Without improving the survival of newborns, meaningful reduction in under-five mortality is difficult. Most neonatal deaths are preventable when appropriate and timely care is sought. In Ethiopia, there is lack of evidence on the type and contribution of delays in treatment seeking to neonatal deaths.
A community based social autopsy (SA) of 39 neonatal deaths was conducted from March 16 to 24, 2016 in Dabat Health and Demographic Surveillance System (HDSS) in northwest Ethiopia. The result was linked with verbal autopsy (VA) information completed for each of the deaths as part of the ongoing HDSS. The SA tool was adapted from INDEPTH Network. Three delay model approach was used to classify the delay types that contributed for the deaths investigated. Descriptive statistics was used to analyze the data.
SA was completed for 37 (94.9%) of the 39 neonatal deaths. Of all the deaths, 51.3% (19/37) of them occurred within the first 24 h, 75.6% (28/37) within the first 6 days and the remaining in 7–28 days. Birth asphyxia was the leading cause of death (34%) followed by bacterial sepsis (31%) and prematurity (16%). The median time from recognition of illness to initiation of modern treatment was 1 day (IQR 1–2.5 days). Delay in treatment seeking outside home (delay one) was associated with 81% of the deaths. Delay in receiving care at a health facility (delay three) and delay in transport (delay two) were associated with 16 and 3% of the deaths, respectively. The major contributors of death for delay one were bacterial sepsis (33.3%), birth asphyxia (30%), unspecified illness (20%) and acute lower respiratory tract illnesses (6.7%). For delay three, the major causes of death included birth asphyxia (50%), prematurity (33.3%) and bacterial sepsis (16.7%).
Delays created at home and at health facility were the major delays contributing to the death of newborns. More focus has to be given in improving delays at home and at health facility.
The Lancet. An executive summary for the lancet ’ s series “ a healthy start is central to the human life course, with birth holding the highest risk of death, disability, and loss of development potential, leading to major societal effects .” 2014. 1-8 p.
UN/WHO/Unicef/World Bank Group. Levels and trends in child mortality: estimates developed by the UN inter-agency Group for Child Mortality Estimation. Report 2015. 2015.
UN. Every newborn : an draft action plan to end preventable deaths. 2014.
Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990 : a systematic analysis of progress, projections, and priorities. PLoSE Med 2011;8(8).
Bay G, Miller T, Faijer DJ. Levels and trends in child mortality: estimates developed by the UN inter-agency group for child mortality estimation. 2014.
Mekonnen Y, Tensou B, Telake DS, Degefie T, Bekele A. Neonatal mortality in Ethiopia : trends and determinants. BMC Public Health]. 2013;13(1):1.
FMOH. National Newborn and Child Survival Strategy Document Brief Summary 2015/16–2019/20. 2015.
WHO, unicef. WHO/UNICEF joint statement: home visits for the newborn child: a strategy to improve survival; 2009. p. 8.
Tran HT, Doyle LW, Lee KJ, Graham SM. A systematic review of the burden of neonatal mortality and morbidity in the ASEAN region. East Asia J Public Heal South. 2012;1(3):239–48. CrossRef
Geldsetzer P, Williams TC, Kirolos A, Mitchell S, Ratcliffe LA, Kohli-lynch MK, et al. The Recognition of and Care Seeking Behaviour for Childhood Illness in Developing Countries : A Systematic Review. PLoS One. 2014;9(4):1–14.
Li C, Yan H, Zeng L, Dibley MJ, Wang D. Predictors for neonatal death in the rural areas of Shaanxi Province of northwestern China : a cross-sectional study. BMC Public Health. 2015:1–8.
Olayinka O. Predictors of neonatal morbidity and mortality in tertiary Hospital in Ogun. Arch Appl Sceince Res. 2012;4(3):1511–6.
Lassi ZS, Dean SV, Mallick D, Bhutta ZA. Preconception care : delivery strategies and packages for care. Reprod health. BioMed Central Ltd. 2014;11(Suppl 3):S7. Available from: http://www.reproductive-health-journal.com/content/11/S3/S7
Beaglehole R, Bonita R, Ezzati M, Alleyne G, Dain K, Kishore SP, et al. The world we want for every newborn child. Lancet [Internet]. Elsevier Ltd; 2014;384(9938):107–109. Available from: https://doi.org/10.1016/S0140-6736(14)60837-0
Kayemba CN. Seeking referral Care for Newborns in eastern Uganda : community health workers ’ role, caretakers ’ compliance and provision of care. 2014.
Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo GW. Using the three delays model to understand why newborn babies die in eastern Uganda. Tropical Med Int Health. 2010;15(8):964–72. CrossRef
Mbaruku G, van Roosmalen J, Kimondo I, Bilango F, Bergström S. Perinatal audit using the 3-delays model in western Tanzania. Int J Gynecol Obstet. 2009;106(1):85–8.
Upadhyay RP, Rai SK, Krishnan A. Using three delays model to understand the social factors responsible for neonatal deaths in rural Haryana, India. J Trop Pediatr. 2013;59(2):100–5.
Science S, April M, Thaddeus S, Maine D, Maine D. Too far to walk : maternal mortality in context IN. 1994;(April).
WHO, HMN, INDEPTH Network. Verbal autopsy standards: the 2012 WHO verbal autopsy instrument release candidate 1. 2012.
Setel PW, Macfarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, et al. Series who Counts ? 1 a scandal of invisibility : making everyone count by counting everyone. 2007;6736(7):2003–2006.
Waiswa P, Kalter HD, Jakob R, Black RE. Increased use of social autopsy is needed to improve maternal, neonatal and child health programmes in low-income countries. Bull World Health Organ. 2012;90(6).
Central Statistical Agency of Ethiopia. Summary and statistical report of the 2007 population and housing census: Population size by age and sex. Federal Democratic Republic of Ethiopia Population Census Commission. 2008.
WHO. International classification of diseases and related health problems. 10th revision. Instructional Manual, vol. 2; 2010.
Källander K, Kadobera D, Williams TN, Nielsen RT, Yevoo L, Mutebi A, et al. Social autopsy : INDEPTH network experiences of utility, process, practices, and challenges in investigating causes and contributors to mortality. Popul Health Metr [Internet]. BioMed Central Ltd; 2011;9(1):44. Available from: http://www.pophealthmetrics.com/content/9/1/44
WHO. Maternal and Perinatal Health Profile: Ethiopia: WHO, African region; 2015.
Indongo N. Risk Factors and causes of neonatal deaths in NAMIBIA. Eur Sci J. 2014;7881(August):466–71.
Amare Y, Degefie T, Mulligan B. Original article newborn care seeking practices in central and southern Ethiopia and implications for community based programming. Ethiop J Heal Dev. 2008;27:3–7.
Warren C. Care of the newborn : community perceptions and health seeking behavior. Ethiop J Heal Dev. 2010;(Special Issue 1):110–4.
Save the Children. Ending newborn deaths: ensuring every baby survives. 2014.
WHO. Postnatal care of the mother and newborn 2013. World heal organ; 2013. p. 1–72. Available from: http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf.
- Why gone too soon? Examining social determinants of neonatal deaths in northwest Ethiopia using the three delay model approach
Tariku Nigatu Bogale
Abebaw Gebeyehu Worku
Gashaw Andargie Bikis
Zemene Tigabu Kebede
- BioMed Central
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