Abstract
BackgroundNeonatal mortality in many low-and middle-income countries (LMICs) remains high despite global efforts at addressing this challenge. Tackling neonatal death in LMICs is further complicated by lack of reliable data from individual countries in the region to inform effective context specific interventions. This study investigates the probability of neonatal survival and socio-demographic risk factors of neonatal mortality in Ghana.MethodsPooled data from three population-based surveys (N = 12,148) were analysed using multivariable Cox Proportional Hazards regression models.ResultsThe risk of dying within the first 28 days of life was highest in the first week of life (early neonatal period), it then decreases sharply around the middle of the second week of life and remains low over the late neonatal period. Adjusted hazard ratios (HRs) showed that: rural residency (HR = 1.80, 95% CI: 1.15-2.75); birth order 2-3 (HR = 1.63, 95% CI: 1.10-2.42); birth order ≥7 (HR = 1.89, 95% CI: 1.07-3.33) increased the risk of neonatal death. Additionally, children born to women who were obese had higher risk of neonatal death (HR = 1.69, CI: 1.12-2.56) compared with those of women with optimal weight. Disparities in the risk of neonatal death by geographical regions were also found.ConclusionThe risk of neonatal mortality is highest during the first week of life and it is socio-demographically patterned. The findings emphasise the need to tackle socio-demographic risk factors of neonatal mortality in order to achieve the Sustainable Development Goal 3, which is aimed at reducing neonatal mortality to 12 per 1000 live births by the year 2030.
Highlights
Neonatal mortality in many low-and middle-income countries (LMICs) remains high despite global efforts at addressing this challenge
Public health interventions undertaken since 1990 to reduce under-five mortality have been mainly driven by the Millennium Development Goal (MDG) 4, which aimed at a two-thirds reduction in mortality risks of children under-five between 1990 and 2015
This study used high quality data pooled from three population-based studies conducted in 2003, 2008 and 2014 to investigate socio-demographic risk factors of neonatal mortality in Ghana
Summary
Neonatal mortality in many low-and middle-income countries (LMICs) remains high despite global efforts at addressing this challenge. Child mortality has decreased globally over the past one and half decades. The levels in most low- and middle-income countries (LMICs), in SubSaharan Africa is unacceptably high. Public health interventions undertaken since 1990 to reduce under-five mortality have been mainly driven by the Millennium Development Goal (MDG) 4, which aimed at a two-thirds reduction in mortality risks of children under-five between 1990 and 2015. Despite the success achieved through the MDGs over the past one and half decades, neonatal mortality figures are still unacceptably high in most LMICs. With a few exceptions, Sub-Saharan Africa is among the regions, which did not meet the MGDs targets. Among the LMICs, Sub-Saharan African countries have the largest burden of neonatal mortality
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