JMIR Publications

ABSTRACT

Background:

The Jordan Stillbirth and Neonatal Mortality Surveillance (JSANDS) is an electronic surveillance system that automatically transfers the data on births, stillbirths, and neonatal deaths to the concerned authorities in the Ministry of Health. JSANDS was implemented and tested in five maternity hospitals during the period May 2019 through December 2020.

Objective:

This study aimed to evaluate the usefulness and performance of JSANDS to register births, stillbirths and neonatal deaths and determine their causes. Specifically, this study examined the JSANDS attributes including acceptability, simplicity, flexibility, stability, representativeness, sustainability, penetration, data quality, sensitivity, and adoption.

Methods:

An evaluation study was conducted after 18 months of the JSANDS implementation using the Updated Guidelines for Evaluating Public Health Surveillance Systems. The evaluation focused on how well the system operated to meet its purpose and objectives. The indicators assessing the system attributes were scored on a Likert scale. Each indicator and overall attribute score percent was represented as score rank and interpreted as excellent (score ≥80%), good (score ≥60 - <80%), average (score ≥40 - <60%), and poor (score <40%).

Results:

A total of 270 healthcare professionals participated in this study and evaluated the system performance. The system users rated the usefulness of JSANDS as excellent (score percent = 85.6%). The overall acceptability (score percent = 82.3%), flexibility (score percent = 80.2%), stability (score percent = 80.0%), and representativeness (score percent = 86.6%) were rated excellent. The overall simplicity was scored good (score percent = 75.4%). All participants were trained on JSANDS and used it in the past 12 months. Of all respondents, 219 (86.2%) reported that they intend to continue using the JSANDS system to register neonatal deaths and stillbirths in future. All variables in JSANDS had complete data with no missing values.

Conclusions:

The performance of JSANDS to completely register stillbirths and neonatal deaths and their causes was excellent. Almost all attributes and indicators of JSANDS functionality were rated excellent. JSANDS can be scaled-up to cover all maternity hospitals in Jordan. The potential for scaling up the system is very high for many reasons including its usefulness, the simplified PNN death review tools, and easy process of reporting.