Background: Although global neonatal mortality declined by about 40 percent from 1990 to 2013, it still accounted for about 2.6 million deaths globally and constituted 42 percent of global under-five deaths. Most of these deaths occur in developing countries. Antenatal care (ANC) is a globally recommended strategy used to prevent neonatal deaths. In Kenya, over 90 percent of pregnant women attend at least one ANC visit during pregnancy. However, Kenya is currently among the 10 countries that contribute the most neonatal deaths globally.Objective: The aim of this study is to examine the effectiveness of ANC services in reducing neonatal mortality in Kenya.Methods: We used binary logistic regression to analyse cross-sectional data from the 2014 Kenya Demographic and Health Survey to investigate the effectiveness of ANC services in reducing neonatal mortality in Kenya. We determined the population attributable neonatal mortality fraction for the lack of selected antenatal interventions.Results: The highest odds of neonatal mortality were among neonates whose mothers did not attend any ANC visit (adjusted odds ratio [aOR] 4.0, 95% confidence interval [CI] 1.7–9.1) and whose mothers lacked skilled ANC attendance during pregnancy (aOR 3.0, 95% CI 1.4–6.1). Lack of tetanus injection relative to one tetanus injection was significantly associated with neonatal mortality (aOR 2.5, 95% CI 1.0–6.0). About 38 percent of all neonatal deaths in Kenya were attributable to lack of check-ups for pregnancy complications.Conclusions: Lack of check-ups for pregnancy complications, unskilled ANC provision and lack of tetanus injection were associated with neonatal mortality in Kenya. Integrating community ANC outreach programmes in the national policy strategy and training geared towards early detection of complications can have positive implications for neonatal survival.
Background: The inequity caused by health financing in Vietnam, which mainly relies on out-ofpocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring whether the Vietnamese are willing to pay enough to sufficiently finance a health insurance system.
Respiratory infection is a major cause of morbidity and mortality, globally. Acute respiratory symptoms are also related to high levels of air pollution. Interventions aimed at reducing exposure to indoor air pollution should focus on cooking and heating practices in developing countries. This study is not undermining the role of other biomass smoke constituents in determining respiratory infections.
Reported smoke exposure was not associated with an increased risk of asthma symptoms or airway obstruction. However, lifetime smoke exposure may explain the reduction in spirometric values in female subjects and with advancing age.
Both DSS and DHS approaches to mortality surveillance gave similar overall results, but both showed method-dependent advantages and disadvantages. In many settings, this kind of joint-source data analysis could offer significant added value to results.
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