Causes and age of neonatal death and associations with maternal and newborn care characteristics in Nepal: a verbal autopsy study.

Autor: Erchick DJ; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. derchick@jhu.edu., Lackner JB; Avant Medical Communications Group, Aptos, CA, USA., Mullany LC; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA., Bhandari NN; Integrated Rural Health Development Training Centre, Maharajgunj, Kathmandu, Nepal., Shedain PR; Integrated Rural Health Development Training Centre, Maharajgunj, Kathmandu, Nepal., Khanal S; Integrated Rural Health Development Training Centre, Maharajgunj, Kathmandu, Nepal., Dhakwa JR; Integrated Rural Health Development Training Centre, Maharajgunj, Kathmandu, Nepal., Katz J; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Jazyk: angličtina
Zdroj: Archives of public health = Archives belges de sante publique [Arch Public Health] 2022 Jan 11; Vol. 80 (1), pp. 26. Date of Electronic Publication: 2022 Jan 11.
DOI: 10.1186/s13690-021-00771-5
Abstrakt: Background: In Nepal, neonatal mortality fell substantially between 2000 and 2018, decreasing 50% from 40 to 20 deaths per 1,000 live births. Nepal's success has been attributed to a decreasing total fertility rate, improvements in female education, increases in coverage of skilled care at birth, and community-based child survival interventions.
Methods: A verbal autopsy study, led by the Integrated Rural Health Development Training Centre (IRHDTC), conducted interviews for 338 neonatal deaths across six districts in Nepal between April 2012 and April 2013. We conducted a secondary analysis of verbal autopsy data to understand how cause and age of neonatal death are related to health behaviors, care seeking practices, and coverage of essential services in Nepal.
Results: Sepsis was the leading cause of neonatal death (n=159/338, 47.0%), followed by birth asphyxia (n=56/338, 16.6%), preterm birth (n=45/338, 13.3%), and low birth weight (n=17/338, 5.0%). Neonatal deaths occurred primarily on the first day of life (27.2%) and between days 1 and 6 (64.8%) of life. Risk of death due birth asphyxia relative to sepsis was higher among mothers who were nulligravida, had <4 antenatal care visits, and had a multiple birth; risk of death due to prematurity relative to sepsis was lower for women who made ≥1 delivery preparation and higher for women with a multiple birth.
Conclusions: Our findings suggest cause and age of death distributions typically associated with high mortality settings. Increased coverage of preventive antenatal care interventions and counseling are critically needed. Delays in care seeking for newborn illness and quality of care around the time of delivery and for sick newborns are important points of intervention with potential to reduce deaths, particularly for birth asphyxia and sepsis, which remain common in this population.
(© 2022. The Author(s).)
Databáze: MEDLINE
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