An analysis of factors associated with neonatal, post-neonatal and child mortality in Haiti, including breastfeeding as a time-dependent variable.

Abstract

The main objective of the study was to identify factors associated with neonatal, post-neonatal and child mortality. The study also investigated breastfeeding status as a time-dependent variable. The 2016-2017 Haitian Demographic and Health Survey was analysed. The analysis was done on 6530 live births. Time-constant and time-dependent multivariable Royston-Parmar spline models were used to identify associated factors for all three age groups. Restricted mean survival times were calculated for the different levels of the breastfeeding variable for each age group. Neonates and post-neonates who were not breastfed were associated with increased mortality, hazard ratio (HR) 22.13 (95% confidence interval (CI), 16.40-29.87) and HR 4.99 (95% CI, 3.29-7.56), respectively. Males in the child age group were associated with increased mortality, HR 2.04 (95% CI, 1.29-3.23) and HR 2.03 (95% CI, 1.28-3.21) under the time-constant and time-dependent models, respectively. Early initiation of breastfeeding and breastfeeding throughout the post-neonatal period is recommended. Outreach programmes that provide support and education for vulnerable families are also recommended.