Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, P.O. Box 1145, Dessie, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMC Public Health. 2024 Aug 30;24(1):2364. doi: 10.1186/s12889-024-19880-1.
Early neonatal deaths, occurring within the first six days of life, remain a critical public health challenge. Understanding the trends and factors associated with this issue is crucial for designing effective interventions and achieving global health goals. This study aims to examine the trends in early neonatal mortality in Ethiopia and identify the key factors associated with changes in early neonatal mortality over time.
This study utilized five consecutive Ethiopian Demographic and Health Survey datasets from 2000 to 2019. To investigate the trends and identify factors influencing changes in early neonatal mortality over time, conducted a trend analysis and a logit-based multivariate decomposition analysis. Data management and analyses were performed using STATA version 17/MP software. All analyses were weighted to account for sampling probabilities and non-response. Statistical significance was determined at a two-sided p-value threshold of less than 0.05.
The analysis included a total of 12,260 weighted women from the 2000 survey and 5,527 weighted women from the 2019 survey. Over the study period, there was an overall downward trend in early neonatal mortality, decreasing from 34 deaths per 1000 live births in 2000 to 27 deaths per 1000 live births in 2019. The annual rate of reduction was estimated to be 1.03%. Approximately 45% of the observed decline in early neonatal mortality rate can be attributed to changes in population characteristics or endowments (E) during the study period. Factors such as the mother's age, maternal education, marital status, preceding birth interval, types of pregnancy, and the sex of the child significantly contributed to the compositional change in the early neonatal mortality rate.
Over the past two decades, Ethiopia has seen a modest decline in early neonatal mortality, but this progress falls short of the Sustainable Development Goal (SDGs) targets. To achieve the SDGs, the Ministry of Health and its partners should intensify efforts to reduce early neonatal mortality. Strategies like preventing early/late pregnancies, promoting appropriate marriage timing, and prioritizing education could help further reduce early neonatal deaths. Further research is also needed to explore the factors driving this issue.
新生儿早期死亡发生在生命的头六天内，仍然是一个严重的公共卫生挑战。了解这一问题的趋势和相关因素对于制定有效的干预措施和实现全球卫生目标至关重要。本研究旨在探讨埃塞俄比亚新生儿早期死亡率的趋势，并确定与新生儿早期死亡率随时间变化相关的关键因素。
本研究利用了 2000 年至 2019 年的五次连续埃塞俄比亚人口与健康调查数据集。为了研究趋势并确定随时间变化影响新生儿早期死亡率的因素，进行了趋势分析和基于对数的多元分解分析。使用 STATA 版本 17/MP 软件进行数据管理和分析。所有分析均经过加权处理，以考虑抽样概率和无响应。双侧 p 值小于 0.05 被认为具有统计学意义。
该分析共纳入了 2000 年调查的 12260 名加权女性和 2019 年调查的 5527 名加权女性。在研究期间，新生儿早期死亡率总体呈下降趋势，从 2000 年的每 1000 例活产 34 例死亡降至 2019 年的每 1000 例活产 27 例死亡。估计每年下降率为 1.03%。在研究期间，人口特征或禀赋（E）的变化约占新生儿早期死亡率观察到的下降的 45%。母亲的年龄、母亲的教育程度、婚姻状况、前次分娩间隔、妊娠类型以及儿童的性别等因素显著导致新生儿早期死亡率的构成变化。
在过去的二十年中，埃塞俄比亚的新生儿早期死亡率有所下降，但这一进展落后于可持续发展目标（SDGs）的目标。为了实现 SDGs，卫生部及其合作伙伴应加大努力降低新生儿早期死亡率。预防早期/晚期妊娠、促进适当的结婚时机以及优先考虑教育等策略可能有助于进一步降低新生儿早期死亡。还需要进一步研究来探讨推动这一问题的因素。
