Abstract
BackgroundThe first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. In Ethiopia, despite a significant reduction in under-five mortality during the last 15 years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia.MethodsA community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant.ResultThe overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR = 3.643; 95% CI, 1.36–9.77), male neonates (AHR = 2.71; 95% CI, 1.03–7.09), neonates that mothers perceived to be small (AHR = 3.46; 95% CI, 1.119–10.704), neonates who had initiated exclusive breast feeding (EBF) after 1 h (AHR = 3.572; 95% CI, 1.255–10.165) and mothers who had no postnatal care (AHR = 3.07; 95% CI, 1.16–8.12).ConclusionNeonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.
Highlights
The first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children
Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals
Our study showed that stillbirth rate in the study area was 24 per 1000 births which is much lower than hospital based prospective cohort study in Uganda which reported stillbirth rate of 120 per 1000 births [9]
Summary
The first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Neonatal mortality (NNM) is the death of a baby within the first 28 days of life and is expressed as neonatal deaths per 1000 live births. Neonatal mortality has become an important public health issue in many developing countries. Among newborns in sub-Saharan Africa, about 1 among 36 children dies in the neonatal period, while in the world’s richest countries the neonatal death is 1 in 333 children [1]. In Sub-Saharan Africa, neonatal mortality accounts for 35% of all child deaths [2]. Ethiopia is the third highest neonatal mortality contributor in Africa with 187,000 neonatal deaths in 2015 [3]
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