Association of postnatal care with neonatal mortality in India: evidences from DLHS-4 data

Abstract

Background: About 0.76 million neonates die every year in India, the highest for any country in the world. Globally antenatal care (ANC) and postnatal care (PNC) of the new born is being promoted as a strategy to reduce neonatal deaths. This paper examines the association of PNC and advice given to women about care of neonates with neonatal mortality in India.Methods: Used DLHS-4 data (2012-13), 319965 ever married women aged 15-49 years from 21 States/UTs of India were covered. Overall 89876 (96.46%) live births were reported from last pregnancy. Bivariate and multiple logistic regression were used to examine associations between exposure and outcome variables.Results: Almost 50% of mothers did not receive advices about neonate care. Children whose mothers did not advised for breastfeeding were 1.42 time more likely to die (CI= 1.16-1.75, p<0.001) than those who received this advice. Crude odds ratio for advice on keeping the neonate warm was 1.43 (CI=1.19-1.71, p<0.001), for advice on cleanliness was 1.55 (CI=1.25-1.93, p<0.001), for better nutrition for mother and child was 1.28 (CI=1.04-1.57, p=0.022). Neonates whose weight were not measured were 1.63 times (CI=0.94-1.67) more likely to die than those whose weight were measured, though this result was not statistically significant. The odds ratios were not much different when the socioeconomic and demographic characteristics were adjusted in the model.Conclusions: Neonatal mortality was high among those who did not receive advices during ANC for new born care and PNC check-up for neonates. Though Government of India launched a number of interventions their implementation needs to be strengthened.