Survival analysis of factors associated with neonatal mortality in rural areas of Ethiopia: Evidence From the 2019 EMDHS
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Date
2024-06
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Addis Ababa University
Abstract
Neonatal mortality carries the highest chance of death among all childhood mortality rates. Despite efforts to meet the Sustainable Development Goals, Ethiopia's overall neonatal mortality rate (NMR) was increased from 29 to 33 over the last three decades. This study is aimed to investigate the risk factors affecting neonatal mortality in rural Ethiopia. The study included 4,425 live births from women aged 15- 49 in the 5 years prior to the 2019 EMDHS. Multivariate Cox-Proportional hazard modeling and Kaplan-Meier estimates to assess the neonates' survival probability and to analyze the relationship between explanatory variables and neonatal death. The early neonatal mortality rate (ENMR) was 30.96 (95% CI: 26.3, 38) and the NMR was 36.9 (95% CI: 31.7, 42.9) according to the Kaplan-Meier estimations. Several important risk factors were discovered using the Cox-proportional hazard model, including multiple births, advanced maternal age, grand multiparous and multiparous, large household size, immediate breast feeding, and the use of maternal contraceptives have been associated with lower risk of neonatal mortality, whereas male neonates, short birth intervals, and cesarean delivery are linked to higher risk. The highest risk of neonatal death occurred in the first week of life. The main predictors of neonatal death were the sex of the neonate, parity, immediate breastfeeding, multiple birth, maternal contraceptive use, and delivery method. Interventions should focus on improving the accessibility and quality of delivery services, with special attention to multiple births, and promoting antenatal care, family planning, and immediate breastfeeding
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multiple births, and promoting antenatal care, family planning