Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death

Abstract

Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health.

Health Care Seeking Behaviour on Neonatal Danger Signs among Mothers in Tenta District, Northeast Ethiopia: Community based cross- sectional study.

“…About two-thirds of neonatal deaths occur in the African and southeast-Asian regions (Save the Children, 2014). Sub-Saharan Africa generally has higher rates of neonatal mortality (Mrisho et al, 2012). Ethiopia has made notable progress in decreasing infant mortality ratio from 97 deaths per 1,000 live births to 59 deaths per 1,000 live births in 2011, and to 48 deaths per 1,000 live births in 2016 (EDHS, 2016).…”

“…Delayed health care seeking can contribute neonatal mortality (Herbert et al, 2012). Understanding the care-seeking behaviour minimize potential delays and effectively improve newborns health (Mrisho et al, 2012).…”

“…Different studies showed that prompt health care seeking behaviour for neonatal danger signs serve as backbone in reducing neonatal mortality (Sandberg et al, 2014;Chandwani and Pandor, 2015). However, a variety of cultural barriers, norms of poor hygiene and isolation impeded neonatal health care seeking behaviour of mothers (Mrisho et al, 2012). Herbert et al (2012) reported that 47.5 present of neonates who were ill or suspected to be ill were taken to health facility.…”

A rapid assessment of the quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania

“…The highest neonatal mortality rates are documented in sub-Saharan Africa [1,6-9]. Tanzania is among the five countries in sub-Saharan Africa recording the highest neonatal mortality rates, [8,10] with birth asphyxia, prematurity and infection as prime causes, all of which are preventable [11]. …”

Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences

“…However, in rural southern Tanzania, deaths at health facilities were higher (32.3 per 1000 live births) than those in the community (29.7 per 1000 live births) [11,12]. Performance of health care workers has become a main challenge in neonatal care [13] such that care at home after home delivery has proved to be less of a problem than care given at the health facility [14]. This leads us to believe that elements such as emotional support, parent empowerment, a welcoming environment with supportive unit policies, and parent education with an opportunity to practice new skills in neonatal care have an impact on improving neonatal care [15-17].…”