Basha Garoma Wakjira, Woya Ashenafi Abate, Tekile Abay Kassa
Department of Statistics, College of Science, Bahir Dar University.
Afr Health Sci. 2020 Jun;20(2):715-723. doi: 10.4314/ahs.v20i2.23.
The first 28 days of life, the neonatal period, are the most vulnerable time for a child's survival. Neonatal mortality accounts for about 38% of under-five deaths in low and middle income countries. This study aimed to identify the determinants of neonatal mortality in Ethiopia.
The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). Once the data were extracted; editing, coding and cleaning were done by using SAS 9.4.Sampling weights was applied to ensure the representativeness of the sample in this study. Both bivariate and multivariable logistic regression statistical analysis was used to identify determinants of neonatal mortality in Ethiopia.
A total of 11,023 weighted live-born neonates born within five years preceding the 2016 EDHS were included this in this study. Multiple logistic regression analysis showed that multiple birth neonates (Adjusted Odds Ratio (AOR)=6.38;95%-Confidence Interval (CI):4.42-9.21), large birth size (AOR=1.35; 95% CI: 0.28-1.62), neonates born to mothers who did not utilize ANC (AOR=1.41; 95% CI: 1.11-1.81), neonates from rural area (AOR=1.88; 95% CI: 1.15-3.05) and neonates born in Harari region (AOR=1.45; 95% CI: 0.61-3.45)had higher odds of neonatal mortality. On the other hand, female neonates (AOR=0.60; 95% CI: 0.47-0.75), neonates born within the interval of more than 36 months of the preceding birth (AOR=0.56; 95% CI: 0.43-0.75), neonates born to fathers with secondary and higher education level (AOR=0.51; 95%CI: 0.22-0.88) had lower odds of neonatal mortality in Ethiopia.
To reduce neonatal mortality in Ethiopia, there is a need to implement sex specific public health intervention mainly focusing on male neonate during pregnancy, child birth and postnatal period. A relatively simple and cost-effective public health intervention should be implemented to make sure that all pregnant women are screened for multiple pregnancy and if positive, extra care should be given during pregnancy, child birth and postnatal.
生命的头28天，即新生儿期，是儿童生存最脆弱的时期。在低收入和中等收入国家，新生儿死亡率约占五岁以下儿童死亡人数的38%。本研究旨在确定埃塞俄比亚新生儿死亡的决定因素。
本研究使用了具有全国代表性的2016年埃塞俄比亚人口与健康调查（EDHS）的数据。数据提取后，使用SAS 9.4进行编辑、编码和清理。应用抽样权重以确保本研究中样本的代表性。采用双变量和多变量逻辑回归统计分析来确定埃塞俄比亚新生儿死亡的决定因素。
本研究纳入了2016年埃塞俄比亚人口与健康调查前五年内出生的11,023名加权活产新生儿。多因素逻辑回归分析显示，多胞胎新生儿（调整优势比（AOR）=6.38；95%置信区间（CI）：4.42 - 9.21）、出生体重较大（AOR = 1.35；95% CI：0.28 - 1.62）、母亲未接受产前护理的新生儿（AOR = 1.41；95% CI：1.11 - 1.81）、农村地区的新生儿（AOR = 1.88；95% CI：1.15 - 3.05）以及在哈拉里地区出生的新生儿（AOR = 1.45；95% CI：0.61 - 3.45）的新生儿死亡几率较高。另一方面，女性新生儿（AOR = 0.60；95% CI：0.47 - 0.75）、上次分娩间隔超过36个月出生的新生儿（AOR = 0.56；95% CI：0.43 - 0.75）、父亲具有中等及以上教育水平的新生儿（AOR = 0.51；95% CI：0.22 - 0.88）在埃塞俄比亚的新生儿死亡几率较低。
为降低埃塞俄比亚的新生儿死亡率，有必要实施针对性别的公共卫生干预措施，主要在孕期、分娩期和产后关注男婴。应实施相对简单且具有成本效益的公共卫生干预措施，以确保对所有孕妇进行多胎妊娠筛查，若筛查结果为阳性，则在孕期、分娩期和产后给予额外护理。
