{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:31:34Z","timestamp":1793255494093,"version":"4.5.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"S1","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Annually, 14 million newborns require stimulation to initiate breathing at birth and 6 million require bag-mask-ventilation (BMV). Many countries have invested in facility-based neonatal resuscitation equipment and training. However, there is no consistent tracking for neonatal resuscitation coverage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The EN-BIRTH study, in five hospitals in Bangladesh, Nepal, and Tanzania (2017\u20132018), collected time-stamped data for care around birth, including neonatal resuscitation. Researchers surveyed women and extracted data from routine labour ward registers. To assess accuracy, we compared gold standard observed coverage to survey-reported and register-recorded coverage, using absolute difference, validity ratios, and individual-level validation metrics (sensitivity, specificity, percent agreement). We analysed two resuscitation numerators (stimulation, BMV) and three denominators (live births and fresh stillbirths, non-crying, non-breathing). We also examined timeliness of BMV. Qualitative data were collected from health workers and data collectors regarding barriers and enablers to routine recording of resuscitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 22,752 observed births, 5330 (23.4%) babies did not cry and 3860 (17.0%) did not breathe in the first minute after birth. 16.2% (<jats:italic>n<\/jats:italic>\u00a0=\u20093688) of babies were stimulated and 4.4% (<jats:italic>n<\/jats:italic>\u00a0=\u2009998) received BMV. Survey-report underestimated coverage of stimulation and BMV. Four of five labour ward registers captured resuscitation numerators. Stimulation had variable accuracy (sensitivity 7.5\u201340.8%, specificity 66.8\u201399.5%), BMV accuracy was higher (sensitivity 12.4\u201348.4%, specificity &gt;\u200993%), with small absolute differences between observed and recorded BMV. Accuracy did not vary by denominator option. &lt;\u20091% of BMV was initiated within 1 min of birth. Enablers to register recording included training and data use while barriers included register design, documentation burden, and time pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Population-based surveys are unlikely to be useful for measuring resuscitation coverage given low validity of exit-survey report. Routine labour ward registers have potential to accurately capture BMV as the numerator. Measuring the true denominator for clinical need is complex; newborns may require BMV if breathing ineffectively or experiencing apnoea after initial drying\/stimulation or subsequently at any time. Further denominator research is required to evaluate non-crying as a potential alternative in the context of respectful care. Measuring quality gaps, notably timely provision of resuscitation, is crucial for programme improvement and impact, but unlikely to be feasible in routine systems, requiring audits and special studies.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12884-020-03422-9","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:06:05Z","timestamp":1616717165000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Neonatal resuscitation: EN-BIRTH multi-country validation study"],"prefix":"10.1186","volume":"21","author":[{"name":"and EN-BIRTH Study Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-4486","authenticated-orcid":false,"given":"Ashish","family":"KC","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-4084","authenticated-orcid":false,"given":"Kimberly","family":"Peven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shafiqul","family":"Ameen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Msemo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omkar","family":"Basnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Ruysen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sojib Bin","family":"Zaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Mkony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash K.","family":"Sunny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qazi Sadeq-ur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Shabani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Chandra","family":"Bastola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Assenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh P.","family":"KC","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shams","family":"El Arifeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Kija","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honey","family":"Malla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nalini","family":"Singhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Niermeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Lincetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise T.","family":"Day","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy E.","family":"Lawn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,26]]},"reference":[{"key":"3422_CR1","doi-asserted-by":"publisher","first-page":"S12","DOI":"10.1186\/1471-2458-11-S3-S12","volume":"11","author":"AC Lee","year":"2011","unstructured":"Lee AC, Cousens S, Wall SN, Niermeyer S, Darmstadt GL, Carlo WA, et al. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect. BMC Public Health. 2011;11:S12.","journal-title":"BMC Public Health"},{"issue":"Suppl 1","key":"3422_CR2","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/pr.2013.206","volume":"74","author":"ACC Lee","year":"2013","unstructured":"Lee ACC, Kozuki N, Blencowe H, Vos T, Bahalim A, Darmstadt GL, et al. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. Pediatr Res. 2013;74(Suppl 1):50\u201372.","journal-title":"Pediatr Res"},{"key":"3422_CR3","doi-asserted-by":"publisher","first-page":"3027","DOI":"10.1016\/S0140-6736(16)31593-8","volume":"388","author":"L Liu","year":"2016","unstructured":"Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016;388:3027\u201335.","journal-title":"Lancet."},{"key":"3422_CR4","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/S0140-6736(15)00837-5","volume":"387","author":"JE Lawn","year":"2016","unstructured":"Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387:587\u2013603.","journal-title":"Lancet"},{"key":"3422_CR5","unstructured":"United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). A Neglected Tragedy: The global burden of stillbirths. New York: United Nations Children\u2019s Fund; 2020. https:\/\/data.unicef.org\/resources\/a-neglectedtragedy-stillbirth-estimates-report\/. Accessed 12 Oct 2020."},{"key":"3422_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2019-001936","volume":"4","author":"R Gurung","year":"2019","unstructured":"Gurung R, Litorp H, Berkelhamer S, Zhou H, Tinkari BS, Paudel P, et al. The burden of misclassification of antepartum stillbirth in Nepal. BMJ Glob Health. 2019;4:e001936.","journal-title":"BMJ Glob Health"},{"key":"3422_CR7","first-page":"13746","volume":"aogs","author":"A KC","year":"2019","unstructured":"KC A, Berkelhamer S, Gurung R, Hong Z, Wang H, Sunny AK, et al. The burden of and factors associated with misclassification of intrapartum stillbirth: Evidence from a large scale multicentric observational study. Acta Obstet Gynecol Scand. 2019;aogs:13746.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"3422_CR8","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0140-6736(14)60792-3","volume":"384","author":"ZA Bhutta","year":"2014","unstructured":"Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384:347\u201370.","journal-title":"Lancet"},{"key":"3422_CR9","unstructured":"World Health Organization. Every newborn: an action plan to end preventable deaths. Geneva: World Health Organization; 2014. https:\/\/www.who.int\/maternal_child_adolescent\/documents\/every-newborn-action-plan\/en\/. Accessed 16 Jan 2020."},{"key":"3422_CR10","doi-asserted-by":"crossref","unstructured":"UNICEF. The State of the World\u2019s Children. Children, food and nutrition: growing well in a changing world. New York: UNICEF; 2019. https:\/\/www.unicef.org\/reports\/state-of-worlds-children-2019. Accessed 14 Jan 2020.","DOI":"10.18356\/22661d90-en"},{"key":"3422_CR11","doi-asserted-by":"crossref","unstructured":"Budhathoki SS, Gurung R, Ewald U, Thapa J, KC A. Does the Helping Babies Breathe Programme impact on neonatal resuscitation care practices? Results from systematic review and meta-analysis. Acta Paediatr. 2019;108:806\u201313.","DOI":"10.1111\/apa.14706"},{"key":"3422_CR12","doi-asserted-by":"crossref","unstructured":"Niermeyer S. Global gains after Helping Babies Breathe. Acta Paediatr. 2017;106:1550\u20131.","DOI":"10.1111\/apa.13999"},{"key":"3422_CR13","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s13012-019-0917-z","volume":"14","author":"R Gurung","year":"2019","unstructured":"Gurung R, Jha AK, Pyakurel S, Gurung A, Litorp H, Wrammert J, et al. Scaling up safer birth bundle through quality improvement in Nepal (SUSTAIN)\u2014a stepped wedge cluster randomized controlled trial in public hospitals. Implement Sci. 2019;14:65.","journal-title":"Implement Sci"},{"key":"3422_CR14","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1186\/1471-2393-15-S2-S4","volume":"15","author":"C Enweronu-Laryea","year":"2015","unstructured":"Enweronu-Laryea C, Dickson KE, Moxon SG, Simen-Kapeu A, Nyange C, Niermeyer S, et al. Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions. BMC Pregnancy Childbirth. 2015;15:S4.","journal-title":"BMC Pregnancy Childbirth."},{"issue":"Suppl 2","key":"3422_CR15","doi-asserted-by":"publisher","first-page":"S120","DOI":"10.1542\/peds.2015-3373D","volume":"136","author":"JM Perlman","year":"2015","unstructured":"Perlman JM, Wyllie J, Kattwinkel J, Wyckoff MH, Aziz K, Guinsburg R, et al. Part 7: neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations (reprint). Pediatrics. 2015;136(Suppl 2):S120\u201366.","journal-title":"Pediatrics."},{"key":"3422_CR16","unstructured":"World Health Organization. Guidelines on basic newborn resuscitation. Geneva: WHO; 2012. https:\/\/www.who.int\/maternal_child_adolescent\/documents\/basic_newborn_resuscitation\/en\/. Accessed 16 Jun 2020."},{"key":"3422_CR17","doi-asserted-by":"crossref","unstructured":"Kamath-Rayne BD, Thukral A, Visick MK, Schoen E, Amick E, Deorari A, et al. Helping Babies Breathe, second edition: A model for strengthening educational programs to increase global newborn survival. Glob Health Sci Pract. 2018;6:538\u201351.","DOI":"10.9745\/GHSP-D-18-00147"},{"key":"3422_CR18","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1186\/s12913-020-5028-7","volume":"20","author":"LT Day","year":"2020","unstructured":"Day LT, Gore-Langton GR, Rahman AE, Basnet O, Shabani J, Tahsina T, et al. Labour and delivery ward register data availability, quality, and utility - every newborn - birth indicators research tracking in hospitals (EN-BIRTH) study baseline analysis in three countries. BMC Health Serv Res. 2020;20:737.","journal-title":"BMC Health Serv Res"},{"key":"3422_CR19","first-page":"597","volume":"83","author":"LB Nolen","year":"2005","unstructured":"Nolen LB, Braveman P, Dachs JNW, Delgado I, Gakidou E, Moser K, et al. Strengthening health information systems to address health equity challenges. Bull World Health Organ. 2005;83:597\u2013603.","journal-title":"Bull World Health Organ"},{"key":"3422_CR20","volume-title":"Health Management Information Systems Review - Survey on Data Availability in Electronic Systems for Maternal and Newborn Health Indicators in 24 USAID Priority Countries","author":"Maternal and Child Survival Program","year":"2016","unstructured":"Maternal and Child Survival Program. Health Management Information Systems Review - Survey on Data Availability in Electronic Systems for Maternal and Newborn Health Indicators in 24 USAID Priority Countries. 2016. https:\/\/www.mcsprogram.org\/wp-content\/uploads\/2016\/09\/Health-Management-Information-Systems-Review.pdf. Accessed 16 Jun 2020."},{"key":"3422_CR21","volume-title":"Barriers to use of health data in low- and middle- income countries. A review of the literature","author":"MEASURE Evaluation","year":"2018","unstructured":"MEASURE Evaluation. Barriers to use of health data in low- and middle- income countries. A review of the literature. North Carolina: Carolina Population Center, University of North Carolina at Chapel Hill; 2018."},{"key":"3422_CR22","doi-asserted-by":"publisher","first-page":"010902","DOI":"10.7189\/jogh.09.010902","volume":"9","author":"LT Day","year":"2019","unstructured":"Day LT, Ruysen H, Gordeev VS, Gore-Langton GR, Boggs D, Cousens S, et al. \u201cEvery newborn-BIRTH\u201d protocol: observational study validating indicators for coverage and quality of maternal and newborn health care in Bangladesh, Nepal and Tanzania. J Global Health. 2019;9:010902.","journal-title":"J Global Health"},{"key":"3422_CR23","doi-asserted-by":"publisher","unstructured":"Day LT, Rahman QS, Rahman AE, Salim N, KC A, Ruysen H, et al. Assessment of the validity of the measurement of newborn and maternal health-care coverage in hospitals (EN-BIRTH): an observational study. Lancet Global Health. 2020. https:\/\/doi.org\/10.1016\/S2214-109X(20)30504-0b.","DOI":"10.1016\/S2214-109X(20)30504-0b"},{"key":"3422_CR24","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2018","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for statistical Computing; 2018. http:\/\/www.R-project.org\/. Accessed 10 Jul 2018."},{"key":"3422_CR25","volume-title":"Data quality review: module 2: desk review of data quality","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. Data quality review: module 2: desk review of data quality. Geneva: World Health Organization; 2017. https:\/\/apps.who.int\/iris\/handle\/10665\/259225. Accessed 7 Jan 2020."},{"key":"3422_CR26","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1093\/heapol\/czp010","volume":"24","author":"A Aqil","year":"2009","unstructured":"Aqil A, Lippeveld T, Hozumi D. PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems. Health Policy Plan. 2009;24:217\u201328.","journal-title":"Health Policy Plan"},{"key":"3422_CR27","doi-asserted-by":"publisher","unstructured":"Shamba D, Day LT, Zaman SB, Sunny AK, Tarimo MN, Peven K, et al. Barriers and enablers to routine register data collection for newborns and mothers: EN-BIRTH multi-country study. BMC Pregnancy Childbirth. 2021. https:\/\/doi.org\/10.1186\/s12884-020-03517-3.","DOI":"10.1186\/s12884-020-03517-3"},{"key":"3422_CR28","doi-asserted-by":"publisher","unstructured":"Peven K, Day LT, Ruysen H, Tahsina T, KC A, Shabani J. Stillbirths including intrapartum timing: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth. 2021. https:\/\/doi.org\/10.1186\/s12884-020-03238-7.","DOI":"10.1186\/s12884-020-03238-7"},{"key":"3422_CR29","doi-asserted-by":"publisher","unstructured":"Ameen S, Siddique AB, Rahman AE, KC A, Day LT, Peven K, et al. Survey of women\u2019s report for 33 maternal & newborn indicators: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth. 2021. https:\/\/doi.org\/10.1186\/s12884-020-03425-6.","DOI":"10.1186\/s12884-020-03425-6"},{"key":"3422_CR30","doi-asserted-by":"publisher","first-page":"S8","DOI":"10.1186\/1471-2393-15-S2-S8","volume":"15","author":"SG Moxon","year":"2015","unstructured":"Moxon SG, Ruysen H, Kerber KJ, Amouzou A, Fournier S, Grove J, et al. Count every newborn; a measurement improvement roadmap for coverage data. BMC Pregnancy Childbirth. 2015;15:S8.","journal-title":"BMC Pregnancy Childbirth."},{"key":"3422_CR31","unstructured":"World Health Organization. Analysis and use of health facility data: guidance for RMNCAH programme managers. Geneva: WHO; 2019. https:\/\/www.who.int\/publications\/m\/item\/analysis-and-use-of-health-facility-data-guidance-for-rmncah-programme-managers. Accessed 7 Jan 2020."},{"issue":"Suppl 1","key":"3422_CR32","doi-asserted-by":"publisher","first-page":"S47","DOI":"10.1016\/j.ijgo.2009.07.013","volume":"107","author":"SN Wall","year":"2009","unstructured":"Wall SN, Lee AC, Niermeyer S, English M, Keenan WJ, Carlo W, et al. Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up? Int J Gynaecol Obstet. 2009;107(Suppl 1):S47\u201364.","journal-title":"Int J Gynaecol Obstet"},{"key":"3422_CR33","doi-asserted-by":"publisher","unstructured":"KC A, Wrammert J, Clark RB, Ewald U, Vitrakoti R, Chaudhary P, et al. Reducing perinatal mortality in Nepal using Helping Babies Breathe. Pediatrics. 2016;137. https:\/\/doi.org\/10.1542\/peds.2015-0117.","DOI":"10.1542\/peds.2015-0117"},{"key":"3422_CR34","doi-asserted-by":"publisher","unstructured":"Msemo G, Massawe A, Mmbando D, Rusibamayila N, Manji K, Kidanto HL, et al. Newborn mortality and fresh stillbirth rates in Tanzania after Helping Babies Breathe training. Pediatrics. 2013. https:\/\/doi.org\/10.1542\/peds.2012-1795.","DOI":"10.1542\/peds.2012-1795"},{"key":"3422_CR35","doi-asserted-by":"crossref","unstructured":"KC A, Ewald U, Basnet O, Gurung A, Pyakuryal SN, Jha BK, et al. Effect of a scaled-up neonatal resuscitation quality improvement package on intrapartum-related mortality in Nepal: A stepped-wedge cluster randomized controlled trial. PLoS Med. 2019;16:e1002900.","DOI":"10.1371\/journal.pmed.1002900"},{"key":"3422_CR36","doi-asserted-by":"publisher","unstructured":"KC A, Lawn JE, Zhou H, Ewald U, Gurung R, Gurung A, et al. Not crying after birth as a predictor of not breathing. Pediatrics. 2020;145. https:\/\/doi.org\/10.1542\/peds.2019-2719.","DOI":"10.1542\/peds.2019-2719"},{"issue":"Supplement","key":"3422_CR37","doi-asserted-by":"publisher","first-page":"S123","DOI":"10.1016\/j.ijgo.2009.07.021","volume":"107","author":"JE Lawn","year":"2009","unstructured":"Lawn JE, Kinney M, Lee AC, Chopra M, Donnay F, Paul VK, et al. Reducing intrapartum-related deaths and disability: Can the health system deliver? Int J Gynecol Obstet. 2009;107(Supplement):S123\u201342.","journal-title":"Int J Gynecol Obstet"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-03422-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12884-020-03422-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-03422-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T01:05:22Z","timestamp":1698109522000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-020-03422-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":37,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["3422"],"URL":"https:\/\/doi.org\/10.1186\/s12884-020-03422-9","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"26 March 2021","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was granted ethical approval by institutional review boards in all operating counties in addition to the London School of Hygiene & Tropical Medicine (Additional\u00a0file\u00a0). Voluntary informed written consent was obtained from all observed participants, their families for newborns, and respondents for the qualitative interviews. Participants were assured of anonymity and confidentiality. All women were provided with a description of the study procedures in their preferred language at admission, and offered the right to refuse, or withdraw consent at any time during the study. Facility staff were identified before data collection began and no health worker refused to be observed whilst providing care. EN-BIRTH is study number 4833, registered at.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"235"}}