Determinants Of Neonatal Mortality Research Articles

Determinants of neonatal mortality among hospitalised neonates with sepsis at Queen Elizabeth Central Hospital, Blantyre, Malawi: A mixed-methods study.

Neonatal sepsis-related deaths remain a significant health problem contributing to higher morbidity and mortality rates, particularly in low resource settings, such as Malawi. However, there is limited information to associate risk factors and health system factors with mortality. This study investigated the risk factors associated with mortality and explored health system factors contributing to deaths among neonates with sepsis at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. This mixed-method study utilised a convergent parallel approach to describe the determinants of neonatal mortality among neonates with sepsis. We selected this design because it allowed the researchers to triangulate, support and enhance the internal and external validity of the results. We retrospectively reviewed 237 neonatal records using a simple random sampling technique for cross-sectional quantitative data. Exploratory qualitative data was collected using a semi-structured interview guide from 10 purposively selected healthcare workers directly involved in providing neonatal care through in-depth interviews. Quantitative data were analysed using univariate and multivariate logistic regression in Stata v.14; qualitative data were analysed manually using a thematic analysis approach. We found that gestation age (OR 0.76 (95% CI: 0.58, 0.99), p-value = 0.040) and number of days spent in the hospital (OR 0.64 (95% CI: 0.48, 0.85), p-value = 0.002) were the most predictive risk factors. The qualitative inquiry showed the maternal behavioural factors; reporting late to hospital, cultural and religious beliefs; maternal health related factors: prolonged labour, unnecessary vaginal examinations, premature rupturing of membranes; Neonatal factors: prematurity, meconium aspiration, home deliveries and lastly, health system factors included delay in treatment, referrals and blood culture results, limited resources contributed to documented clinical outcomes. Determinants of neonatal mortality were gestation age, number of days spent in the hospital, maternal behavioural and health related, neonatal and health system factors. Reducing mortality among neonates with sepsis will require a multi-sectoral approach.

Determinants of Neonatal Mortality at a Referral Paediatric Hospital in Angola: A Case–Control Study Using Theoretical Frameworks

Neonatal mortality rates in developing countries are influenced by a complex array of factors. Despite advancements in healthcare, Angola has one of the highest neonatal mortality rates in sub-Saharan Africa, with significant contributors including premature birth, intrapartum events, tetanus, and sepsis. This study, utilizing key theoretical frameworks such as intersectionality, social determinants of health (SDOH), and ecosocial theory, aimed to identify the primary causes and contributing factors of neonatal mortality among infants admitted to the Neonatology Service at DBPH in Luanda from May 2022 to June 2023. A retrospective matched case–control design was employed, pairing each neonatal death with two surviving neonates based on age and sex. The analysis included 318 newborns, of whom 106 experienced hospital deaths. A stepwise binary logistic regression model was used to examine associations between variables and neonatal mortality. Variables with p < 0.25 in bivariate analysis were included in the multivariate model. Significant factors associated with neonatal mortality included the following: a low Apgar score at 1 min (<7) (OR 2.172; 95% CI: 1.436–4.731); maternal age under 20 years (OR 3.746; 95% CI: 2.172–6.459); home delivery (OR 1.769; 95% CI: 1.034–3.027); and duration of illness before admission ≥ 3 days (OR 2.600; 95% CI: 1.317–5.200). Addressing these issues requires urgent interventions, including improving Apgar score management through enhanced training for healthcare professionals, supporting young mothers with intensified maternal education, ensuring deliveries occur in appropriate healthcare settings, and improving universal health coverage and referral systems. These measures could be crucial for enhancing neonatal care and reducing mortality.

Neonatal mortality in the 2011 JAKIDS birth cohort

ABSTRACT This study aimed to determine the mortality in a Jamaican birth cohort over a 3-month period. Data on the outcome of 87.5% of all births in Jamaica between July and September 2011 were used to determine trends in and determinants of neonatal mortality. There were 9650 live births and 144 neonatal deaths yielding a Neonatal Mortality Rate of 14.9/1000 (95% CI: 12.6–17.52/1000) livebirths. One hundred and twenty-one (84%) deaths occurred within the first seven days of life giving an Early Neonatal Mortality Rate of 12.5/1000 (95%CI: 10.4–15.0/1000) livebirths and a Late Neonatal Mortality Rate of 2.38/1000 (95%CI: 1.51–3.57/1000) live births. Sixty-nine (48%) deaths occurred within the first 24 hours. Thirty-eight neonates (26%) died prior to being admitted to a neonatal unit, approximately within 2 hours of life. Maternal age <15 years, decreasing birthweight, prematurity, male gender, multiple gestation and birth by caesarean section were associated with an increased risk of mortality p < 0.05. In order for Jamaica to experience further decline in its Neonatal Mortality Rate to meet the Sustainable Developmental Goal of at least as low as 12 per 1,000 live births by 2030 the focus must be on decreasing mortality in the very low birth weight infants who disproportionally contribute to mortality as well as continuing to implement measures to further decrease mortality in the larger infants.

Trends and population attributable risk estimates for individual and community-level factors of neonatal mortality in Pakistan (1990–2018)

PurposePakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue.Design/methodology/approachThe study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as “cases,” while those who survived beyond a specific timeframe were referred to as “noncases.” To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the “syncmrates” package in Stata 15.FindingsDuring the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly.Originality/valueThis study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604

Trend and Determinants of Neonatal Mortality at the Buea and Limbe Regional Hospitals, Southwest Region, Cameroon

Background: Over the years the rate of neonatal mortality in low-income settings has been on the increase and most cases of neonatal mortality can be associated with modifiable risk factors. However, the rate of neonatal mortality remains high in Cameroon with the Southwest Region having one of the highest rates of neonatal mortality. Objectives: We aimed to determine the trend and determinants of neonatal mortality in Buea and Limbe Regional Hospitals. Method and Materials: A hospital based retrospective study of files of neonates was conducted from the 1st of January 2017 to the 31st of December 2022. Socio-demographic, clinical and outcome data were obtained using a data extraction form and analyzed using Statistical Package for Social Science (SPSS) Version 27. Results: The trend of neonatal mortality was apparently constant (16.1% and 17.8%) between 2017 to 2022. Birth asphyxia 150(53.4%) was found to be the most common cause of neonatal mortality. Identified determinants were: acute fetal distress (AOR:2.6 [1.333-5.346]), no ANC visit (AOR:13.1 [3.849-44.284]), birth weight less than 2500g (AOR:2.050 [0.039-4.216]), birth weight greater than 4000 g (AOR:2 [1.002-3.43]), Apgar Score ˂ 3 (AOR:99.9 [87.036-100.000]) and Apgar score ˂ 6 (AOR=5.164 [1.768-15.082]). Conclusion: Neonatal mortality in our context is still below the expectations of SDG3 with perinatal asphyxia and its related modifiable factors influencing neonatal mortality the most. Therefore, more impactful community education and information sessions to build a positive mind set on pregnant women and their families to reduce neonatal mortality is required from all health sectors.

Determinants of neonatal mortality in Amhara regional state, Ethiopia: Further investigation of EDHS 2016

Background Globally, 2.4 million newborns died in the first month of life in 2019, approximately 6,700 newborn deaths every day-with about a third of all neonatal deaths occurring within the first day after birth and occurring within the first week of life 1.

Determinants of Neonatal Mortality in the United States.

Introduction Despite a notable reduction in infant mortality over recent decades, the United States, with a rate of 5.8 deaths per 1,000 live births, still ranks unfavorably compared to other developed countries. This improvement appears inadequate when contrasted with the country's healthcare spending, the highest among developed nations. A significant proportion of this infant mortality rate can be attributed to neonatal fatalities. Objective The present study aimed to determine the risk factors associated with neonatal deaths in the United States. Method Using the United States Vital Statistics records, we conducted a retrospective study on childbirths between 2015 and 2019 to identify risk factors for neonatal mortality. Our final multivariate analysis included maternal parameters like age, insurance type, education level, cesarean section rate, pregnancy inductions and augmentations, weight gain during pregnancy, birth weight, number of prenatal visits, pre-existing conditions like chronic hypertension and prediabetes, and pregnancy complications like gestational diabetes mellitus (GDM). These variables were incorporated to enhance our model's sensitivity and specificity. Result There were 51,174 neonatal mortalities. Mothers with augmentation of labor had a 25% reduction in neonatal mortalities (NM) (OR=0.75; 95% CI 0.72-0.79), while labor induction was associated with a 31% reduction in NM (OR=0.69; 95% CI 0.66-0.72). Women above 40 years had a 29% increase in NM rate (OR=1.29;95% CI 1.15-1.44). Women without prenatal care have a 22% increase in the risk of NM (OR=1.22; 95% CI 1.14-1.30). The present model has a 60.7% sensitivity and a 99.9% specificity. Conclusion In the present study, significant interventions such aslabor induction, augmentation, and prenatal care were associated with improved neonatal outcomes. These findingscould serve as an algorithm for improving neonatal outcomes in the United States.

Determinants of neonatal mortality in Margaret Kenyatta Mother Baby Wing at Nakuru level 5 hospital, Nakuru County, Kenya

Background: Nakuru county has 41.9 neonatal deaths per 1000 live births, more than double the national average of 19. This study examined Nakuru level 5 hospital neonatal mortality risk factors. Methods: A retrospective mismatched case-control study was used. The 429 neonates (143 cases and 286 controls) were estimated assuming a 1:2 case-to-control ratio and 18% prevalence of exposure among controls. Binary logistic regression measured dependent-independent variable correlation. Results: The study found that high parity, high number of stillbirths, positive HIV, HBsAg, syphilis, pregnancy-induced hypertension, antepartum hemorrhage, PROM 18hours, and maternal peri-partum increased the risk of neonatal. Similarly, mothers who had fewer ANC visits throughout their pregnancy had a higher risk of neonatal mortality compared to mothers who attended more than three ANC clinics, with mortality risk reducing by 69% and 59% for 1-2 visits and more than 3 visits, respectively, compared to non-attendance. Vaginal aided birth had an or of 2.188 and vaginal unassisted OR=4.533 compared to caesarian delivery. Antibiotics and prenatal dexamethasone decreased maternal mortality. Antibiotics lowered NMR or 0.381. Newborns admitted from referral facilities or labor wards had or 1.11 and or 6.220 death rates. Low birth weight, admission weight, gain weeks, and congenital defects increased mortality. In this study, birthweight decreased newborn mortality. Conclusions: The study concluded that maternal characteristics, neonatal complications are key to improving neonatal outcomes. The study recommends regular training of staff working in the maternity and newborn unit on emergency care and neonatal resuscitation.

Determinants of neonatal mortality in the neonatal intensive care unit of Dilla University Referral Hospital, Southern Ethiopia; 2019–2020; A matched, case–control study

BackgroundNeonatal mortality rate (NMR) refers to the number of deaths occurring from birth to 28 days of life per-1000 Live Births (LB). The global NMR declined from 37 deaths per- 1,000 LB in 1990 to 18 in 2017, whereas it was 27 deaths per 1000 LB in the Sub-Saharan region. Ethiopia plans to reduce the NMR from 28 deaths to 11 deaths per 1,000 LB by 2020 and to end all preventable child deaths by 2035. The aim of this study was to identify the determinants of neonatal mortality in the neonatal intensive care unit (NICU) of Dilla University Referral Hospital (DURH). MethodsAn age-matched case control study was conducted at DURH's NICU. Two controls having age 2 days before or after the case were used for matching. One hundred eighteen cases (died) and 236 controls (survived) neonates admitted to the NICU from January 11, 2018, to February 25, 2020, were studied. Missed data were filled by multiple imputations. Multicollinearity was checked by the variance inflation factor. For variables with a P-value <0.2 on bivariable conditional logistic regression, multivariable conditional logistic regression analysis was performed to control for confounders using clogit command in a survival package to identify the risk factors for neonatal mortality using R version 3.6.3. ResultGestational age <37 weeks (Adjusted matched odds ratio (AmOR): 14.02; 95% confidence interval (CI): 3.68–53.46), first-minute APGAR score <7 (AmOR: 5.68; 95% CI: 1.76–18.31), perinatal asphyxia (PNA) (AmOR: 4.62; 95% CI: 1.15–18.53) and being twins (AmOR: 6.84; 95% CI: 1.34–34.96) were significantly associated with neonatal deaths in our study. Furthermore, antenatal care and follow-up during pregnancy (AmOR: 0.15; 95% CI: 0.04–0.53) and having a normal random blood sugar level at admission (AmOR: 0.1; 95% CI: (0.02–0.66) were found to be determinant of neonatal mortalities in our study. ConclusionGestational age less than 37 weeks, first-minute APGAR scores <7, being twins, diagnosis of PNA, antenatal care and follow-up of mothers during pregnancy and normoglycemia in neonates at admission were significant determinant of neonatal death in the NICU of DURH.

Determinants of Neonatal Mortality: A Case Study in Sleman District

Background: Neonatal mortality is a significant global health problem. Most of the cases occur in low and middle-income countries including Indonesia. In Sleman District, Yogyakarta for the last five years, the neonatal mortality rate has not improved and remains high. This research aimed to identify the root causes of newborn deaths in Sleman District.Methods: A case study approach was used with qualitative methods to describe and discuss five infant mortality cases in Sleman District. This study involved in-depth interviews with 3 mothers of neonates as the main informants, three public figures as society representatives, and other health stakeholders represented by local midwives in Sleman District.Results adn Discussion: There were 12 sub-themes identified in this study that reflected 3 main themes associated with neonatal mortality which are: 1) the neonates’ condition: premature birth, pneumonia, low birthweight, and immaturity of vital organs; 2) the maternal factors: psychological stress, hypertension, diabetes, and obesity; and 3) the healthcare system: midwives’ roles, village cadre roles, and health data collection of mothers and children.Conclusion: Generally, the causes of neonatal mortality were due to prematurity and multiple fetuses; therefore, in-depth screening is needed to prevent neonatal mortality.Keywords: Determinant; Neonatal Mortality; Healthcare System; Case Study.

Determinant Factors of Neonatal Mortality in Preeclampsia Mother

BACKGROUND: Preeclampsia (PE) is a specific multisystemic disorder in pregnancy and a significant cause of maternal and fetal death. The percentage of infant mortality due to preeclampsia is greater than maternal mortality. Infant mortality occurs due to several risk factors in mothers with preeclampsia. AIM: This study aims to analyze the determinants of infant mortality in mothers with preeclampsia. METHODS: An observational analytic study with a cross-sectional design was undertaken at the Department of Obstetrics and Gynecology at the Koja Hospital, North Jakarta, from June to September 2021. Three hundred and twenty-eight research subjects met the research criteria. Bivariate analysis using Chi-square and Fisher’s exact test and multivariate analysis using logistic regression test. All data analyzed with SPPS version 22.0 RESULTS: In this study, there was no relationship between maternal age (p = 0.842), body mass index (p = 0.768), education (p = 0.345), occupation (p = 1,000), mode of delivery (p = 0.753), anemia (p = 0.707), leukocytosis (p = 0.772), hypoalbuminemia (p = 0.688), and bacteriuria (p = 0.245) with neonatal mortality in mothers with preeclampsia. In addition, the results showed that the factors that contributed to neonatal mortality in mothers with preeclampsia were parity (PR (CI 95%) =15.279 (2.304–101.301); p = 0.005) and proteinuria (PR (CI 95%) =9.649 (1.123–82.875); p = 0.039). CONCLUSION: It can be concluded that parity and proteinuria are determinants of neonatal mortality in mothers with preeclampsia.

Determinants of neonatal mortality among preterm births in Black Lion Specialized Hospital, Addis Ababa, Ethiopia: a case–cohort study

BackgroundPreterm neonatal death is a global burden in both developed and developing countries. In Ethiopia, it is the first and fourth cause of newborn and under-5 deaths, respectively. From 2015...

Incidence and determinants of neonatal mortality in the first three days of delivery in northwestern Ethiopia: a prospective cohort study

BackgroundAddressing sustainable development goals to reduce neonatal mortality remains a global challenge, and it is a concern in Ethiopia. As a result, the goal of this study was to assess the incidence and determinants of neonatal mortality in the first 3 days among babies delivered in the referral hospitals of the Amhara National Regional State.MethodsA hospital-based prospective cohort study was conducted among 810 neonates in the first 3 days of delivery between March 1 and August 30, 2018. The neonates were followed up from the time of admission to 72 h. Interviewer-administered questionnaires and medical record reviews were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analysed using STATA™ version 16.0. The neonate’s survival time was calculated using the Cox-Proportional hazards model.ResultsThe overall incidence of neonatal mortality in this study was 151/1000 births. Neonatal mortality was significantly higher among neonates whose mothers came between 17 and 28 weeks of gestation for the first visit; among those whose mothers labour was not monitored with a partograph, mothers experienced postpartum haemorrhage and developed a fistula first 24 h, and experienced obstructed labour. However, 39% were less risky among neonates whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-h, both.ConclusionsThis study revealed that approximately 1 in 7 neonates died within the first 3 days of life. The determinants were the timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking care. Thus, scaling up evidence-based interventions and harmonising efforts to improve antenatal care quality, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.

Determinants of neonatal mortality among newborns admitted in neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern, Ethiopia: unmatched case control study

BackgroundAround two and half million neonatal mortality occurred in 2017, especially in developing countries. This study was conducted to determine the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern Ethiopia.MethodsAn unmatched case-control study was conducted from February, 24 to March 6, 2020 at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by statistical package for social science software Version 22.Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95 % CI and P-values < 0.05 were used to declare statistical significance.ResultsIn this study, a total of 304 cases were assessed with 100 % reviewed rate. It was found that referrals from other health facilities, [AORs = 2.43, 95 % CI (1.14, 5.22)], gestational age < 37 weeks,[AORs = 2.50, 95 % CI (1.12, 5.58)], the weight of newborn < 2500 g, [AORs = 2.44, 95 % CI (1.13, 5.28)], neonates positive for sepsis, [AORs = 2.45, 95 % CI (1.11, 5.41)]and neonates who not breastfed within first hour after delivery,[AORs = 5.24, 95 % CI (2.42, 11.37)] were statistically significant determinants to neonatal mortality.ConclusionsThis study suggests that referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. This study shows that neonatal intensive care unit service should be strengthened in Dilla University Referral Hospital; targeting neonate aged below 28 days. Most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care.

Geospatial analysis of determinants of neonatal mortality in Ghana

BackgroundGhana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana.MethodsThe study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant.ResultsPopulation density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05].ConclusionNeonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.

Socio-demographic determinants of neonatal mortality in Algeria according to MICS4 data (2012-2013).

Neonatal mortality remains a public health problem in developing countries, including Algeria. Information on this indicator makes it possible to assess government efforts to improve the living conditions of target populations. This study aims to identify some determinants associated with this mortality from data of multiple indicator cluster survey conducted in Algeria in 2012-2013 (mics 4). A retrospective case-control study including 1047 cases and 1041 controls. From a logistic regression model, we appreciated the role of different factors, socio-demographic, economic and geographic (Mother's age, level of education, wealth index, area of residence) in newborn survival. The main factors associated with neonatal mortality were rural residence (p<0.01; OR= 1.3; CI 1.08-1.54), South geographical area (p<0.05; OR=1.5; CI 1.18-1.84), low education level of mother (p<0.01; OR= 2.10; CI 1.35- 3.29), early age of maternal procreation (p<0.001; OR=4.34; CI 2.19- 14.40), the birth rank "7 and over" (<0.01; OR = 1.57; CI 1.13 - 2.44) and the two lowest wealth indices (p <0.001; OR = 2; 1.45-2.62 and p <0.01; OR = 1.66; CI 1.23-2.26). In addition to the various reproductive health strategies already adopted by the authorities for health promotion and family planning, action should be taken to evaluate their implementation with sustained assistance for disadvantaged people and in risk areas.

Differentials and determinants of neonatal mortality in Pakistan: A cross sectional analysis; Pakistan Demographic and Health Survey (2017-18).

To investigate differentials and determinants of neonatal mortality in Pakistan. The cross-sectional data-based study was conducted at Lahore College for Women University, Lahore, Pakistan from February to July 2019, and comprised data obtained from the Pakistan Demographic and Health Survey 2017-18 which related to the period from November 22, 2017, to April 30, 2018. Neonatal mortality rates were computed to observe the differentials in relation to various categories of socio-demographic factors. Cox proportional hazard model was used to identify significant factors affecting neonatal mortality. Hazard of neonatal mortality significantly decreased as household size increased (hazard ratio: 0.41 and 0.36). Household with improved toilet facility had significantly lower chances (hazard ratio: 0.57) of neonatal death compared to that with unimproved toilet facility. Significantly elevated risk (hazard ratio: 5.56) of neonate death was observed in case of multiple births. Children had better chances (hazard ratio: 0.32 and 0.34) of surviving in neonatal period as duration of birth spacing increased (24-35 months; 36 or more months). Household size, improved toilet facilities, multiple births and preceding birth intervals had significant effect on neonatal mortality.

Differential and Determinants of Neonatal Mortality: A Comparative Study in Northern and Southern Regions of India.

Background:The Government of India initiated different programs to reduce neonatal mortality. However, the variability of neonatal deaths occurs among states of India.Objective:This study aimed to identify the differential determinants associated with neonatal deaths in northern and southern regions of India.Materials and Methods:Bivariate analysis and Cox regression analysis have been performed to evaluate the predictors of neonatal mortality from National Family Health Survey (NFHS-4) data.Results:For neonatal mortality, mother and child factors became more consistent in the southern region than northern regions of the country, while household factor was almost the same in both regions of India.Conclusions:Primary intervention is also required to reduce public health problem as neonatal mortality. It should be focused on education of mother, birth interval, age at birth, antenatal care, poverty reduction programs, and proper heath facility to pregnant mothers.

Trends and determinants of neonatal mortality in Uganda: Analysis of the Uganda demographic and health surveys

Background : Uganda’s neonatal mortality has stagnated at 27 deaths per 1,000 live births over the past decade. Studying consistent factors could inform policy to reduce it. Data Source and Methods : We used Uganda Demographic and Health Surveys (2001 to 2016) in analyses. Results : Children who were not put on breast milk immediately after birth and children of mothers with multiple maternal risk factors were associated with higher odds (3.1 and 2.0 respectively) of neonatal deaths in 2016. The maternal risk factors include: young mothers, too old, short birth intervals or many children. Neonatal deaths was also higher among male compared to female newborns. Conclusion: There is a need to raise awareness about the importance of breastfeeding newborns immediately after birth. Interventions to reduce maternal risk factors are critical to reducing neonatal mortality in Uganda. Programmes need measures that can reduce more neonatal deaths among male than female.

Neonatal Mortality and Maternal/Child Health Care in Nigeria: An Impact Analysis

Reducing the rate of mortality in neonates to as low as 12 per 1,000 live births is one of the clearly spelt out aims of the third tenet of the Sustainable Development Goals (SDG) because of its importance to the dynamics of population. While there have been various studies focused majorly on the causes, rates and determinants of neonatal mortality in Nigeria, studies on the impact of maternal/child care characteristics on neonatal mortalityand the potential implication of failing to attain the SDG target for neonatal mortality have seemingly been neglected. In this study, we undertake an analysis of the impact of maternal / child care characteristics on neonatal mortality using the logistic regression model. Results from the study showed that antenatal care (P-value = 0.000, odds ratio = 0.546 for women who visited the hospital during pregnancy on more than 5 occasions), post natal care (P-value = 0.004, odds ratio = 0.402 for women who received early neonatal care from skilled medical personnel), place ofdelivery (P-value = 0.000, odds ratio = 0.592 for babies that were delivered in a government hospital) and skill of birth attendant (P-value = 0.000, odds ratio = 0.706 for babies who were delivered by trained doctors/nurses/midwives) had significant impact on neonatal mortality at the 95% confidence level implying that improved maternal health care: before, during and immediately after delivery as well as the quality of care to motherand child are both important and necessary to the reduction of neonatal mortality in Nigeria. To achieve the sustainable development target for neonatal mortality, it is therefore recommended that stake holders in the public health sector improve the quality of existing health care facilities and access to quality services.&#x0D; Keywords: Neonatal mortality, logistic regression, maternal care, child health care, Nigeria