scholarly journals Factors associated with neonatal mortality in the general population: evidence from the 2007 Zambia Demographic and Health Survey (ZDHS); a cross sectional study

Author(s):  
Etambuyu Lukonnga ◽  
Charles Michelo
BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051161
Author(s):  
Bekahegn Girma ◽  
Jemberu Nigussie

ObjectiveThis study aimed to assess the magnitude of preterm neonatal mortality in hospitals and associated factors in northern Ethiopia.DesignInstitutional-based cross-sectional study.SettingComprehensive specialised hospitals in the Tigray region, northern Ethiopia.ParticipantsPreterm neonates admitted in Ayder and Aksum comprehensive specialised hospitalsPrimary outcomeMagnitude of preterm neonatal mortality.Secondary outcomeFactors associated with preterm neonatal mortalityResultThis study was conducted from 1 April 2019 to 15 May 2019 among 336 participants with a response rate of 96.8%. The magnitude of preterm neonatal mortality was 28.6% (95% CI: 24.0 to 33.7). In multivariable logistic regression, respiratory distress syndrome (adjusted odd ratio (AOR)=2.85; 95% CI: 1.35 to 6.00), apnoea of prematurity (AOR=5.45; 95% CI: 1.32 to 22.5), nulli parity (AOR=3.63; 95% CI: 1.59 to 8.24) and grand parity (AOR=3.21; 95% CI: 1.04 to 9.94) were significant factors associated with preterm neonatal mortality. However, receiving Kangaroo mother care (AOR=0.08; 95% CI: 0.03 to 0.20) and feeding initiated during hospitalisation (AOR=0.07; 95% CI: 0.03 to 0.15) were protective against preterm neonatal mortality.ConclusionsThe magnitude of preterm neonatal mortality in hospitals was still high. Interventions geared towards curbing preterm in-hospital neonatal mortality should strengthen early diagnosis and treatment of preterm newborns with respiratory distress syndrome and apnoea of prematurity; while concomitantly reinforcing the implementation of kangaroo care and early feeding initiation is important.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031986
Author(s):  
Dabere Nigatu ◽  
Demewoz Haile ◽  
Bereket Gebremichael ◽  
Yordanos M Tiruneh

ObjectivesThe study was designed to evaluate the accuracy of maternally perceived baby birth size assessments as a measure of birth weight and examine factors influencing the accuracy of maternal size assessments.Study designCross-sectional study.SettingThe study is based on national data from the 2016 Ethiopian Demographic and Health Survey.ParticipantsWe included 1455 children who had both birth size and birth weight data.Main outcome measuresPredictive accuracy of baby birth size for low birth weight. Level of discordance between maternally perceived birth size and birth weight including factors influencing discordance.ResultsMother-reported baby birth size had low sensitivity (57%) and positive predictive value (41%) to indicate low birth weight but had high specificity (89%) and negative predictive values (94%). The per cent of agreement between birth weight (<2500 g vs ≥2500 g) and maternally perceived birth size (small size vs average or above) was 86% and kappa statistics indicated a moderate level of agreement (kappa=0.41, p<0.001). Maternal age, wealth index quintile, marital status and maternal education were significant predictors of the discordance between birth size and birth weight.ConclusionsMaternal assessment of baby size at birth is an inaccurate proxy indicator of low birth weight in Ethiopia. Therefore, a mother’s recall of birth size should be used as a proxy indicator for low birth weight with caution and should take maternal characteristics into consideration.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e053196
Author(s):  
Rafi Amir-ud-Din ◽  
Hafiz Zahid Mahmood ◽  
Faisal Abbas ◽  
Muhammad Muzammil ◽  
Ramesh Kumar ◽  
...  

ObjectivesThis study analysed the association between breast feeding (BF) and birth interval (BI) (both succeeding and preceding) with neonatal mortality (NM), infant mortality (IM) and under-5 mortality (U5M).DesignThis cross-sectional study used data from the Pakistan Demographic and Health Survey 2017–2018.SettingsAll provinces, Islamabad and Federally Administered Tribal Areas were included in the analysis.ParticipantsA total of 12 769 children born to ever-married multiparous women aged 30–49 years who gave live birth within 5 years preceding the interview. Multiple births are not included.Data analysisMultivariate logistic regression analysis was used.ResultsWe found that BF was associated with nearly 98% lower risk of NM (OR 0.015; 95% CI: 0.01 to 0.03; p<0.001), 96% lower risk of IM (OR 0.038; 95% CI: 0.02 to 0.06; p<0.001) and 94% lower risk of U5M (OR 0.050; 95% CI: 0.03 to 0.08; p<0.001). Compared with optimal preceding birth interval (PBI) (36+ months), short PBI (<18 months) was associated with around six times higher risk of NM (OR 5.661; 95% CI: 2.78 to 11.53; p<0.001), over five times risk of IM (OR 4.704; 95% CI: 2.70 to 8.19; p<0.001) and over five times risk of U5M (OR 4.745; 95% CI: 2.79 to 8.07; p<0.001). Disaggregating the data by child’s gender, place of residence and mother’s occupational status showed that being ever breast fed was associated with a smaller risk of NM, IM and U5M in all three disaggregations. However, the risk of smaller PBI <18 months was generally more pronounced in female children (NM and U5M) or when the children lived in rural areas (NM, IM and U5M). PBI <18 months was associated with greater risk of NM and IM, and smaller risk of U5M when mothers did a paid job.ConclusionThis study’s significance lies in the fact that it has found BF and BI to be consistent protective factors against NM, IM and U5M. Given Pakistan’s economic constraints, optimal BF and BI are the most cost-effective interventions to reduce child mortality.


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