Neonatal mortality and its associated factors among neonates admitted at public hospitals, pastoral region, Ethiopia: A health facility based study

Abstract

Background Neonatal mortality is a public health issue in, Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged in developing regions of the country. Regrettably, there is no single study to show the rates and predictors of neonatal mortality for Afar region. Thus, this study aims to assess neonatal mortality and associated factors in Afar region, Ethiopia. Methods A health facility-based cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care units (NICUs) from January 2015 to December 2019. Maternal and neonatal medical records were reviewed and audited using structured data extraction checklist. The data was collected by four trained nurses and midwives. The medical records were selected using a systematic random sampling technique. Bivariate and multivariable logistic regression analyses were done. Adjusted odds ratio with the corresponding 95% confidence interval were used to assess the association between neonatal mortality and the associated factors. Finally, the statistical significance level was declared at a p-value of less than 0.05. Results In this study, 391 medical records of newborns were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 57 (14.6%) [95% CI 11.0%-18.4%]. A multivariable logistic regression showed that lack of antenatal care (ANC) follow up [AOR = 4.69: 95%CI (1.77, 12.47)], giving birth through cesarean section [AOR 3.59, 95%CI (1.22, 10.55)], having admission temperature less than 36.5°C [AOR 10.75, 95%CI (3.75, 30.80)], birth asphyxia [AOR 7.16, 95%CI (2.22, 23.10)], and having a length of stay greater than five days in the hospital [AOR 0.23, 95%CI (0.08, 0.66)] were significantly associated with neonatal mortality. Conclusion This study revealed that the rate of neonatal mortality is still high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature at admission and birth asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention to improve antenatal care, intrapartum care and standardized care for admitted neonates. Furthermore, prospective studies are recommended.

Neonatal Mortality and Associated Factors Among Neonates Admitted to the Neonatal Intensive Care Unit of Dil Chora Referral Hospital, Dire Dawa City, Ethiopia, 2021: A Facility-Based Study

“…Neonates born from a mother with no ANC visit increases the odds of neonatal death compared with mothers with ANC visits. This finding is supported by a study conducted in the Afar region (21). Women who do not have antenatal care followup during pregnancy are more at a menace for pregnancy and intrapartum-related complications, which, in turn, place the newborn at danger of death (25).…”

“…This variation might also be due to the variation in sample sizes (11,17). Other possible justification may be the difference in the health service utilization including giving birth at health institutions by skilled care providers and health seeking for sick neonates, the variation in health institution setup (equipment available and skilled persons), and economic disparities among study participants (11,13,21). Besides, this study used data of those critically sick babies that were admitted to the neonatal intensive care unit.…”

“…Women who do not have antenatal care followup during pregnancy are more at a menace for pregnancy and intrapartum-related complications, which, in turn, place the newborn at danger of death (25). Therefore, women who complete antenatal care visits have a better chance of prompt detection and management of birth-related problems, and also establishing good health before childbirth and early postnatal period (21,26). Besides, women who had complete ANC followup had an increased likelihood of giving birth by a skilled birth attendant who leads to having quality essential newborn care (ENC), which decreases the odds of neonatal death (16).…”

Antenatal Care Predicts Neonatal Mortality in Eastern Africa: A Systematic Review and Meta-analysis of Observational Studies

“…The majority of the included studies were published in the last 5 years. We included 12 cohort-studies, 21, 22, 24, 26, 28, 30, 31, 4748495051 10 cross-sectional, 19, 25, 27, 29, 32, 5253545556 and 5 case-control studies. 23, 57585960 The sample size of the studies is ranged from 228 to 14,188.…”

Determinants and causes of early neonatal mortality: Hospital based retrospective cohort study in Somali region of Ethiopia

“…Furthermore, maternal illness and death, as well as a poor Apgar score, are two additional causes of neonatal mortality [7,12,13,18]. Maternal child spacing, on the other hand, protects against it [6].Finally, duration of stay is another driver in Ethiopia, particularly in pastoralist communities, in addition to the other primary causes of newborn mortality in low-income countries like Ethiopia [8,19].…”