https://orcid.org/0000-0002-4371-6792
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ABSTRACT
Background
Half of global under-five mortalities is neonatal. The highest rates are found in low-income countries such as Ethiopia. Ethiopia has made progress in reducing under-five mortality, but neonatal mortality remains high. Evidence collected continuously at the community level is crucial for understanding the trends and causes of neonatal mortality.
Objectives
To analyse the trends and causes of neonatal mortality at the Kilte-Awlelo Health and Demographic Surveillance System (KAHDSS) site in Ethiopia from 2010 to 2017.
Methods
A descriptive study was conducted using data from neonates born between 2010 and 2017 at the KAHDSS site. Data were collected using interviewer-administered questionnaires. Causes of death were examined, and neonatal mortality trends were described using simple linear regression.
Results
The overall average neonatal mortality rate was 17/1000 live births (LBs). The rate increased from 12 per 1000 LBs in 2010 to 15 per 1000 LBs in 2017. The majority of neonatal deaths occurred during the first week of life, and more than one-half died at home. The leading causes were sepsis, pre-term birth (including respiratory distress), disease related to the perinatal period, birth asphyxia, and neonatal pneumonia.
Conclusions
The high neonatal mortality in Ethiopia requires urgent attention and action. Sepsis, preterm birth, perinatal diseases, asphyxia, and neonatal pneumonia are the leading causes of death in neonates. Facility- and community-based health services should target the leading causes of neonatal deaths.
Responsible Editor Jennifer Stewart Williams
Responsible Editor Jennifer Stewart Williams
Acknowledgements
We appreciate the support Mekelle University has given us. We thank all workers in the surveillance system for their efforts in data collection and the Tigray regional health bureau for its financial support in facilitating the data analysis workshop. Finally, we thank the participants of the HDSS data collection for their time in providing this vital information.
Authors contributions
As members of KAHDSS, MWG, MT, and HTA supervised data collection, cleaning, and management. Data processing and analysis: MWG, MT, HTA, AG, SB, ABA, and SW; writing of the paper: MWG, MT, HTA, AG, SB, ABA, and SW. All the authors read the final paper and approved it.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The HDSS site received ethical clearance from the Institutional Review Board (IRB) of Mekelle University, College of Health Sciences. Hence, no further ethical approval was required for the present study. Permission to access the data was obtained from Mekelle University Kilte-Awlaelo HDSS via an agreement on the data-sharing policy. While capturing vital events, informed consent has been obtained from the head of the family or an eligible adult member. Data containing the personal identifiers of subjects were not shared with the third party.
Paper context
This descriptive study reports neonatal mortality data collected from a Health and Demographic Surveillance System site in Ethiopia (2010–2017). The average neonatal mortality rate was 17/1000 live births. There was a 25% increase between 2010 and 2017. The majority of mortality occurred during the first week of life, and most deaths occurred at home. Leading causes of death were infection, pre-term birth, and perinatal disorders. Neonatal mortality requires urgent attention and action in Ethiopia.