Dessie Anteneh Mengist, Nigatu Dabere, Yadita Zemenu Shiferaw, Yimer Yalemwork Anteneh, Yalew Anteneh Kassa, Aychew Eden Workneh, Feleke Sefineh Fenta
Department of Public Health, College of Health Science Debre Tabor University Debre Tabor Ethiopia.
Department of Reproductive Health and population studies, School of public health, College of Medical & Health Sciences Bahir Dar University Bahir Dar Ethiopia.
Health Sci Rep. 2023 Oct 9;6(10):e1613. doi: 10.1002/hsr2.1613. eCollection 2023 Oct.
Neonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub-Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia.
A single-arm community-based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi-structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan-Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a -value < 0.05 was considered statistically significant.
The neonatal mortality rate was 44 (95% confidence interval [CI]: 33-60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21-2.23) per 1000 neonate days. Three-quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21-10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01-1.47), being male (AHR = 2.45, 95% CI: 1.12-5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52-11.10) were found to be predictors of neonatal mortality.
Neonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival.
新生儿期是儿童面临死亡风险最大的最脆弱时期。在全球范围内，每年有数以百万计的新生儿在出生后的第一个月内死亡。撒哈拉以南非洲地区，尤其是埃塞俄比亚受到的影响很大。然而，关于研究地区新生儿的生存状况及其死亡率的决定因素，信息却十分匮乏。因此，本研究旨在调查埃塞俄比亚西北部贾比泰南地区的新生儿死亡率及其预测因素。
2021年3月，对2020年8月至2021年2月期间出生的952名新生儿进行了一项单臂社区回顾性队列研究。通过半结构化问卷收集数据，并采用多阶段分层抽样技术从该地区选取1个城市社区和10个农村社区。然后，将总样本量按比例分配到这些选定的社区。通过社区诊断确定新生儿死亡情况。采用Kaplan-Meier曲线估计生存时间。使用Cox回归确定相关因素，估计风险比，P值<0.05被认为具有统计学意义。
每1000例活产儿的新生儿死亡率为44例（95%置信区间[CI]：33-60）；每1000个新生儿日的发病率为1.64例（95%CI：1.21-2.23）。四分之三的死亡发生在出生后的第一周。中等家庭财富指数（调整后风险比[AHR]=3.54；95%CI：1.21-10.35）、怀孕次数增加（AHR=1.22；95%CI：1.01-1.47）、男性（AHR=2.45，95%CI：1.12-5.35）以及出生后第一小时内未开始母乳喂养（AHR=4.00；95%CI：1.52-11.10）被发现是新生儿死亡的预测因素。
与国家目标相比，新生儿死亡率较高。财富、怀孕次数、新生儿性别和母乳喂养开始情况是与新生儿死亡相关的因素。因此，加强诸如在人群中提供性教育、在豁免服务中考虑中等财富指数的家庭以及为母亲提供关于早期开始母乳喂养的咨询等干预措施，将提高新生儿存活率。
