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Determinants of Neonatal Mortality in a Public Urban Maternity Hospital in Kenya

Author: Tele A. K , Nyamu D.G , Juma R. , Gitonga I.
Is Part Of: Pharmaceutical Journal of Kenya, Volume 23, No. 1 (2016)
Background: The neonatal period carries the highest risk of death in the human lifespan. Published data on prevalence and determinants of neonatal mortality in Kenya remain scant.
Objectives: To find out the prevalence, causes and determinants of neonatal mortality at Pumwani Maternity Hospital in Kenya.
Design and Methodology: A retrospective study was conducted through audit of 600 neonatal records with detailed analysis of child’s health outcome in the first 28 days of life. The health outcome included post delivery complications such as respiratory distress, asphyxia prematurity and birth weights. Maternal bio-demographic and socio-economic variables were also abstracted. The socio-economic variables listed included maternal’s highest education level, occupation, and marital status. The bio-demographic variables included maternal age at delivery, gender of the child and type of birth while and utilization of antenatal care. Data analysis was done using SPSS Version 20 computer software. Descriptive, cross tabulation and logistic regression analysis were done to examine the association of neonatal mortality and the individual risk factors for death while adjusting for covariates.
Results: Prevalence of neonatal mortality was 12.8%, with neonatal respiratory distress accounting for 49.8% of all deaths followed by asphyxia (11.7%) and prematurity (11.2%). The odds of neonatal death were found to be highest among neonates born to mothers who did not utilize antenatal care services [OR=6.52; CI= 2.76 -15.37, p<0.001] and in neonates whose birth weight was less than 2500 grams [OR=10.25, CI= 3.57 -18.49, p<0.001]. A reduction in the odds of neonatal deaths occurred as the level of mothers’ education increased (p=0.008). In addition, neonates born to young mothers (15-19 years) and older mothers (45-49 years) were less likely to die compared to other age categories.
Conclusion: Neonatal mortality rate at Pumwani hospital is high and multiple factors associated with death have been identified. These factors may be modifiable through intensification of antenatal and intrapartum care.

Keywords: Neonatal mortality, Determinants, Pumwani maternity hospital
Publisher: The Pharmaceutical Society of Kenya