The Role of Place of Delivery in Preventing Neonatal and Infant Mortality Rate in India

Hazi Mohammad Azamathulla,Barkha Chaplot,Ujjwal Das

doi:10.3390/geographies1010004

Abstract

Skilled birth attendance and institutional delivery have been advocated for reducing maternal, neonatal mortality and infant mortality (NMR and IMR). This paper examines the role of place of delivery with respect to neo-natal and infant mortality in India using four rounds of the Indian National Family Health Survey conducted in 2015–2016. The place of birth has been categorized as “at home” or “public and private institution.” The role of place of delivery on neo-natal and infant mortality was examined by using multivariate hazard regression models adjusted for clus-tering and relevant maternal, socio-economic, pregnancy and new-born characteristics. There were 141,028 deliveries recorded in public institutions and 54,338 in private institutions. The esti-mated neonatal mortality rate in public and private institutions during this period was 27 and 26 per 1000 live births respectively. The study shows that when the mother delivers child at home, the chances of neonatal mortality risks are higher than the mortality among children born at the health facility centers. Regression analysis also indicates that a professionally qualified provider′s antenatal treatment and assistance greatly decreases the risks of neonatal mortality. The results of the study illustrate the importance of the provision of institutional facilities and proper pregnancy in the prevention of neonatal and infant deaths. To improve the quality of care during and imme-diately after delivery in health facilities, particularly in public hospitals and in rural areas, accel-erated strengthening is required.

Highlights

Neonatal deaths account for a major proportion of the world’s pediatric deaths
Looking at private health facilities, highest percentage of births delivered in southern states, e.g., in Kerala 61% of birth delivered in public hos-pital followed by Telangana 58%, Andhra Pradesh 53% and Tamil Nadu 32%
In complete contract in neo-natal and infant mortality due to health facility highest mortality in public and private hospital both are found in the states of Uttar Pradesh followed by Chhattisgarh and Madhya Pradesh and Bihar respectively

Summary

Introduction

Neonatal deaths account for a major proportion of the world’s pediatric deaths. Glob-ally, the neonatal mortality declined from 37 deaths in 1990 to 18 deaths per 1000 live births in 2017, but that decline was slower than the decline in mortality among children aged 1–59 months [3]. In 2018, 2.5 million children died in the first month of life-approximately 7000 neonatal deaths every day, with one third dying on the first day of life [4]. There exist marked disparities in neonatal mortality across regions and countries. Re-gionally, neonatal mortality was highest in sub-Saharan Africa and South Asia, with each estimated at 28 and 26 deaths per 1000 live births in 2018, respectively [4]

Methods

Results

Discussion

Conclusion