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National routine data for low birthweight and preterm births: Systematic data quality assessment for United Nations
Yemisrach B Okwaraji1, Ellen Bradley1, Eric O Ohuma1
1Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Insights
This study assessed global data quality for low birthweight and preterm births. Significant data gaps exist in Sub-Saharan Africa and South Asia, highlighting opportunities for improvement in newborn health monitoring.
Area of Science:
- Public Health
- Health Informatics
- Neonatal Health
Background:
- Low birthweight and preterm birth are critical indicators of newborn vulnerability.
- Accurate data on these outcomes are essential for effective public health interventions and resource allocation.
- Existing administrative data sources require systematic quality assessment to ensure reliability.
Purpose of the Study:
- To systematically evaluate the data quality of low birthweight and preterm birth information within national routine administrative data systems.
- To identify regional disparities in data availability, reporting, and consistency.
- To inform strategies for improving data quality and utilization for newborn health initiatives.
Main Methods:
- A systematic data quality assessment was conducted using the WHO Data Quality Framework.
- Data from national routine administrative systems for 195 UN member states (2000-2020) covering over 700 million live births were analyzed.
- Key metrics included data availability, reporting quality, and internal/external consistency for low birthweight and preterm birth data.
Main Results:
- National data on low birthweight were available in 64% of countries, and preterm birth data in 40%.
- Data reporting was highest in North America, Australasia, and Europe, but lowest in Sub-Saharan Africa and Southern Asia.
- Data quality and consistency were generally high in developed regions, but significant gaps and inconsistencies were found in Sub-Saharan Africa and Southern Asia.
Conclusions:
- Sub-Saharan Africa and South Asia face significant data challenges but also possess opportunities for rapid improvement in newborn data collection.
- Leveraging existing facility-based electronic health systems and incorporating accurate gestational age measurement can enhance data quality.
- Transitioning to individual-level data collection is crucial for monitoring quality of care, long-term outcomes, and progress towards Sustainable Development Goals.
Objective:
Low birthweight (<2500 g) and preterm birth (<37 weeks) are markers of newborn vulnerability. To facilitate informed decisions about investments in prevention and care, it is imperative to enhance data quality and use. Hence, the objective of this study is to systematically assess the quality of data concerning low birthweight and preterm births within routine administrative data sources.
Design:
Systematic data quality assessment by adopting the WHO Data Quality Framework.
Setting:
National routine data system from UN member states.
Population:
Livebirths.
Methods:
National routine administrative data on low birthweight and preterm births for 195 countries from 2000 to 2020 were systematically collated, totalling >700 million live births. The WHO data quality framework was adapted to undertake standardised data quality assessments.
Main Outcome Measures:
Availability, reporting quality, internal and external consistency of low birthweight and preterm data.
Results:
Most United States Member States (64%: 124/195) had national data on low birthweight and (40%: 82/195) had data on preterm birth. Routine data system reporting was highest in North America, Australasia and Europe, where more than 95% live births had data on low birthweight and over 75% had data preterm births. In contrast, data reporting was lowest in sub-Saharan Africa (13% for low birthweight, 8% for preterm births) and Southern Asia (16% for low birthweight, 5% for preterm births). Most countries collect individual-level data; but, aggregate data reporting from hospital-based systems remain common in sub-Saharan Africa and Southern Asia. While data quality was generally high in North America, Australasia and Europe, gaps remain in the availability of gestational age metadata. Consistency between low birthweight and preterm rates were poor in Southern Asia and sub-Saharan Africa regions across time. There was high external consistency between low birthweight rates obtained from routine administrative data compared with low birthweight rates obtained from survey data for countries with high data quality.
Conclusions:
Sub-Saharan Africa and South Asia countries have data gaps but also opportunities for rapid progress. Most births occure in facilities, electronic health information systems already include low birthweight, and adding accurate gestational age including with ultrasound assessment is becoming increasingly attainable. Moving toward the collection of individual level data would enable monitoring of quality of care and longer-term outcomes. This is crucial for every child and family and essential for measuring progress towards relevant sustainable development goals. The assessment will inform countries' actions for data quality improvement at national level and use of data for impact.
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