Neonatal Mortality in the Eastern Mediterranean Region: Socio-Demographic, Economic and Perinatal Factors, 1990 - 2013

Abstract

Background: The neonatal mortality rate (NMR) is considered amongst the most important socioeconomic and health indicators of a community development. Globally, it has been reported that the daily mortality rate during the neonatal period is much higher (30-fold) than the post-neonatal period. In the Eastern Mediterranean Region, about 40% of the under-5 mortality occurs in the neonatal period. This study aimed to explore the association between the socio-economic, demographic and perinatal care related factors, and the neonatal mortality in the Eastern Mediterranean Region. Methods: The secondary data for the 1990 to 2013 on neonatal mortality rates, socio-demographic, socio-economic and health factors were extracted from official websites, including united nations children’s fund (UNICEF), world health organization (WHO), and united nations educational, scientific and cultural organization (UNESCO). Data were collected using the following keywords: ‘neonatal mortality’, ‘perinatal deaths’, ‘child health, education’, ‘expenditure on health’, ‘safe water’, ‘sanitation’ and ‘health indicators’. We used secondary data analysis to explore the relationship between the possible explanatory variables and neonatal mortality using correlation coefficient analysis. Results: There was a noticeable decline in neonatal mortality rates (NMR) among the Eastern Mediterranean countries from 1990 to 2013. The neonatal mortality rate had a negative and significant association with literacy status of both sexes, annual growth rates, antenatal care coverage, birth attendance by skilled health personnel, Gross National Income (GNI), total health expenditure per capita, safe drinking water and adequate sanitation facilities. However, the neonatal mortality rate had significant and positive relationships with maternal mortality ratio, total fertility rate, population size, total births and low birth weight. Conclusion: Despite the fall in the neonatal mortality rate, it remains high in the Eastern Mediterranean countries. Socioeconomic and other related factors appear to play a major role in determining neonatal mortality and there is an inverse relationship between socioeconomic status and the neonatal mortality rate. Neonatal health in Eastern Mediterranean countries needs a more effective and innovative approach to sustain the rapid progress in the overall reduction of child mortality.