# “We want to know the cause of neonate's death to prevent similar incident in the future …”: A Formative Study to Introduce Minimally Invasive Tissue Sampling Procedure at Community Level in Butajira

## TL;DR

This study explores how to introduce a minimally invasive tissue sampling method to determine neonatal death causes in Butajira, Ethiopia, by understanding community perspectives and facilitators.

## Contribution

The study identifies community and cultural factors critical for implementing MITS in a low-resource setting.

## Key findings

- Community members and parents showed interest in knowing the definitive cause of neonatal death using MITS.
- Husbands and wives are key decision-makers for authorizing MITS, while community and religious leaders influence these decisions.
- Awareness and engagement of opinion leaders are essential for successful MITS implementation.

## Abstract

Diagnostic autopsy has been in use for long to determine the cause of death. Since recently however ‘Minimally Invasive Tissue Sampling’ (MITS) is introduced to determine definitive cause of neonatal death. This study describes locally established facilitators to introduce MITS procedures to determine cause of neonatal death in Ethiopia.

Exploratory study was conducted in Butajira community where twenty-two key informants representing community opinion leaders' health care workers, five in depth interviews with parents who recently lost neonates and eight FGDs with community members were completed to generate evidences in line with the research question. Interviews and discussions were audio recorded, transcribed verbatim and analysed facilitated by open-code software. Thematic analysis was applied to identify and interpret patterns of the evidences

In Butajira, ANC and delivery in health facilities was found to have improved over the years. Yet, child death remains an outstanding problem. While different factors were identified to cause the death of a child, relatively few participants choose to accept newborn death as a natural occurrence or will of the creator. Majority of the study participants expressed interest to know definitive cause of death using MITS. Yet, awareness about MITS and how it works was unanimously desired. It was found that husbands and wives are key to authorize MITS procedure while community opinion leaders including religious leaders were identified as key to influence parental decisions for the procedure

Building awareness of the community members and engagement of opinion leaders is critical to introduce MITS.