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Dessie AM, Nigatu D, Yadita ZS, Yimer YA, Yalew AK, Aychew EW, Feleke SF. Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single-arm retrospective cohort study. Health Sci Rep 2023; 6:e1613. [PMID: 37822845 PMCID: PMC10562526 DOI: 10.1002/hsr2.1613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Background and Aims Neonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub-Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia. Method A single-arm community-based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi-structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan-Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a p-value < 0.05 was considered statistically significant. Results The neonatal mortality rate was 44 (95% confidence interval [CI]: 33-60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21-2.23) per 1000 neonate days. Three-quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21-10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01-1.47), being male (AHR = 2.45, 95% CI: 1.12-5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52-11.10) were found to be predictors of neonatal mortality. Conclusion Neonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival.
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Affiliation(s)
- Anteneh Mengist Dessie
- Department of Public Health, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Dabere Nigatu
- Department of Reproductive Health and population studies, School of public health, College of Medical & Health SciencesBahir Dar UniversityBahir DarEthiopia
| | - Zemenu Shiferaw Yadita
- Department of Reproductive Health and population studies, School of public health, College of Medical & Health SciencesBahir Dar UniversityBahir DarEthiopia
| | - Yalemwork Anteneh Yimer
- Department of pediatric and child health, Tibebe Ghion specialized hospital, college of medicine and health scienceBahir Dar universityBahir DarEthiopia
| | - Anteneh Kassa Yalew
- Department of Public Health, College of Health ScienceWolkite UniversityWolkiteEthiopia
| | - Eden Workneh Aychew
- Department of Midwifery, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health ScienceWoldia UniversityWoldiaEthiopia
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Kibria GMA, Crispen R. Disparities, distribution, and determinants in appropriate timely initiation, number, and quality of antenatal care in Bangladesh: Evidence from Demographic and Health Survey 2017-18. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002325. [PMID: 37610995 PMCID: PMC10446198 DOI: 10.1371/journal.pgph.0002325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
Like many other low- and middle-income countries, Bangladesh experiences a disproportionately higher number of maternal and neonatal deaths compared to high-income countries. Despite this, a majority of pregnant women in Bangladesh do not receive appropriate antenatal care (ANC). We investigated the disparities, distribution, and determinants of the timing, number, and quality of ANC in this country. This cross-sectional study analyzed Bangladesh Demographic and Health Survey (BDHS) 2017-18 data on ever-married reproductive-age (i.e., 15-49-year-olds) women. After describing the study sample and proportions, multilevel logistic regression was applied to study determinants. The prevalence and odds of the studied outcomes were higher among women with higher parity, a higher education level, more highly educated husbands, urban residence, and residence in some administrative divisions (p<0.05). For instance, among women in the poorest, poorer, middle, richer, and richest wealth quintiles, the proportions of those who initiated ANC during the first trimester were 22.2% (95% confidence interval (CI): 19.6-25.0), 30.1% (95% CI: 27.1-33.2), 35.1% (95% CI: 31.7-38.6), 38.5% (95% CI: 35.2-42.0), and 61.0% (95% CI: 57.5-64.3). Then, compared to women in the poorest wealth quintile, the adjusted odds ratio (AOR) for ANC initiation was higher among those in the poorer (AOR: 1.3, 95% CI: 1.1-1.7), middle (AOR: 1.5, 95% CI: 1.2-1.9), richer (AOR: 1.4, 95% CI: 1.1-1.8), and richest (AOR: 2.7, 95% CI: 2.1-3.5) household wealth quintiles. Given the importance of appropriate ANC, it is crucial to increase awareness and coverage among women with low socioeconomic status and rural residence, among other factors studied.
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Affiliation(s)
- Gulam Muhammed Al Kibria
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Reese Crispen
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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Adongo EA, Ganle JK. Predictors of neonatal mortality in Ghana: evidence from 2017 Ghana maternal health survey. BMC Pregnancy Childbirth 2023; 23:556. [PMID: 37533034 PMCID: PMC10394848 DOI: 10.1186/s12884-023-05877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Neonatal mortality contributes about 47% of child mortality globally and over 50% of under-5 deaths in Ghana. There is limited population level analysis done in Ghana on predictors of neonatal mortality. OBJECTIVES The objective of the study was to examine the predictors of neonatal mortality in Ghana. METHOD This study utilizes secondary data from the 2017 Ghana Maternal Health Survey (GMHS). The GMHS survey focuses on population and household characteristics, health, nutrition, and lifestyle with particular emphasis on topics that affect the lives of newborns and women, including mortality levels, fertility preferences and family planning methods. A total of 10,624 respondents were included in the study after data cleaning. Descriptive statistical techniques were used to describe important background characteristics of the women and Pearson's Chi-squares (χ2) test used to assess association between the outcome (neonatal death) and independent variables. Multivariate logistic regression analysis was done to estimate odd ratios and potential confounders controlled. Confidence level was held at 95%, and a p < 0.05 was considered statistically significant. Data analysis was done using STATA 15. RESULTS The prevalence of neonatal mortality was 18 per 1000 live births. ANC attendance, sex of baby, and skin-to-skin contact immediately after birth were predictors of neonatal mortality. Women with at least one ANC visit were less likely to experience neonatal mortality as compared to women with no ANC visit prior to delivery (AOR = 0.11; CI = 0.02-0.56, p = 0.01). Girls were less likely (AOR = 0.68; CI = 0.47-0.98; p = 0.03) to die during the neonatal period as compared to boys. Neonates who were not put skin-to-skin contact immediately after birth were 2.6 times more likely to die within the neonatal period than those who were put skin-to-skin contact immediately after birth (AOR = 2.59; CI = 1.75-3.83, p = 0.00). CONCLUSION Neonatal mortality remains a public health concern in Ghana, with an estimated rate of 18 deaths per 1,000 live births. Maternal and neonatal factors such as the sex of the newborn, the number of antenatal care visits, and skin-to-skin contact between the newborn and mother immediately after birth are the predictors of neonatal mortality in Ghana.
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Affiliation(s)
- Emmanuel Ayire Adongo
- World Child Cancer, Moorfields House, Slater Avenue, Korle Bu, P. O. Box KB273, Accra, Ghana
- Ghana College of Nurses and Midwives, 214 Westlands Residential Area, Accra, Ghana
| | - John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra Ghana
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Murad MW, Abdullah ABM, Islam MM, Alam MM, Reaiche C, Boyle S. Determinants of neonatal, infant and under-five mortalities: evidence from a developing country, Bangladesh. J Public Health Policy 2023; 44:230-241. [PMID: 37117262 PMCID: PMC10232642 DOI: 10.1057/s41271-023-00413-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/30/2023]
Abstract
We investigated the macroeconomic determinants of neonatal, infant, and under-five mortalities in Bangladesh for the period 1991-2018 and discuss implications of the United Nations' Sustainable Development Goal 3 (SDG 3) and Millennium Development Goal 4 (MDG 4) for developing countries. We used annual time series data and the econometric techniques of Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) regressions for analysis. Determinants most effective in combating neonatal, infant, and under-five mortalities include variables such as 'protecting newborns against tetanus', 'increasing healthcare expenditure', and 'making sure births are attended by skilled healthcare staff'. Employing more healthcare workers and assuring more and improved healthcare provisions can further reduce the neonatal, infant, and under-five mortalities. Developing countries with similar macroeconomic profiles can achieve similar SDG 3 and MDG 4 outcomes by emulating the policies and strategies Bangladesh applied to reducing child mortalities over the last three decades.
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Affiliation(s)
- Md Wahid Murad
- UniSA Education Futures, University of South Australia, Adelaide, SA Australia
| | - A. B. M. Abdullah
- UniSA Business, University of South Australia, 49 North Terrace, Adelaide, SA 5001 Australia
| | - Md Mazharul Islam
- Department of Finance, College of Business, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Md Mahmudul Alam
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Kedah Malaysia
| | - Carmen Reaiche
- College of Business, Law and Governance, James Cook University, Townsville, QLD Australia
| | - Stephen Boyle
- College of Business, Law and Governance, James Cook University, Townsville, QLD Australia
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Kibria GMA, Hashan MR, Hanif AAM, Maniar V, Shawon MSR. Mobile phone use for pregnancy-related healthcare utilization and its association with optimum antenatal care and hospital delivery in Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001762. [PMID: 37022996 PMCID: PMC10079009 DOI: 10.1371/journal.pgph.0001762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Pregnancy-related healthcare utilization is inadequate in Bangladesh, where more than half of pregnant women do not receive optimum number of antenatal care (ANC) visits or do not deliver child in hospitals. Mobile phone use could improve such healthcare utilization; however, limited evidence exists in Bangladesh. We investigated the pattern, trends, and factors associated with mobile phone use for pregnancy-related healthcare and how this can impact at least 4 ANC visits and hospital delivery in the country. We analyzed cross-sectional data from Bangladesh Demographic and Health Survey (BDHS) 2014 (n = 4,465) and 2017-18 (n = 4,903). Only 28.5% and 26.6% women reported using mobile phones for pregnancy-related causes in 2014 and 2017-18, respectively. Majority of the time, women used mobile phones to seek information or to contact service providers. In both survey periods, women with a higher education level, more educated husbands, a higher household wealth index, and residence in certain administrative divisions had greater likelihoods of using mobile phones for pregnancy-related causes. In BDHS 2014, proportions of at least 4 ANC and hospital delivery were, respectively, 43.3% and 57.0% among users, and 26.4% and 31.2% among non-users. In adjusted analysis, the odds of utilizing at least 4 ANC were 1.6 (95% confidence interval (CI): 1.4-1.9) in BDHS 2014 and 1.4 (95% CI: 1.3-1.7) in BDHS 2017-18 among users. Similarly, in BDHS 2017-18, proportions of at least 4 ANC and hospital delivery were, respectively, 59.1% and 63.8% among users, and 42.8% and 45.1% among non-users. The adjusted odds of hospital delivery were also high, 2.0 (95% CI: 1.7-2.4) in BDHS 2014 and 1.5 (95% CI: 1.3-1.8) in BDHS 2017-18. Women with history of using mobile phones for pregnancy-related causes were more likely to utilize at least 4 ANC visits and deliver in health facilities, however, most women were not using mobile phones for that.
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Affiliation(s)
| | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
- Central Queensland University, Rockhampton, Australia
| | | | - Vidhi Maniar
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Chafik K, Aslaou F, Barich F, Laamiri FZ, El Ouardighi I, Barkat A. The Prevalence of Neonatal Near Misses in Rabat, Morocco. Cureus 2023; 15:e34486. [PMID: 36874298 PMCID: PMC9982691 DOI: 10.7759/cureus.34486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The concept of near-miss neonatal (NMN) is a potentially useful approach in assessing the quality of newborn care. However, data collected on the status of NMN cases in Morocco is scarce. OBJECTIVE The objective of this study is to determine the prevalence of NMN cases among live births at the University Hospital of Rabat, Morocco. MATERIALS AND METHODS An observational cross-sectional study was conducted on 2676 newborns born at the University Hospital of Rabat, Morocco, and admitted to the National Reference Center of Neonatology and Nutrition (NRCN) from January 1 to December 31, 2021. The main inclusion criteria were the pragmatic and/or management markers of the definition of NMN. Data were extracted using a structured, pre-tested checklist, entered into EpiData, and exported to Statistical Software for the Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY), and descriptive statistics were performed. RESULTS Among the 2676 selected live births, 2367 were NMN cases (88.5%; 95% CI: 88.3-90.7). More than half of new mothers (57.5%) were referrals, 59.9% of women were multiparous, and 78.5% had under four prenatal care consultations. Obstetric problems affected 373 of the women during pregnancy. A pragmatic criterion was met in 43.6% of NMN situations. Among the management criteria, the use of intravenous antibiotics was the most common factor at 56.0%. CONCLUSIONS This study revealed a high prevalence of NMN. Therefore, concerted efforts are needed to improve maternal health care services, including early identification of complications and appropriate management.
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Affiliation(s)
- Kawtar Chafik
- Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Fatima Aslaou
- Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Fatima Barich
- Research, Higher Institute of Nursing Professions and Health Techniques, Rabat, MAR
| | - Fatim Zahra Laamiri
- Laboratory of Health Sciences and Technology, Hassan First University of Settat, Higher Institute of Health Sciences of Settat, Settat, MAR
| | - Ilham El Ouardighi
- Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Amina Barkat
- Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
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Islam MZ, Billah A, Islam MM, Rahman M, Khan N. Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis. J Glob Health 2022; 12:04070. [PMID: 36057919 PMCID: PMC9441110 DOI: 10.7189/jogh.12.04070] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Methods Eight databases, PubMed, CINAHL, Web of Science, Embase, PsycINFO, Cochrane Library, Popline, and Maternity and Infant Care, were searched, covering the period of January 2000 to January 2022. Studies that had examined the association between SBI and any form of child mortality were included. The findings of the included studies were summarized through fixed-effects or random-effects meta-analysis and the model was selected based on the heterogeneity index. Results A total of 51 studies were included. Of them, 19 were conducted in Ethiopia, 10 in Nigeria and 7 in Bangladesh. Significant higher likelihoods of stillbirth (odds ratio (OR) = 2.11; 95% confidence interval (CI) = 1.32-3.38), early neonatal mortality (OR = 1.58; 95% CI = 1.04-2.41), perinatal mortality (OR = 1.71; 95% CI = 1.32-2.21), neonatal mortality (OR = 1.85; 95% CI = 1.68-2.04), post-neonatal mortality (OR = 3.01; 95% CI = 1.43-6.33), infant mortality (OR = 1.92; 95% CI = 1.77-2.07), child mortality (OR = 1.67; 95% CI = 1.27-2.19) and under-five mortality (OR = 1.95; 95% CI = 1.56-2.44) were found among babies born in short birth intervals than those who born in normal intervals. Conclusions SBI significantly increases the risk of child mortality in LMICs. Programmes to reduce pregnancies in short intervals need to be expanded and strengthened. Reproductive health interventions aimed at reducing child mortality should include proper counselling on family planning, distribution of appropriate contraceptives and increased awareness of the adverse effects of SBI on maternal and child health.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.,Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Arif Billah
- Department of Social Work and Counselling, Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Malaysia
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mostafizur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
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Influence of sociodemographic factors on child mortality in Bangladesh: a multivariate analysis. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01378-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Patel KK, Kumar M. Differential and Determinants of Neonatal Mortality: A Comparative Study in Northern and Southern Regions of India. Indian J Community Med 2021; 46:405-410. [PMID: 34759476 PMCID: PMC8575228 DOI: 10.4103/ijcm.ijcm_425_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 04/22/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Government of India initiated different programs to reduce neonatal mortality. However, the variability of neonatal deaths occurs among states of India. OBJECTIVE This study aimed to identify the differential determinants associated with neonatal deaths in northern and southern regions of India. MATERIALS AND METHODS Bivariate analysis and Cox regression analysis have been performed to evaluate the predictors of neonatal mortality from National Family Health Survey (NFHS-4) data. RESULTS For neonatal mortality, mother and child factors became more consistent in the southern region than northern regions of the country, while household factor was almost the same in both regions of India. CONCLUSIONS Primary intervention is also required to reduce public health problem as neonatal mortality. It should be focused on education of mother, birth interval, age at birth, antenatal care, poverty reduction programs, and proper heath facility to pregnant mothers.
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Affiliation(s)
- Kamalesh Kumar Patel
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Mukesh Kumar
- Department of Statistics, MMV, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Sushma R, Norhayati MN, Nik Hazlina NH. Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:422. [PMID: 34107909 PMCID: PMC8190855 DOI: 10.1186/s12884-021-03894-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 05/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. METHODS A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0. RESULTS One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07-9.84) and no formal education (aOR 2.16; 95% CI 1.12-4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32-0.86) and caesarean section (aOR 0.44; 95% CI 0.19-0.99) had negative associations with NNM. CONCLUSIONS Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.
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Affiliation(s)
- Rajbanshi Sushma
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - Nik Hussain Nik Hazlina
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
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Kananura RM. Mediation role of low birth weight on the factors associated with newborn mortality and the moderation role of institutional delivery in the association of low birth weight with newborn mortality in a resource-poor setting. BMJ Open 2021; 11:e046322. [PMID: 34031115 PMCID: PMC8149436 DOI: 10.1136/bmjopen-2020-046322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To assess low birth weight's (LBW) mediation role on the factors associated with newborn mortality (NM), including stillbirth and the role of institutional delivery in the association between LBW and NM. DESIGN AND PARTICIPANTS I used the 2011-2015 event histories health demographic data collected by Iganga-Mayuge Health Demographic and Surveillance Site (HDSS). The dataset consisted of 10 758 registered women whose birth occurred at least 22 weeks of the gestation period and records of newborns' living status 28 days after delivery. SETTING The Iganga-Mayuge HDSS is in Eastern Uganda, which routinely collects health and demographic data from a registered population of at least 100 000 people. OUTCOME MEASURE The study's key outcomes or endogenous factors were perinatal mortality (PM), late NM and LBW (mediating factor). RESULTS The factors that were directly associated with PM were LBW (OR=2.55, 95% CI 1.15 to 5.67)), maternal age of 30+ years (OR=1.68, 95% CI 1.21 to 2.33), rural residence (OR=1.38, 95% CI 1.02 to 1.85), mothers with previous experience of NM (OR=3.95, 95% CI 2.86 to 5.46) and mothers with no education level (OR=1.63, 95% CI 1.21 to 2.18). Multiple births and mother's prior experience of NM were positively associated with NM at a later age. Institutional delivery had a modest inverse role in the association of LBW with PM. LBW mediated the association of PM with residence status, mothers' previous NM experience, multiple births, adolescent mothers and mothers' marital status. Of the total effect attributable to each of these factors, LBW mediated +25%, +22%, +100%, 25% and -38% of rural resident mothers, mothers with previous experience of newborn or pregnancy loss, multiple births, adolescent mothers and mothers with partners, respectively. CONCLUSION LBW mediated multiple factors in the NM pathways, and the effect of institutional delivery in reducing mortality among LBW newborns was insignificant. The findings demonstrate the need for a holistic life course approach that gears the health systems to tackle NM.
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Affiliation(s)
- Rornald Muhumuza Kananura
- Department of International Development, London School of Economics and Political Science, London, UK
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
- Center of Excellence for Maternal and Newborn Health, Makerere University School of Public Health, Kampala, Uganda
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Al-Sheyab NA, Khader YS, Shattnawi KK, Alyahya MS, Batieha A. Rate, Risk Factors, and Causes of Neonatal Deaths in Jordan: Analysis of Data From Jordan Stillbirth and Neonatal Surveillance System (JSANDS). Front Public Health 2020; 8:595379. [PMID: 33194998 PMCID: PMC7661434 DOI: 10.3389/fpubh.2020.595379] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background: It has been estimated that 27.8 million neonates will die worldwide between 2018 and 2030 if no improvements in neonatal and maternal care take place. The aim of this study was to determine the rate, risk factors, and causes of neonatal mortality in Jordan. Methods: In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 and January 2020 were exported from the JSANDS and analyzed. Results: A total of 10,328 births [10,226 live births (LB) and 102 stillbirths] were registered in the study period, with a rate of 14.1 deaths per 1,000 LBs; 76% were early neonatal deaths and 24% were late deaths. The odds of deaths in the Ministry of Health hospitals were almost 21 times (OR = 20.8, 95% CI: 2.8, 153.1) higher than that in private hospitals. Low birthweight and pre-term babies were significantly more likely to die during the neonatal period compared to full-term babies. The odds of neonatal mortality were significantly higher among babies born to housewives compared to those who were born to employed women (OR = 2.7; 95% CI: 1.2, 6.0). Main causes of neonatal deaths that occurred pre-discharge were respiratory and cardiovascular disorders (43%) and low birthweight and pre-term (33%). The main maternal conditions that attributed to these deaths were complications of the placenta and cord, complications of pregnancy, and medical and surgical conditions. The main cause of neonatal deaths that occurred post-discharge were low birthweight and pre-term (42%). Conclusions: The rate of neonatal mortality have not decreased since 2012 and the majority of neonatal deaths occurred could have been prevented. Regular antenatal visits, in which any possible diseases or complications of pregnant women or fetal anomalies, need to be fully documented and monitored with appropriate and timely medical intervention to minimize such deaths.
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Affiliation(s)
- Nihaya A. Al-Sheyab
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S. Khader
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khulood K. Shattnawi
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad S. Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Anwar Batieha
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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