The magnitude of neonatal mortality and its predictors in Ethiopia: a systematic review and meta-analysis

Abstract

AbstractsBackground: Although neonatal death is a global burden, it is the highest in Sub Saharan Africa countries such as Ethiopia. This study was aimed to provide pooled national prevalence and predictors of neonatal mortality in Ethiopia. Objective:To assess the pooled prevalence and predictors of neonatal mortality in Ethiopia.Search Strategy: global databases were systematically explored. Systematically searched using the following databases: Boolean operator, Cochrane library, PubMed, EMBASE, HINARI, and Google Scholar. Selection, screening, reviewing and data extraction was done by two reviewers independently using Microsoft excel spread sheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence Selection criteria: All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included Data Collection and Analysis: Data were extracted using a Microsoft Excel spreadsheet software and imported into STATA Version 14 s for further analysis. The pooled effect size with 95% confidence interval of neonatal mortality rate was determined using a weighted inverse variance random-effects model. Publication bias was checked using funnel plots, Egger's and bagger's regression test. Heterogeneity also checked by Higgins's method. A random effects meta-analysis model was computed to estimate the pooled effect size (i.e. prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size and study design were done. Results:After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 11.9, 20.7, I 2 =88.6%). The subgroup analysis indicated that the highest prevalence was observed in Amhara region with a prevalence of 20.3% (95% CI: 9.6, 31.1, I 2 =98.8) followed by Oromia, 18.8% (95%CI: 11.9,49.4, I 2 =99.5). Gestational age AOR,1.14 (95% CI: 0.94 ,1.3), neonatal sepsis (OR:1.2(95% CI: 0.8, 1.5), respiratory distros (OR: 1.2(95% CI: 0.8, 1.5) and place of residency (OR:1.93 (95% CI:1.1,2.7) were the most important predictor.Conclusions: neonatal mortality in Ethiopia was significantly decreased than the national report.There was evidence that neonatal sepsis, gestational age, respiratory distress were the significant predictors. We strongly recommended that health care workers should give a priority for the identified predictors.

Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study

“…Hypothermia and oxygen saturation < 90% during transportation was an independent predictor of neonatal death. This study is similar to a previous study conducted in Ethiopia [ 11 ], Mauritania [ 28 ], and India [ 2 , 12 ]. Lack of emergency care on the way to higher centers, poor stabilization before referral and inadequate care during transport increase clinical instability [ 2 , 41 ].…”

“…However, neonatal mortality still continues increase from 29 to 30 deaths per 1000 live births between 2016 and 2019 and varies across regions. According to research finding neonatal mortality in the Amhara regional state is 20.3% [ 4 , 9 – 11 ].…”

Bayesian Spatial Analysis of Factors Influencing Neonatal Mortality and its Geographic Variation in Ethiopia

“…The current study showed that neonates born to mothers residing in rural areas were at higher risk of neonatal mortality compared with those living in urban areas. This nding is in line with a meta-analysis nding in Ethiopia [10], a study in Nigeria [29] and another study from Gansu province China [55]. This can be related to the limited access to obstetric and neonatal care services such as low institutional delivery and caesarean delivery rates [56], limited sanitation and water supplies and a lower proportion of education and awareness about neonatal care in the rural areas [57].…”

“…Evidence from studies on neonatal survival in Ethiopia report inconsistent neonatal mortality rates. A meta-analysis that pooled prevalence studied showed an overall neonatal mortality rate of 163.5 per 1000 live births [10]. A nding from another systematic review and meta-analysis of 11 studies conducted after 2012 in Ethiopia reported a neonatal mortality rate of 67.8 per 1000 live births [11], but with considerable heterogeneity.…”

Bayesian spatial analysis of factors influencing neonatal mortality and its geographic variation in Ethiopia

“…Like most Sub-Saharan countries, Ethiopia has a high neonatal mortality rate [10][11][12][13]. In 2012, Ethiopia had the sixth-highest neonatal mortality rate globally, with an estimated death of 87,800 neonates or 31 deaths per 1000 live births [14,15].…”