Risk Factors of Neonatal Mortality in Ethiopia: Applications of Survival Analysis Methods
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Date
2013-06
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Addis Ababa University
Abstract
Neonatal m011ality accounts for almost 40 percent of under-five child mortality, globally
(WHO 2005). An understanding of risk factors related to neonatal mot1ality is important
to guide the development of focused and evidence-based health interventions to reduce
neonatal deaths. This study aimed to identifY the risk factors of neonatal mortality in
Ethiopia. The data source for the analysis was the 20 II EDI-IS data from whi ch survival
information of 8,651 li ve-born neonates born fi ve years before the survey was examined.
Stratified Cox-proportional hazards model was employed to analyze risk factors
associated with neonatal deaths, using socio-economic, demographic and maternal health
service factors. About 71 % and 79% of the neonatal deaths occurred within the first and
second weeks of follow-up time, respectively. The estimated hazard ratios of mortali ty
were higher for twins or multiple births (HR=3.728, 95% CI: 2.813-4.942), first order
birth (HR=1.675 , 95% CI: 1.252-2.242), male sex (HR=1.26, 95% CI: 1.057-1.50 I), birth
interval shorter than 24 months (HR=1.633, 95% CI:1.3 12-2.032), very small and very
large sized neonates at birth, (HR=1.833, 95% CI:I.457-2.305) and (HR=1.966, 95%
CI: 1.535-2.5 19), respectively, neonates born to mothers aged less than 20 years and
above 34 yeaTs, (HR=1.382, 95% CI:1.051-1.8 18) and (HR=1.323, 95% CI:1.060-2.799),
respectively, and neonates whose mothers had a history of pregnancy complications (HR
= 1.732, 95% CI: 1.266-2.239). The risk of dying were lower for neonates whose mothers
attended antenatal visits (HR=0.716, 95% CI: 0.577-0.889) and neonates put to breast
immediately upon birth (HR=0.828, 95% Cl: 0.693-0.989). Thus, public health
interventions directed at reducing neonatal death should address demographic and
maternal health service factors which significantly influence neonatal mortality in
Ethiopia.
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Keywords
Risk Factors of Neonatal Mortality in Ethiopia