Mobile Phone Survey Estimates of Perinatal Mortality in Malawi: A Comparison of Data from Truncated and Full Pregnancy Histories

Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)
Julio E. Romero-Prieto, London School of Hygiene and Tropical Medicine (LSHTM)
Michael Chasukwa, Institute of Public Opinion and Research
Funny Muthema, Institute of Public Opinion and Research
Sarah Walters, .
Bruno Masquelier, Louvain University (UCL)
Jethro Banda, Malawi Epidemiology Intervention Research Unit
Emmanuel Souza, University of Malawi
Boniface Dulani, Institute of Public Opinion and Research

In many LMICs, perinatal mortality is estimated retrospectively from household surveys. Mobile Phone Surveys (MPS) offer advantages in terms of cost and ease of implementation. However, their suitability for monitoring mortality has not been established. In this contribution, we use data from the 2021-‘23 Malawi Rapid Mortality Mobile Phone Survey to estimate stillbirth and perinatal mortality and compare those to other sources. Female respondents of reproductive age were randomly allocated to either one of two versions of the survey instrument: a Full Pregnancy History (FPH, N=2,086) and a shorter Truncated Pregnancy History (TPH, N=2,117). The sample was generated through random digit dialling (RDD) with active strata monitoring. Post-stratification weighting was used to correct for sample selection bias, and estimates are reported with bootstrap confidence intervals. Weighted point estimates of the stillbirth (19.38 deaths per 1,000 pregnancies, 95%-CI: 14.03-25.42), perinatal (42.00, 95%-CI: 34.27-50.78), and extended perinatal mortality rates (49.57, 95%-CI: 41.62-59.43) from the FPH instrument are in line with the 2015-’16 Malawi DHS and UN-IGME estimates. The stillbirth rate from the TPH instrument is higher. Post-stratification weighting produces a small upwards adjustment. We conclude that MPS are suitable for collecting perinatal mortality data, and particularly so via the FPH instrument.

Keywords: Data and Methods, Mortality and Longevity, Population, Shocks and Pandemics, Randomized controlled experiments

See paper.