Abebe Haimanot, Wasie Abebaw, Yeshaneh Alex, Shitu Solomon, Mose Ayenew, Adane Daniel, Workye Haile, Gashu Molla
Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Pediatric Health Med Ther. 2021 Mar 19;12:129-139. doi: 10.2147/PHMT.S302363. eCollection 2021.
It is highly economical and commendable to identify the determinants of neonatal near miss which will be utilized as proxy determinants of neonatal mortality rate. However, neither determinants of neonatal mortality rate nor a determinant of a neonatal near miss are adequately investigated specifically within the study area. Therefore, this study is aimed to identify the determinants of neonatal near-miss among neonates admitted in hospitals of the Gurage zone, Southern Ethiopia.
Unmatched case-control study was conducted to identify factors associated with neonatal near-miss among neonates admitted in Gurage zone hospitals. A pre-tested structured interviewer-administered questionnaire was used to collect the data. Besides, data related to the clinical diagnosis of neonates and managements given were extracted from patient records. In this study, a total of 105 cases and 209 controls have participated. To recruit cases and controls consecutive sampling methods and simple random sampling techniques were used respectively. Data were entered using Epi Data software and exported to SPPS for analysis. To identify the determinate factors of the outcome variable binary and multivariable logistic regression were employed.
The determinate factors of the outcome variable include a history of abortion with AOR 3.9 [95%C1 3.53-10.15], referred from other health care institution AOR 7.53[95% CI 3.99-14.22], severe maternal morbidity during pregnancy AOR 4.57[95% CI 1.77-11.79], cesarean section mode of delivery 4.45[95% CI 1.76-11.25], and good essential newborn care knowledge AOR 3.33[95% CI 1.54-7.19].
In this study, easily modifiable/preventable maternal and health service utilization-related factors are increasing the menace of a neonatal near-miss in the Gurage zone. It is the signal that shows the primary health care program needs to be further enhanced to bring more desirable health outcomes and/or effectiveness of health policies needs to be examined to introduce more impactful strategies.
确定新生儿接近死亡的决定因素具有很高的经济性且值得称赞，这些因素可作为新生儿死亡率的替代决定因素。然而，在研究区域内，既没有对新生儿死亡率的决定因素进行充分调查，也没有对新生儿接近死亡的决定因素进行充分研究。因此，本研究旨在确定埃塞俄比亚南部古拉格地区医院收治的新生儿中接近死亡的决定因素。
开展了非匹配病例对照研究，以确定古拉格地区医院收治的新生儿中与接近死亡相关的因素。使用经过预测试的结构化访谈问卷收集数据。此外，从患者记录中提取了与新生儿临床诊断和所给予治疗相关的数据。本研究共有105例病例和209名对照参与。分别采用连续抽样方法和简单随机抽样技术招募病例和对照。数据使用Epi Data软件录入，并导出到SPPS进行分析。采用二元和多变量逻辑回归来确定结局变量的决定因素。
结局变量的决定因素包括流产史，比值比（AOR）为3.9[95%置信区间（CI）3.53 - 10.15]；从其他医疗机构转诊而来，AOR为7.53[95%CI 3.99 - 14.22]；孕期严重孕产妇疾病，AOR为4.57[95%CI 1.77 - 11.79]；剖宫产分娩方式，AOR为4.45[95%CI 1.76 - 11.25]；以及具备良好的基本新生儿护理知识，AOR为3.33[95%CI 1.54 - 7.19]。
在本研究中，易于改变/可预防的孕产妇因素和与卫生服务利用相关的因素正在增加古拉格地区新生儿接近死亡的威胁。这表明需要进一步加强初级卫生保健项目，以实现更理想的健康结果，和/或需要审视卫生政策的有效性，以引入更具影响力的策略。
