Prevalence and determinants of early neonatal mortality in Ethiopia: findings from the Ethiopian Demographic and Health Survey 2016

Abstract

BackgroundEarly neonatal death accounts for a significant number of under-5 mortality worldwide. However, the problem is under-researched and under-reported in low-income and middle-income countries, particularly in Ethiopia. The magnitude of mortality during the early neonatal period and associated factors should be studied for designing appropriate policies, and strategies that could help tackle the problem. Hence, this study aimed to determine the prevalence and identify factors associated with early neonatal mortality in Ethiopia.MethodsThis study was conducted by using data from Ethiopian Demographic and Health Survey 2016. A total of 10 525 live births were enrolled in the study. A multilevel logistic regression model was used to identify determinants of early neonatal mortality. Adjusted OR (AOR) at a 95% CI was computed to assess the strength and significance of the association between outcome and explanatory variables. Factors with a p<0.05 were declared statistically significant.ResultsThe national prevalence of early neonatal mortality in Ethiopia was 41.8 (95% CI 38.1 to 45.8) early neonatal deaths per 1000 live births. The extreme ages of pregnancy (under 20 years (AOR 2.7, 95% CI 1.3 to 5.5) and above 35 years (AOR 2.4, 95% CI 1.5 to 4)), home delivery (AOR 2.4, 95% CI 1.3 to 4.3), low birth weight (AOR 3.3, 95% CI 1.4 to 8.2) and multiple pregnancies (AOR 5.3, 95% CI 4.1 to 9.9) were significantly associated early neonatal mortality.ConclusionsThis study revealed a higher prevalence of early neonatal mortality as compared with prevalence in other low-income and middle-income countries. Thus, it is determined to be essential to design maternal and child health policies and initiatives with a priority on the prevention of early neonatal deaths. Emphasis should be given to babies born to mothers at extreme ages of pregnancy, to those born of multiple pregnancies delivered at home and to low birthweight babies.

Time, cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals, northwest Ethiopia: a prospective follow-up study

“…The possible explanation for this difference might be study design, availability of medical equipment, NICU setup, sample size difference, and the fact that nearly all of the critically ill neonates in our study area were brought in from referred cases throughout the Amhara region, including Benishangul Gumuz region. The numbers in our study were also higher than the national-level population-based survey (41.8 deaths per 1,000 live births) ( 38 ) and the average national mini-EDHS 2019 (33 deaths per 1,000 live births). A possible explanation might be that because our study was conducted in the NICU, those critical neonates were admitted while the national average mini-EDHS included high-risk, low-risk, full neonatal period, and healthy neonates.…”

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“…The possible explanation for this difference might be study design, availability of medical equipment, NICU setup, sample size difference, and the fact that nearly all of the critically ill neonates in our study area were brought in from referred cases throughout the Amhara region, The overall Kaplan-Meier failure estimates of early neonatal deaths admitted to Bahir Dar City public hospitals, northwest Ethiopia, 2023. including Benishangul Gumuz region. The numbers in our study were also higher than the national-level population-based survey (41.8 deaths per 1,000 live births) (38) and the average national mini-EDHS 2019 (33 deaths per 1,000 live births). A possible explanation might be that because our study was conducted in the NICU, those critical neonates were admitted while the national average mini-EDHS included high-risk, low-risk, full neonatal period, and healthy neonates.…”

Burden of early neonatal mortality in Sub-Saharan Africa. A systematic review and meta-analysis

“…The included studies were either cross-sectional (n = 8), retrospective (n = 4) or prospective studies (n = 2) [ 5 , 8 , 17 – 28 ]. Of all studies five studies were conducted in Ethiopia [ 8 , 17 , 25 , 27 , 28 ], two in Nigeria [ 19 , 23 ], two in Ghana [ 5 , 21 ], two in Tanzania [ 22 , 26 ], one in Cameroon [ 18 ], one in Central Africa [ 20 ] and one in Malawi and Zambia [ 24 ]. All studies in this review were published in the year between 2009 and 2023.…”