Determinants of neonatal mortality in Ethiopia: an analysis of the 2016 Ethiopia Demographic and Health Survey

Basha, Garoma Wakjira; Woya, Ashenafi Abate; Tekile, Abay Kassa

doi:10.4314/ahs.v20i2.23

Cited by 30 publications

(24 citation statements)

References 20 publications

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“…Children living in urban areas were less likely to die than those living in rural areas. The result is consistent with studies conducted by Basha and colleagues 49 – 51 . The reason might be that urban residences have better education and facilitated living conditions compared to rural residences.…”

Section: Discussionsupporting

confidence: 93%

Analysis of regional heterogeneity and determinants of perinatal mortality in Ethiopia: review

Adebe¹,

Wake

Mekebo

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: The rate of mortality during the perinatal period is higher than at any other time in a person’s life, making it the most vulnerable. This study aimed to examine regional heterogeneity and the determinants of perinatal mortality in Ethiopia. Methods: The data for this study was obtained from the 2019 Ethiopia Demographic and Health Survey (2019 EMDHS) data. Logistic regression modeling and multilevel logistic modeling were used for data analysis. Results: A total of 5753 live birth children were included in this study. Of the total live births, 220 (3.8%) died in the first 7 days of life. Urban residence [adjusted odds ratio (AOR)=0.621; 95% CI: 0.453–0.850], residence in Addis Ababa (AOR=0.141; 95% CI: 0.090–0.220), family size of four or less (AOR=0.761; 95% CI: 0.608–0.952), age of mother at first birth of less than 20 years (AOR=0.728; 95% CI: 0.548–0.966), and using contraceptives (AOR=0.597; 95% CI: 0.438–0.814) were associated with lower risk of perinatal mortality compared to the respective reference categories whereas residence in Afar (AOR=2.259; 95% CI: 1.235–4.132), residence in Gambela (AOR=2.352; 95% CI: 1.328–4.167), no education (AOR=1.232; 95% CI: 1.065–1.572), poor wealth index (AOR=1.670; 95% CI: 1.172–2.380), and wealth index (AOR=1.648; 95% CI: 1.174–2.314) were associated with higher risk of perinatal mortality compared to the respective reference categories. Conclusion: In this study, the overall prenatal mortality rate was 38 (95% CI: 33–44) deaths per 1000 live births, which is high in magnitude. The study identified place of residence, region, wealth index, age of the mother at first birth, educational level of the mother, family size, and use of contraceptive methods as significant determinants of perinatal mortality in Ethiopia. Thus, mothers with no education should be given health education. Women should also be given awareness regarding the use of contraceptives. In addition, further research needs to be conducted in each region separately and information made available at the disaggregate level.

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Section: Discussionsupporting

confidence: 93%

Analysis of regional heterogeneity and determinants of perinatal mortality in Ethiopia: review

Adebe¹,

Wake

Mekebo

et al. 2023

Annals of Medicine &Amp; Surgery

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“…Male neonates had a higher hazard of neonatal mortality. This is similar to study findings in Ethiopia 14,[17][18][19]25 Bangladesh 32 Iran, 22 and the African Great Lakes region. 16 This could be due to the fact that the neonatal period is the time at which natural differences between males and females were more pronounced.…”

Section: Discussionsupporting

confidence: 91%

“…The finding of NMR in this study was in line with the finding from a study conducted in the Jimma zone, Aroresa district, Butajira, and Bangladesh 14,17,32,33 . However, this rate was higher than studies conducted in India and Pakistan 34,35 .…”

Section: Discussionsupporting

confidence: 90%

“…The finding of NMR in this study was in line with the finding from a study conducted in the Jimma zone, Aroresa district, Butajira, and Bangladesh. 14,17,32,33 However, this rate was higher than studies conducted in India and Pakistan. 34,35 This might be attributed to the difference in socioeconomic status of the population, and the study area is known to have poor access to basic health services.…”

Section: Discussionmentioning

confidence: 90%

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Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single‐arm retrospective cohort study

Dessie,

Nigatu,

Yadita

et al. 2023

Health Science Reports

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Background and AimsNeonatal 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.MethodA 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.ResultsThe 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.ConclusionNeonatal 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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“…15 25 However, not all of the most recent Ethiopian studies agree on the role of these factors on perinatal mortality; quite the opposite, all show that the number of previous deliveries and previous obstetric complications make the greatest contribution, and among the socioeconomic determinants, the residence in a rural area shows the greatest association with perinatal mortality. [30][31][32] These three factors are all known during pregnancy and may act as crucial indications for admission to the MWH. In addition to this, our study is monocentric; although a detailed description of the context may allow for comparisons between situations with a similar-or, by contrast, different-background, the extendibility of our findings remains limited, suggesting the need for multicentre researches.…”

Section: Bmj Global Healthmentioning

confidence: 99%

The effectiveness of maternity waiting homes in reducing perinatal mortality: a case–control study in Ethiopia

Zuanna

Fonzo

Resti³

et al. 2021

BMJ Glob Health

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BackgroundThe 2030 Agenda for Sustainable Development aims to reduce neonatal mortality to at least 12 per 1000 live births. Most of the causes can be prevented or cured. Access to quality healthcare during pregnancy and labour is the key to reduce perinatal deaths, and maternity waiting homes (MWHs) may have an impact, especially for women who live far from the healthcare system. We conducted a case–control study to evaluate the effectiveness of MWH in reducing perinatal mortality in a secondary hospital in Ethiopia.MethodsWe did a nested case–control study from January 2014 through December 2017. The enrolled cases were mothers whose childbirth resulted in stillbirth or early neonatal death. The controls were mothers with an alive baby at 7 days or with an alive baby on discharge. We collected demographic, anamnestic, pregnancy-related and obstetric-related data. The effectiveness of the MWH on perinatal death was assessed by a logistic regression model, adjusted for all other variables investigated as potential confounders. We also did a sensitivity analysis to explore the role of twin pregnancies.ResultsWe included 1175 cases and 2350 controls. The crude analysis showed a protective effect of the MWH towards perinatal mortality (OR=0.700; 95% CI: 0.505 to 0.972), even more protective after adjustment for confounders (adjusted OR (AOR)=0.452; 95% CI: 0.293 to 0.698). Sensitivity analyses showed a consistent result, even excluding twin pregnancies (AOR=0.550; 95% CI: 0.330 to 0.917).ConclusionMWHs appear to reduce perinatal mortality by 55%. Our findings support the decision to invest in MWH to support pregnant women with higher quality and more comprehensive healthcare strategy, including quality antenatal care in peripheral primary care clinics, where risk factors can be recognised and women can be addressed for admission to MWH.

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Determinants of neonatal mortality in Ethiopia: an analysis of the 2016 Ethiopia Demographic and Health Survey

Cited by 30 publications

References 20 publications

Analysis of regional heterogeneity and determinants of perinatal mortality in Ethiopia: review

Analysis of regional heterogeneity and determinants of perinatal mortality in Ethiopia: review

Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single‐arm retrospective cohort study

The effectiveness of maternity waiting homes in reducing perinatal mortality: a case–control study in Ethiopia

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