Abstract
BackgroundThe rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors.MethodsA hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.ResultsOne thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07–9.84) and no formal education (aOR 2.16; 95% CI 1.12–4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32–0.86) and caesarean section (aOR 0.44; 95% CI 0.19–0.99) had negative associations with NNM.ConclusionsMaternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.
Highlights
The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries
Neonatal near miss (NNM) is a novel concept that has recently emerged and is similar to maternal near miss (MNM). It provides vital information required for evaluation of the quality of care in hospitals and explores opportunities to improve the performance of healthcare providers [5]
Shifting the focus from neonatal mortality towards NNM and associated factors can be useful information for policymakers to improve neonatal care. This cross-sectional study was conducted on 1000 newborns and their mothers admitted to the postnatal ward in Koshi Hospital, Morang district, Nepal
Summary
The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The neonatal mortality rate in Nepal was 21 per 1,000 live births in 2016; about four-fifths (79%) of all neonatal deaths were early neonatal deaths and 57% of all births were institutional births [4]. Nepal needs to reduce its neonatal mortality rate by half in the 10 years to achieve SDG3.2. Neonatal near miss (NNM) is a novel concept that has recently emerged and is similar to maternal near miss (MNM). It provides vital information required for evaluation of the quality of care in hospitals and explores opportunities to improve the performance of healthcare providers [5]. NNM evaluations can provide abundant evidence of the causal pathways responsible for neonatal deaths [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
