Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study

Concept analysis of Neonatal Near Miss

OBJECTIVE

To analyze the concept of Neonatal Near Miss (NNM) using Walker and Avant's method.

METHOD

This study employs conceptual analysis following Walker and Avant's model, involving concept selection, objective definition, identification of potential uses, determination of attributes, model case creation, additional case consideration, antecedent identification, consequent analysis, and empirical reference examination. To elucidate the concept, a scoping review was conducted across journals indexed in scientific databases such as Web of Science, EMBASE, SCOPUS, and MEDLINE/PubMed.

RESULTS

The analysis encompassed 43 articles, revealing diverse definitions of neonatal near miss across different contexts. A comprehensive definition emerged from identified antecedents: risk of death, susceptibility to adverse outcomes, and potential adverse events. These antecedents were categorized into maternal conditions, neonatal conditions, and healthcare assistance.

CONCLUSION

The analysis and definition of the NNM concept was successful, and its antecedents, attributes, and consequences were delineated.

IMPLICATIONS

Identifying the risk factors associated with NNM cases may contribute to reducing infant morbidity and mortality and improving the quality of care, facilitating future research and improving the use of the NNM concept.

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis

Background

Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia.

Methods

A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors.

Result

The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association.

Conclusion and recommendation

One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.