Predictive model and determinants of odds of neonates dying within 28 days of life in Ghana

Abstract

Background One of the priorities and important current problem in public health research globally is modeling of neonatal mortality and its risk factors in using the appropriate statistical methods. It is believed that multiple risk factors interplay to increase the risk of neonatal mortality. To understand the risk factors of neonatal mortality in Ghana, the current study carefully evaluated and compared the predictive accuracy and performance of two classification models. Methods This study reviewed the birth history data collected on 5884 children born in the 5 years preceding the 2014 Ghana Demographic and Health Survey (GDHS). The 2014 GDHS is a cross‐sectional nationally representative household sample survey. The relevant variables were selected using leaps‐and‐bounds method, and the area under curves were compared to evaluate the predictive accuracy of unweighted penalized and weighted single‐level multivariable logistic regression models for predicting neonatal mortality using the 2014 GDHS data. Results The study found neonatal mortality prevalence of 2.8%. A sample of 4514 children born in the 5 years preceding the 2014 GDHS was included in the inferential analysis. The results of the current study show that for the unweighted penalized single‐level multivariable logistic model, there is an increased risk of neonatal death among babies born to mothers who received prenatal care from non‐skilled worker [OR: 3.79 (95% CI: 2.52, 5.72)], multiple births [OR: 3.10 (95% CI: 1.89, 15.27)], babies delivered through caesarian section [OR: 2.24 (95% CI: 1.30, 3.85)], and household with 1 to 4 members [OR: 5.74 (95% CI: 3.16, 10.43)], respectively. The predictive accuracy of the unweighted penalized and weighted single‐level multivariable logistic regression models was 82% and 80%, respectively. Conclusion The study advocates that prudent and holistic interventions should be institutionalized and implemented to address the risk factors identified in order to reduce neonatal death and, by large, improve child and maternal health outcomes to achieve the SDG target 3.2.

Multilevel modelling of neonatal mortality in Ghana: Does household and community levels matter?

“…Comparing the findings from a weighted single level logistic multivariable regression model used in our previous study [ 20 ] and the findings from a weighted two-level random intercept model used in the current study, notable differences were observed. For example, type of birth was not significant in our previous study but significant in the present study.…”

“…It is evident from previous studies that complex multiple risk factors such as mothers with a history of previous children who died in the first year of life, hospitalization during pregnancy, and low birth weight [ 14 ], preterm labor and intrapartum asphyxia [ 15 ], belonging to the poorest household wealth index quintile, male infants, first rank baby, smaller than average birth size and mothers with delivery complications [ 10 ], residing in a rural area, being a large body size baby and a mother experiencing pregnancy complication [ 16 ] were identified to increase the risk of neonatal mortality. However, most of these studies [ [17] , [18] , [19] , [20] ] have applied a single-level modeling approach to the data ignoring the hierarchical data structure. Neonatal mortality cannot be explained entirely by individual-level effects because persistent group effects vary across higher levels.…”

Influence of the Corporate Image of Nursing Homes on the Loyalty of Residents’ Family Members

“…As ref. [ 83 ] stated, values between 0.2 and 0.4 indicate an excellent fit, which is still a generally accepted benchmark range [ 84 , 85 ]. Accordingly, our model shows the goodness of fit.…”

Predictors of Preterm Neonatal Mortality in India and Pakistan: A Secondary Analysis of Data from PURPOSe Study

“…A study conducted in Ghana reported that neonatal and household factors have more predictive accuracy for preterm neonatal deaths within 28 days as compared to maternal factors. 22 Other studies suggest that neonatal factors are more predictive of neonatal death as compared to maternal factors alone. We also found that overall, preterm neonates with congenital malformations were more likely to die.…”