The Association between Quality of The First Neonatal Visit Services with Neonatal Death: Data Analysis of 2017 IDHS

Abstract

Purpose : To assess the association between the quality of first neonatal visit with neonatal death in Indonesia. Methods : We conducted secondary analysis of the 2017 Indonesian Demographic and Health Survey (IDHS) which was analyzed with retrospective cohort design. We analyzed 6,561 last born children to women aged 15-49 in the 2 years before the survey. The association between the quality of first neonatal visit and other independent variables with neonatal death were analyzed by chi square test and poisson regression. Results : Newborns who did not recieve first neonatal visit services (aRR= 63.64; 95% CI=8.57-472.7) and newborns who received poor-quality of first neonatal visit services (aRR=21.01; 95%CI=2.82-156.4) had higher risk of neonatal death compared with newborns who received good-quality of first neonatal visit services by controlling for frequency of antenatal care, delivery characteristics, birth weight and infant sex. The majority (71%) of newborns who received good-quality first neonatal services were newborns in Java, Bali and NTB region. Low birth weight (LBW) infants (aRR=0.05; 95%CI=8.57-472.7) and male infants (aRR=15.93; 95%CI=8.24-30.80) had higher risk of neonatal death. Conclusion : Quality of first neonatal visit services, birth weight and infants sex were associated with neonatal death in Indonesia. Efforts to prevent neonatal deaths should be focused on quality and equality of first neonatal visit improvement and prevention and care for LBW infants.