Abstract
Abstract
Background
Communities and their composition have an impact on neonatal mortality. However, considering the smallest health administrative units as communities and investigating the impact of these communities and their composition on neonatal mortality in Ghana have not been studied. Therefore, this study aimed to investigate the effect of community-, household- and individual-level factors on the risk of neonatal mortality in two districts in Ghana.
Methods
This was a longitudinal study that used the Kintampo Health and Demographic Surveillance System as a platform to select 30,132 neonatal singletons with 634 deaths. Multilevel cox frailty model was used to examine the effect of community-, household- and individual-level factors on the risk of neonatal mortality.
Results
Regarding individual-level factors, neonates born to mothers with previous adverse pregnancy (aHR = 1.38, 95% CI: 1.05–1.83), neonates whose mothers did not receive tetanus toxoid vaccine (aHR = 1.32, 95% CI: 1.08–1.60) and neonates of mothers with Middle, Junior High School or Junior Secondary School education (aHR = 1.30, 95% CI: 1.02–1.65) compared to mothers without formal education, had a higher risk of neonatal mortality. However, female neonates (aHR = 0.61, 95% CI: 0.51–0.73) and neonates whose mother had secondary education or higher (aHR = 0.37, 95% CI: 0.18–0.75) compared to those with no formal education had a lower risk of mortality. Neonates with longer gestation period (aHR = 0.95, 95% CI: 0.94–0.97) and those who were delivered at home (aHR = 0.56, 95% CI: 0.45–0.70), private maternity home (aHR = 0.45, 95% CI: 0.30–0.68) or health centre/clinic (aHR = 0.40, 95% CI: 0.26–0.60) compared to hospital delivery had lower risk of mortality. Regarding the household-level, neonates belonging to third quintile of the household wealth (aHR = 0.70, 95% CI: 0.52–0.94) and neonates belonging to households with crowded sleeping rooms (aHR = 0.91, 95% CI: 0.85–0.97) had lower risk of mortality.
Conclusion
The findings of the study suggest the risk of neonatal mortality at the individual- and household-levels in the Kintampo Districts. Interventions and strategies should be tailored towards the high-risk groups identified in the study.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference72 articles.
1. UNICEF. Levels & Trends in child mortality. UNICEF, WHO, World Bank Group, UN; 2019. https://www.unicef.org/media/60561/file/UN-IGME-child-mortality-report-2019.pdf. Accessed 20 Nov 201.
2. United Nations Children’s Funds. Committing to child survival: a promise renewed; 2014. http://www.apromiserenewed.org. Accessed 25 Jun 2017.
3. United Nations Children’s Funds. Committing to child survival: a promise renewed; 2015. http://www.apromiserenewed.org. Accessed 30 Jun 2017.
4. World Health Organisation. Fact Sheet. 2016. http://www.who.int/mediacentre/factsheets/fs178/en/. Accessed 20 Feb 2018.
5. World Health Organisation. Newborns: reducing mortality. 2019. https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Accessed 20 Nov 2019.
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