“Investigating data availability and determinants of stillbirths in Jhabua district, Madhya Pradesh: a protocol for a mixed method study” (Preprint)
Authors: Gautam Minakshi , Gopinathan Preetha 
Published: January 2025

BACKGROUND

Despite stillbirth being the critical quality measure for care during pregnancy and childbirth, it is often overlooked especially amongst marginalized populations. Our study aims to add to the limited body of knowledge on stillbirth determinants and barriers to stillbirth data availability, in tribal populations.

OBJECTIVE

The study objectives are; 1) to determine the factors associated with stillbirth, 2) to review the stillbirth reporting system and identify existing barriers, and 3) to make recommendations to address the determinants and improve the stillbirth reporting system in the study area.

METHODS

A mixed-methods approach integrating aspects of, both, quantitative and qualitative designs is adopted for the study. The quantitative component will be a population-based, matched case-control study with case to control ratio of 1:2. A total of 450 participants i.e. 150 cases and 300 controls will be included. Cases will be the tribal women in age group 15-49 years who delivered a stillborn in last one year. Selection of cases will be based on WHO definition of late fetal deaths i.e. third trimester stillbirths at > 28 completed weeks of gestation. The controls will be the tribal women (15-49 years) who delivered a live baby irrespective of gestation period but during the similar time period. Both cases and controls will be selected randomly from all the six blocks of Jhabua district of Madhya Pradesh, India. The qualitative component will include four focused group discussions and 22 in-depth interviews with various stakeholders. The study has been approved by Research Advisory Board of IIHMR Delhi and is approved at participating study site too.

RESULTS

The data collection will take approximately three months and will start from February 2025. The study is scheduled from February 2025 to January 2026. Statistical analysis will be performed on collected data utilizing SPSS V.21.0. Univariate logistic regression will be performed for each independent variable to estimate crude odds ratio at 95% confidence interval. Sensitivity analysis will be carried out to assess the impact of missing data, if any. For qualitative data, we will use ATLAS.ti software to assign preliminary codes. Deductive approach will be utilized for development of themes. The findings of both, quantitative data and qualitative data will be integrated using a mixed-methods matrix. We plan to publish our results in a peer-reviewed journal and present our findings at academic conferences.

CONCLUSIONS

The study is expected to generate evidence on the gravity of situation in the tribal population of Jhabua district. The critical findings of the study and exploration into association between variables will inform the targeted interventions and policy recommendations to enhance stillbirth surveillance and reporting systems in marginalized communities. The results will be instrumental in addressing data gaps and fostering equitable healthcare practices in resource-limited settings.

CLINICALTRIAL

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