Perinatal Periods of Risk
Analytic Readiness Bill Sappenfield
A CityMatCH “How-to-Do” Workshop
“If you don’t know where you are going, there are many ways to get there…”
Old African Proverb
PPOR Conceptual Framework
Improve Maternal & Infant Health
Seeing the “Big Picture”
Seeing the “Big” Picture
Planning Cycle
Assessment
Perinatal Periods of Risk
Big Picture Planning Cycle
Community readiness and investment Stakeholders Vision Planning process Resources available or planned Timeframe Accountability
Community Assessment
Previous assessments Previous perinatal studies or surveillance Fetal and infant mortality reviews PRAMS or other surveys Health system assessments Asset mapping Previous policy and program evaluations Decision-making process
Analytic Readiness:What Does it Mean?
PPOR Analytic Readiness:
What does it means? Data access/quality Minimum number of events Adequately trained analytic staff Adequately trained communication
staff Analysis team including program staff Sufficient staff hours Strong leadership agreement &
support
Direct Data Access/Quality?
Fetal death files (no gest. age restrictions)
Linked birth—infant death certificate files
Unlinked infant death certificate files Key data items missing or poor quality
Gestational age Birthweight Education Race/Ethnicity
PPOR Minimum?
Overall, and every subpopulation or geographic region needs roughly 60 feto-infant deaths to have sufficient numbers to calculate rates.
Adequately Trained Analytic Staff?
Analyze large data files Familiarity with birth and death files Assess data quality and reporting Calculate and compare rates Estimate confidence limits and p-values Investigate causes and risk factors Conduct multivariate analysis Summarize analytic findings Understand perinatal health issues
Adequately Trained Communication Staff?
Determine Single Overriding Communication Objective
Develop compelling messages Condense numbers and figures Write reports and fact sheets Produce graphic presentations Tailor communications to the
audience
Analysis Team?
Data analyst Policymaker or staff Program or content specialist Clinical specialist Vital records specialist Communication expertise
Sufficient Staff Hours for Both Phases?
Preparation Phase 1 analysis Phase 2 analyses Communication preparation Participation in dissemination and
follow up
Strong Leadership Agreement & Support?
Understands the feto-infant mortality problem
Understands the work plan Commits to providing resources for
the investigation Commits to providing resources for
community collaboration Gives priority and champions the
initiative
PPOR Analytic Readiness:
What does it mean? Data access/quality Minimum number of events Adequately trained analytic staff Adequately trained communication
staff Analysis team including program staff Sufficient staff hours Strong leadership agreement &
support
PPOR Analytic Readiness:
What does it mean? Data access/quality Minimum number of events Adequately trained analytic staff Adequately trained communication
staff Analysis team including program staff Sufficient staff hours Strong leadership agreement &
support
Ready, Aim, and Fire!
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