Abstract
BackgroundNeonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal.MethodsA case–control study was conducted during April–July 2012. The study used a mixed-method approach, in which records of neonatal deaths were obtained from the District Public Health Office and a comparison group, survivors, was obtained from the same community. A total of 198 mothers (of 99 neonatal deaths and 99 survivor neonates) were included in the survey. Focus group discussions, in-depth interviews and case studies were also conducted. Maternal characteristics were analyzed using descriptive statistics, Mc Nemar’s Chi square test and multivariable backward conditional logistic regression analysis. Qualitative data were analyzed by narrative analysis method.ResultsMore than four-fifth of mothers (86 %) had antenatal check-up (ANC) and the proportion of four or more ANC was 64 %. Similarly, the percentage of mothers having institutional delivery was 62 %, and postnatal check-up was received by 65 % of mothers. In multivariable analysis, low birth weight [adjusted odds ratio: 8.49, 95 % CI (3.21–22.47)], applying nothing on cord [adjusted odds ratio: 5.72, 95 % CI (1.01-32.30)], not wrapping of newborn [adjusted odds ratio: 9.54, 95 % CI (2.03–44.73)], and no schooling of mother [adjusted odds ratio: 2.09, 95 % CI (1.07–4.11)] were significantly associated with an increased likelihood of neonatal mortality after adjusting for other confounding variables. Qualitative findings suggested that bathing newborns after 24 h and wrapping in clean clothes were common newborn care practices. The mothers only attended postnatal care services if health problems appeared either in the mother or in the child.ConclusionResults of this study suggest that the current community based newborn survival intervention should provide an even greater focus to essential newborn care practices, low birth weight newborns, and female education.
Highlights
Neonatal mortality has remained unchanged since 2006 in Nepal
Delay in decision to seek care is influenced by who makes the decision like individual, spouse, relatives or family, status of women, perceived severity of illness, distance to health facility, financial and opportunity cost, previous exposure to health care system and perceived quality of care
This study aimed to identify the socio-demographic factors, maternal and newborn health care practices that contributed to neonatal deaths in Chitwan district of Nepal
Summary
Neonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal. A total of 6.3 million children under-5 died in 2013; of which, about 42 % occurred during neonatal period [1]. The 2.8 million newborn children died mainly from preventable causes such as preterm birth complications (35.7 %), intrapartum complications (23.4 %), and sepsis (15.6 %) [2]. Shah et al BMC Res Notes (2015) 8:818 care, second delay in arrival to a health facility, and third delay in receiving adequate care at health facility [4, 5]. Third delay in receiving adequate care at the facility is influenced by referral system; shortages of supplies, equipment, and human resources; and skills of the available human resources [5]
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