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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Individual and community determinants of neonatal mortality in Ghana: A multilevel analysis
BMC Pregnancy and Childbirth, Volume 14, No. 1, Article 165, Year 2014
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Description
Background: Neonatal mortality is a global challenge; identification of individual and community determinants associated with it are important for targeted interventions. However in most low and middle income countries (LMICs) including Ghana this problem has not been adequately investigated as the impact of contextual factors remains undetermined despite their significant influence on under-five mortality and morbidity.Methods: Based on a modified conceptual framework for child survival, hierarchical modelling was deployed to examine about 6,900 women, aged 15 - 49 years (level 1), nested within 412 communities (level 2) in Ghana by analysing combined data of the 2003 and 2008 Ghana Demographic and Health Survey. The aim was to identify individual (maternal, paternal, neonatal, antenatal, delivery and postnatal) and community (socioeconomic disadvantage communities) determinants associated with neonatal mortality.Results: The results showed both individual and community characteristics to be associated with neonatal mortality. Infants of multiple-gestation [OR 5.30; P-value < 0.001; 95% CI 2.81 - 10.00], neonates with inadequate birth spacing [OR 3.47; P-value < 0.01; 95% CI 1.60 - 7.57] and low birth weight [OR 2.01; P-value < 0.01; 95% CI 1.23 - 3.30] had a lower chance of surviving the neonatal period. Similarly, infants of grand multiparous mothers [OR 2.59; P-value < 0.05; 95% CI 1.03 - 6.49] and non-breastfed infants [OR 142.31; P-value < 0.001; 95% CI 80.19 - 252.54] were more likely to die during neonatal life, whereas adequate utilization of antenatal, delivery and postnatal health services [OR 0.25; P-value < 0.001; 95% CI 0.13 - 0.46] reduced the likelihood of neonatal mortality. Dwelling in a neighbourhood with high socioeconomic deprivation was associated with increased neonatal mortality [OR 3.38; P-value < 0.01; 95% CI 1.42 - 8.04].Conclusion: Both individual and community characteristics show a marked impact on neonatal survival. Implementation of community-based interventions addressing basic education, poverty alleviation, women empowerment and infrastructural development and an increased focus on the continuum-of-care approach in healthcare service will improve neonatal survival. © 2014 Kayode et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Kayode, Gbenga Ayodele
Netherlands, Utrecht
University Medical Center Utrecht
Ansah, Evelyn K.
Ghana, Accra
Ghana Health Service
Agyepong, Irène Akua
Ghana, Accra
Ghana Health Service
Ghana, Accra
University of Ghana
Amoakoh-Coleman, Mary
Netherlands, Utrecht
University Medical Center Utrecht
Ghana, Accra
Ghana Health Service
Grobbee, Diederick E Egbertus
Netherlands, Utrecht
University Medical Center Utrecht
Klipstein-Grobusch, Kerstin
Netherlands, Utrecht
University Medical Center Utrecht
South Africa, Johannesburg
Wits School of Public Health
Statistics
Citations: 92
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2393-14-165
e-ISSN:
14712393
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Ghana
Participants Gender
Female