DETERMINANTS OF NEONATAL MORTALITY IN NEONATAL INTENSIVE CARE UNIT OF SIDAMA REGION HOSPITALS, ETHIOPIA: MATCHED CASE CONTROL STUDY

Abstract

Abstract Background: Neonatal mortality accounts for estimated 2.5 million deaths worldwide. In Ethiopia neonatal mortality constitutes 55 % of <5years mortality and 70% of infant mortality. Neonatal mortality determinant varies by country with the availability and quality of health care. The aim of this study is to identify determinant of neonatal mortality in sidama region Ethiopia. Method: Matched case-control study carried out among 267 neonates (89 cases and 178 controls) admitted in public hospitals of Sidama region from March 18 to June 30/2021. Cases were neonate discharged as dead, with two controls matched by gestational age, admitted to same Hospital, and survived >28 days of life birth. Data were collected by reviewing chart, interviewing parents using structured questionnaires and in addition for controls from follow up chart. Data entered in Epi info7 software and exported to SPSS version25 for cleaning, recoded and analysis. Descriptive statistics was done to describe and summarize the outcome and exposure variables. Conditional logistic regression was used to estimate the effect size (odd ratio) and identify factors associated with neonatal mortality in Sidama region public hospitals. Results: The odd of neonate who were born from mother who had no antenatal care visit were 6.90 times at risk of death than their encounter (AOR = 6.90; 95% CI 2.67, 17.98), the neonatal deaths were more likely observed among odd of neonate who had delivered at home (AOR = 2.90; 95% CI=1.09, 7.83) than odd of neonate who delivered at health facility, furthermore no postnatal care visit (AOR = 2.67; 95% CI =1.16. 6.14), not initiating breast feeding within an hour (AOR = 3.65 95% CI=1.65, 8.07), perinatal asphyxia (AOR=6.0; 95%CI=1.98, 18.35), and congenital malformed neonate(AOR=3.40; 95%CI=1.32, 8.80) were determinant of neonatal mortality in Sidama region public hospitals. Conclusion: Antenatal care visit, maternal home delivery, postnatal care visit, history of antenatal complication, initiating breast feeding within one hour, neonatal complication at birth, perinatal asphyxia, congenital malformed neonate were identified neonatal mortality risk factors, which are preventable and manageable by good antenatal care, intra-partum care, neonatal care increase access of well-equipped ambulance transport system, health education and building the capacity of health professional through training and providing orientations. Key words: Perinatal death, Neonatal Intensive Care Unit, Sidama Region Southern Ethiopia