Lars Wallin
%A Uwe Ewald
%A Lars-£¿ke Persson
%J BMC International Health and Human Rights
%D 2008
%I BioMed Central
%R 10.1186/1472-698x-8-4
%X Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam in 2005 was ascertained by systematic inventory through group interviews with key informants, questionnaires and examination of health facility records. Health care staff at 187 Community Health Centers (CHC) and 18 hospitals, in addition to 1372 Village Health Workers (VHW), were included in the study. Results were compared with the official reports of the Provincial Health Bureau.The neonatal mortality rate (NMR) was 16/1000 (284 neonatal deaths/17 519 births), as compared to the official rate of 4.2/1000. The NMR varied between 44/1000 and 10/1000 in the different districts of the province. The under-reporting was mainly attributable to a dysfunctional reporting system and the fact that families, not the health system, were made responsible to register births and deaths. This under-reporting has severe consequences at local, national and international levels. At a local level, it results in a lack of awareness of the magnitude and differentials in NMR, leading to an indifference towards the problem. At a national and international level the perceived low mortality rate is manifested in a lack of investments in perinatal health programs.This example of a faulty health information system is reportedly not unique in low and middle income countries where needs for neonatal health reforms are greatest. Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality in order to reach the fourth millennium goal.It is increasingly acknowledged that the neonatal period has been neglected in the pursuit of improved child survival [1] and that deaths in the neonatal period (the first 28 days after delivery) today constitute an increasing proportion of the overall under-5 mortality[2]. This neglect is not only a matter of withheld interventions, but also very much a question of invisibility of the problem[3]. Thousa
%U http://www.biomedcentral.com/1472-698X/8/4