Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v5 ◽

2019 ◽

Author(s):

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso ◽

Desalegn Tsegaw Hibstu

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of being small baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v4 ◽

2019 ◽

Author(s):

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso ◽

Desalegn Tsegaw Hibstu

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v1 ◽

2019 ◽

Author(s):

Desalegn Tsegaw Hibstu ◽

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Cox Regression ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

P Value ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. Objective The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), small sized baby (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated EBF after one hour (AHR=3.572; 95% CI, 1.255-10.165) and with mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion Neonatal mortality in study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

First Experience of Implementation of Kangaroo Mother Care in Punjab- Pakistan to Reduce Morbidity and Mortality in Preterm Infants

Annals of King Edward Medical University ◽

10.21649/akemu.v23i4.2197 ◽

2018 ◽

Vol 23 (4) ◽

pp. 496-502 ◽

Cited By ~ 1

Author(s):

Noreen Rasul ◽

Madeeha Rashid ◽

Aqeela Abbas ◽

Rubina Sohail

Keyword(s):

Birth Weight ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Kangaroo Mother Care ◽

Morbidity And Mortality ◽

Essential Newborn Care ◽

Skin Contact

The study was planned to assess the effect of Kangaroo Mother Care on preterm and stable neonates in reducing neonatal morbidity and mortality. This is a case series design of 121preterm and low birth weight neonates, weighing less than 2500 gram, enrolled from 1 August 2016 till31 January 2017.Kangaroo Mother Care is initiated after birth, after performing early essential newborn care practices. Weight gain of 20-30 gram for three consecutive days, establishment of breast-feeding for 20-30 minutes every two hourly and maintenance of body temperature at 37 degree centigrade is the discharge criteria. During the periodof six months, total number of deliveries was 6459, out of them spontaneous vaginal deliveries were 52.2% (3372) and caesarean sections were 47.7% (3087). In 55.4%neonate’s(both preterm and term)early essential newborn care was practiced.Total preterm were 290 (4.5%), out of them 121 (2%) neonates were kept inKangaroo Mother Care position and 129 (44%) were shifted to neonatal intensive care unit. 14% parents refused for KMC position and discharged. Mortality in preterm newborn in neonatal unit was 29.4% (without KMC) but no mortality occurred after 3 months follow up in KMC babies. All the neonates from KMC unitwere discharged in satisfactory condition and called for follow up investigations. All Kangaroo Mother Care babies had exclusive breast-feeding. Taken together, the results indicate that prolonged skin-to-skin contact and exclusive breast feeding reduces neonatal mortality and morbidity in birth weight 1.5 to 2.5 kg in stable neonates in hospital. However KMC is limited to SHL at present. Workshops are being conducted to teach other doctors and nurses for early essential newborn care and kangaroo mother care. They are still facing controversies and challenges in initiation of KMC in many hospitals. However it is essential to strengthen KMC services in healthcare facilities as it significantly reduces neonatal mortality.

Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions

BMJ Open ◽

10.1136/bmjopen-2020-041829 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041829

Author(s):

Wen Qu ◽

Qing Yue ◽

Yan Wang ◽

Jin Liuxing Yang ◽

Xi Jin ◽

...

Keyword(s):

Health Outcomes ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Western China ◽

Comparison Study ◽

Essential Newborn Care ◽

Breastfeeding Rate ◽

Care Practices ◽

Childbirth Care

ObjectiveTo explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).DesignA pre-comparison and post-comparison study.SettingThe study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.Participants46 hospitals that provide delivery services participated in the study.InterventionsEENC practices were introduced and implemented in the 46 hospitals.Outcome measuresThe changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).Results54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.ConclusionsThe introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.

Risk Factors of Stunting Among Children Aged 6-59 Months In Bensa District ISTRICT, Sidama Region, South Ethiopia: Unmatched Case-Control Study

10.21203/rs.3.rs-283465/v1 ◽

2021 ◽

Author(s):

TEMESGEN TAFESSE ◽

AMANUEL YOSEPH ◽

KALEB MAYISO ◽

TAYE GARI

Keyword(s):

Risk Factors ◽

Breast Feeding ◽

Formal Education ◽

Case Control Study ◽

Case Control ◽

Under Five ◽

South Ethiopia ◽

Male Sex ◽

Control Study

Abstract Background: Stunting remains one of the most common under-nutrition problems among children in the Ethiopia. Children aged 6-59 months share for 35–45% of the burden in endemic areas. Identifying the causes of stunting assists health planners to prioritize prevention strategies, and is a fundamental step for intervention. However, evidence scarce about risk factors of stunting among children aged 6-59 months in study area. Therefore, this study aimed to assess risk factors of stunting among children aged 6-59 months in Bensa district, South Ethiopia; 2019. Methods: A facility-based unmatched case-control study was conducted from January 10 to March 10, 2018 on a sample of 237(79 cases and 158 controls) children aged 6-59 months with their respective mothers. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered using EPINFO version 7 and WHO Anthro software version 3.0.1 and analyzed using SPSS version 20. Chi-square(X2) test was used to determine the overall association between explanatory and outcome variables. The variables were entered to the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) were computed to evaluate the presence and strength of associations. Results: Diarrhea in past two weeks (AOR = 2.71, 95% CI: 1.42-5.16) and male sex (AOR = 2.37, 95% CI: 1.224-4.59) were positively associated with stunting. The odds of stunting increased 2.7 times for children who had inappropriate exclusive breast feeding (AOR =2.07, 95%CI: 1.07-4.01) as compared to those who had the appropriate exclusive breast feeding. Having less than or equal to three under five children in the household (AOR = 2.18, 95%CI: 03-4.64), and mothers had no formal education (AOR =3.28, 95%CI: 1.56-6.924) were positively associated with stunting. Conclusions: Male sex, diarrhea in past two weeks, inappropriate exclusive breast feeding, number of the under five children in the household and mothers had no formal education were major predictors of the stunting. Educating mothers/care takers on Infant and Young Child Feeding practice. Findings support a focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition.

Study on outcome of guided newborn care in postnatal ward and common practices of newborn care among mothers followed in outpatient department at Hi-Tech medical college and hospital, Bhubaneswar

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213222 ◽

2021 ◽

Author(s):

Maneesha Sabat ◽

Suryakanta Swain ◽

Hemant Agrawal ◽

Aishwarya Panda ◽

Sthita Prajnya Beura ◽

...

Keyword(s):

Developing Countries ◽

Neonatal Mortality ◽

Neonatal Period ◽

Newborn Care ◽

Mortality Rates ◽

Essential Newborn Care ◽

Under Five ◽

Postnatal Ward ◽

Thermal Care ◽

Abdominal Colic

Background: Neonatal period is the most vulnerable phase in a child's life. The aim and goal of newborn care is not only to reduce neonatal mortality but more importantly to ensure their survival to the fullest. The neonatal mortality rate of India is 22 per 1000 live births. The neonatal period is only for 28 days yet it accounts for significant deaths under 5 years of age. Newborn morbidity and mortality contribute significantly to the infant mortality and under-five mortality rates in developing countries. About two-thirds of all infant deaths and 38% of all under-five deaths occur during the neonatal period, resulting in about 4 million neonatal deaths globally per year. Infant and under-five mortality ratio in developing countries have declined significantly in the past couple of decades, yet neonatal mortality rates have remained relatively static. The objective of this study was to understand the outcome of guided newborn care along with the patterns and determinants of essential newborn care and practices.Methods: A prospective cohort study was done among newborns in the postnatal ward and the outpatient (OPD) based newborns at HMCH Bhubaneswar from July 2020 to June 2021. The mothers in the postnatal ward were taught cord care, skin care, optimal thermal care and neonatal feeding practices. The regular follow-up was done maximum up to 7 days. Newborn who came to OPD were evaluated on perspective of essential newborn care and practices, followed by their mothers at home. A questionnaire was formulated for the OPD based patients to be answered before and after guidance.Results: 100 early neonates were taken (N=50 from postnatal ward and N=50 from OPD). Out of 50 neonates in the postnatal ward. 4 (8%) had abdominal colic, 10 (20%) had skin rashes, 2 (4%) had fever, 5 (10%) had feeding issues and 9 (18%) had neonatal hyperbilirubinemia respectively. In OPD neonates 3 (6%) were diagnosed with early onset neonatal sepsis (EONS), 7 (14%) had refusal to feed, 12 (24%) had skin rashes, 5 (10%) had abdominal colic, 14 (28%) were applying coconut oil and 7 (14%) developed hyperbilirubinemia. Whereas in OPD 5 (10%) neonates needed admission NICU and rest were managed symptomatically.Conclusions: Newborn care education and guidance helped in reduction of EONS, in gaining appropriate weight, in delivering optimal thermal care, practicing healthy skin care and implementing proper feeding techniques. All mothers need proper counselling and guidance in essential newborn care.

Essential newborn care practice and its associated factors in Southwest Ethiopia

Archives of Public Health ◽

10.1186/s13690-021-00568-6 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Haimanot Abebe ◽

Daniel Adane ◽

Solomon Shitu

Keyword(s):

Associated Factors ◽

Newborn Care ◽

Care Practice ◽

Framework Analysis ◽

Cross Sectional ◽

Essential Newborn Care ◽

Southwest Ethiopia ◽

The Past ◽

Newborn Care Practice ◽

Abstract Background Essential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02. Result Overall good essential newborn care practice was found to be 41.0% [95%CI, 36.6–44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03–2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14–5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21–2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65–5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47–3.10] were significantly associated with good essential newborn care practice. Conclusion This study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.