Neonatal mortality and its risk factors in Eastern Ethiopia: A prospective cohort study in Kersa health and demographic surveillance system (Kersa HDSS)

Abstract

Background: Neonatal mortality continues to be a major problem in Ethiopia though the country has registered a good progress in under five age child mortality in the last decade. This paper focuses on identifying the risk factors for neonatal mortality based on data from Kersa Health and Demographic Surveillance (Kersa HDSS), Eastern Ethiopia for the period from 2007 to 2012. Methods: The analysis used data extracted from Kersa HDSS. Kersa HDSS was established in 2007 and uses an open cohort surveillance. Data extraction includes all live births recorded in the system. The main outcome was the occurrence of death within the first 28 days after birth. The survival time was calculated in days between the date of birth and the date of death. Kaplan-Meier survival curve was used to depict the pattern of death in the first 28 days and Cox-proportional hazard model was used to identify the risk factors of the neonatal death. Results: The overall, the early and the late neonatal mortality rates were 28.37, 19.55 and 8.82 per 1000 live births, respectively. The person days Neonatal Mortality Rate was 1 per 1000 (95% CI, 0.87-1.15). The hazard of neonatal mortality was increased among twin born (HR=5.40; 95% CI, 3.64-8.02), preterm birth (HR=11.17; 95% CI, 7.17-17.40), and previous sibling death (HR=2.15; 95% CI, 1.39-3.33) and among women with no previous birth (HR=1.78; 95% CI, 1.17-2.72). Conclusions: Neonatal mortality is high and is in line with the national average. Majority of the deaths occurred during the early neonatal period. Detecting risk factors such as twin pregnancy and previous child death during antenatal care (ANC) and promoting institutional delivery helps in identifying and dealing with the causes early.