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Cited by 234Global Maternal and Child HealthMaternal and Neonatal HealthcareInfant Development and Preterm Care

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Neonatal mortality in Ethiopia: trends and determinants

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Mekonnen, Yared, Tensou, Biruk, Telake, Daniel S, Degefie, Tedbabe, Bekele, Abeba·2013·BMC Public Health
DOI 10.1186/1471-2458-13-483PMC PMC3659057
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Abstract

BACKGROUND: The Ethiopian neonatal mortality rate constitutes 42% of under-5 deaths. We aimed to examine the trends and determinants of Ethiopian neonatal mortality. METHODS: We analyzed the birth history information of live births from the 2000, 2005 and 2011 Ethiopia Demographic and Health Surveys (DHS). We used simple linear regression analyses to examine trends in neonatal mortality rates and a multivariate Cox proportional hazards regression model using a hierarchical approach to examine the associated factors. RESULTS: The neonatal mortality rate declined by 1.9% per annum from 1995 to 2010, logarithmically. The early neonatal mortality rate declined by 0.9% per annum and was where 74% of the neonatal deaths occurred. Using multivariate analyses, increased neonatal mortality risk was associated with male sex (hazard ratio (HR) = 1.38; 95% confidence interval (CI), 1.23 - 1.55); neonates born to mothers aged < 18 years (HR = 1.41; 95% CI, 1.15 - 1.72); and those born within 2 years of the preceding birth (HR = 2.19; 95% CI, 1.89 - 2.51). Winter birth increased the risk of dying compared with spring births (HR = 1.28; 95% CI, 1.08 - 1.51). Giving two Tetanus Toxoid Injections (TTI) to the mothers before childbirth decreased neonatal mortality risk (HR = 0.44; 95% CI, 0.36 - 0.54). Neonates born to women with secondary or higher schooling vs. no education had a lower risk of dying (HR = 0.68; 95% CI, 0.49 - 0.95). Compared with neonates in Addis Ababa, neonates in Amhara (HR: 1.88; 95% CI: 1.26 - 2.83), Benishangul Gumuz (HR: 1.75; 95% CI: 1.15 - 2.67) and Tigray (HR: 1.54; 95% CI: 1.01 - 2.34) regions carried a significantly higher risk of death. CONCLUSIONS: Neonatal mortality must decline more rapidly to achieve the Millennium Development Goal (MDG) 4 target for under-5 mortality in Ethiopia. Strategies to address neonatal survival require a multifaceted approach that encompasses health-related and other measures. Addressing short birth interval and preventing early pregnancy must be considered as interventions. Programs must improve the coverage of TTI and prevention of hypothermia for winter births should be given greater emphasis. Strategies to improve neonatal survival must address inequalities in neonatal mortality by women's education and region.

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Crossref · 10.1186/1471-2458-13-483

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Figures

Figure 1 Indicators of completeness and quality of the Ethiopian neonates birth history data: 2000, 2005 and 2011 DHS. (A) Relative standard error. (B) proportion of living and dead children with non-missing month and year of birth. (C) birth ratio. (D) Age pattern of neonatal death. (E) NMR for year 2000 based on two data sources- 2000 and 2005 DHS.
Figure 1 Indicators of completeness and quality of the Ethiopian neonates birth history data: 2000, 2005 and 2011 DHS. (A) Relative standard error. (B) proportion of living and dead children with non-missing month and year of birth. (C) birth ratio. (D) Age pattern of neonatal death. (E) NMR for year 2000 based on two data sources- 2000 and 2005 DHS.CC BY · PubMed Central
Figure 2 Trends in Neonatal, Early and Late Neonatal Mortality rate (in log scale): 1995–2010, Ethiopia.
Figure 2 Trends in Neonatal, Early and Late Neonatal Mortality rate (in log scale): 1995–2010, Ethiopia.CC BY · PubMed Central
Figure 3 Ethiopian neonatal, early neonatal and late neonatal mortality rates by year.
Figure 3 Ethiopian neonatal, early neonatal and late neonatal mortality rates by year.CC BY · PubMed Central

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Citations

Cites

Show all 51 references

Research works printed but not linked: 8

  1. World Health Organization: Estimates. State of the World’s Newborns. 2001, Washington, DC: Saving Newborn Lives, Save the Children/ USA, 1-49.
  2. Central Statistical Agency [Ethiopia]: Populating and housing census of Ethiopia. 2007, Ethiopia: Central Statistical Agency
  3. Central Statistical Authority and ICF International: Ethiopia Demographic and Health Survey 2011. 2012, Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency
  4. Mulligan B, Degefie T, Tensou B, Matios B: Levels, Timing and Causes of Neonatal Mortality in Rural Ethiopian Communities. 13th World health congress on public health, Addis Ababa, April 23–27. 2012, Ethiopian Public Health Association
  5. Central Statistical Authority [Ethiopia] and ORC Macro: Ethiopia Demographic and Health Survey 2005. 2006, Addis Ababa, Ethiopia and Calverton, Maryland, USA:
  6. Obungu W, Kizito P, Bicego GT: Macro International. Institute for Resource Development. Demographic and Health, Trends, age patterns, and determinants of early childhood mortality in Kenya. DHS Further Analysis No. 12. 1994, Macro International Inc: Calverton, Maryland
  7. Motherhood S: Mother-Baby Package: Implementing safe motherhood in countries. 1994, Geneva, Switzerland: WHO/FHE/MSM/94.11
  8. World Health Organization, Thermal Protection of the Newborn: A Practical Guide. Report No.: WHO/RHT/MSM/97.2. 1997, Geneva: World Health Organization

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Metadata

Authors
Mekonnen, Y., Tensou, B., Telake, D. S., Degefie, T., & Bekele, A.
Affiliations
  • Save the Children (US)
  • United Nations Children's Fund (US)
Corresponding author
Mekonnen, Yared
ORCID
Mekonnen, Yared
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2013-05-17
Volume
13
Issue
1
Pages
483-483
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-13-483
PMC
PMC3659057
OpenAlex
W2055079578
Cited by
234
References
51
Citations by year
2026: 6 · 2025: 9 · 2024: 18 · 2023: 17 · 2022: 30 · 2021: 35 · 2020: 39 · 2019: 23 · 2018: 16 · 2017: 14 · 2016: 13 · 2015: 4 · 2014: 10
FWCI
8.29
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
Ethiopia, mortality trends, early neonatal mortality, risk factors, season of birth, maternal education, maternal age, parity, sex differences, regional disparities, under-five mortality, Addis Ababa, Amhara, Benishangul-Gumuz, Tigray
MeSH terms
Adolescent, Adult, Birth Intervals, Ethiopia, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Male, Middle Aged, Pregnancy, Prenatal Care, Risk Factors, Healthcare Disparities

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