Multilevel Analysis on the Contextual Effect of Village and Sociodemographic Factors on Neonatal Death in Karanganyar, Central Java

Abstract

Background: Globally, the number of neo­natal death in 2018 was 7,000 cases per day. Three-quarters of deaths occurred in the first week of life and 40% of them died in the first 24 hours after birth. Neonatal death is affected by various factors such as direct factors from the baby and indirect factors from the mother. It is also affected by external factors such as socioeconomic conditions. This study aimed to examine the biological and socio-demographic factors affecting neonatal death in Karanganyar Regency, Central Java. Subjects and Method: This was a case control study conducted in Karanganyar, Central Java. The population was all infants at neonatal age in Karanganyar Regency. The sample was 200 respondents with 50 cases of neonatal death and 150 infants who were alive during the neonatal period. This study used fixed disease sampling. The dependent variable was neonatal death. The independent variables were Mid-Upper Arm Circumference (MUAC) of the mother, maternal age, maternal educa­tion, maternal occupation, total family income, number of maternal deliveries, and the Alert Village level. The data were analyzed using logistic regression analysis with STATA 14. Results: The risk of neonatal death decreased with maternal MUAC ≥ 23.5 cm (b=-1.19; 95% CI=-2.02 to -0.36; p=0.005); maternal age between 20–35 years (b=-0.98; 95%CI=-1.76 to -0.20; p=0.014); maternal education ≥Senior High School (b=-0.67; 95%CI=-1.46 to 0.12; p= 0.097); unemployed mothers (b= -1.07; 95% CI= -1.95 to -0.19; p= 0.017); total family income ≥Rp 1,833,000 (b= -1.17; 95%CI=-2.04 to -0.30; p=0.008); and the number of birth deliveries of 2-4 (b=-0.79; 95%CI=-1.53 to -0.05; p= 0.036). The level of Alert Village had a very low effect on the risk of neonatal death (ICC was <0.01%). Conclusion: Neonatal mortality is affected by maternal MUAC, maternal age, maternal education, maternal occupation, total family income, and number of maternal deliveries. The level of Alert Village has a very low effect on neonatal death. Keywords: Neonatal death, sociodemo­graphic, mother Correspondence: Amin Sukoco. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Su­tami 36A, Surakarta 57126, Indonesia. Email: soekotjo78@gmail.com. Mobile: +628132938­7610. Journal of Maternal and Child Health (2021), 06(02): 207-219 https://doi.org/10.26911/thejmch.2021.06.02.08