Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006–07

BMC Public Health

Michael J Dibley¹  Yasir Bin Nisar¹ 

[1] Sydney School of Public Health, The University of Sydney, Room 128C, Edward Ford Building, Sydney NSW 2006, Australia

关键词: Delivery complications;    Birth size;    Neonatal mortality;    Determinants;   

Others  :  1129037
DOI  :  10.1186/1471-2458-14-663

 received in 2013-12-05, accepted in 2014-06-25,  发布年份 2014

【 摘 要 】

Background

Globally 7.6 million children died in 2010 before reaching their fifth birthday and 40% of these deaths occur in the neonatal period. Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important to investigate factors associated with neonatal mortality. The aim of the current study was to identify determinants of neonatal mortality in Pakistan.

Methods

Data was derived from the Pakistan Demographic and Health Survey 2006–07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality.

Results

A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan.

Conclusions

To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan.

【 授权许可】

   
2014 Nisar and Dibley; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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