Neonatal Mortality And Associated Factors In A Pastoral Region, Afar, Ethiopia: A Health Facility Based Study

Abstract Abstract Background: Neonatal mortality is public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region. Thus, this study aims to assess neonatal mortality and associated factors in pastoral communities residing in Afar, Ethiopia. Methods: A health facility based retrospective cross sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1 st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using standardized data extraction checklist. The medical records were selected using a systematic random sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05. Results: 391 medical records of newborns were included with data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%). Lack of antenatal care (ANC) follow up (AOR = 4.69: 95%CI 1.77, 12.47), giving birth through cesarean section (AOR 3.59, 95%CI 1.22, 10.55), having a temperature less than 36.5 o C within the first hour of admission (AOR 10.75, 95%CI 3.75, 30.80), perinatal asphyxia (AOR 7.16, 95%CI 2.22, 23.10) and/or having a length of stay greater than five days in the hospital (AOR 0.23, 95%CI 0.08, 0.66) were significantly associated with neonatal mortality. Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature with in the first hour of admission and perinatal asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention for improving antenatal cares, intra-partum cares and standardized cares for admitted neonates. Additional prospective studies are recommended.