Neonatal mortality predictors in Nepal: Nepal demographic health survey 2011

Abstract

Background: The neonatal period (0-28 days after delivery) in human life is critical and carries a high risk of mortality. According to the Nepal Demographic Health Survey (NDHS) 2011, Nepal has a Neonatal Mortality Rate (NMR) of 33/1000 live births which is one of the highest in the world. The neonatal mortality accounts for 61% of the under-five mortality. There has been very limited progress in reducing neonatal mortality in Nepal during the last decade. Purpose of the study: The purpose of the current study is to determine factors associated with neonatal mortality in Nepal. Methodology: Data from NDHS 2011 was used and the study included 4033 women who gave birth from 2006 to 2010. A study was performed to find associations between neonatal mortality and certain predictor variables. Associations were assessed by multivariate analysis, univariate and multivariate (backward LR) logistic regression. Results: The neonatal mortality in the study population was determined to be 33.4 per 1000 live births. Neonatal mortality was found higher among the neonates from younger women [age at delivery less than 20 years (OR: 1.94, CI: 1.18-3.20) compared to 20 or more years], high parity mothers [5 or more (OR: 3.50, CI: 1.82-6.74) compared to 1], mothers without health care decision autonomy [no (OR: 1.43, CI: 1.04-1.97) compared to yes] and mothers who deliver at health care center [healthcare center (OR: 0.65, CI: 0.46-0.92) compared to home]. Mothers’ low education and poverty were found to be significantly associated with higher neonatal mortality after adjusting for age. Conclusion: High neonatal mortality was observed among mothers with younger age, high parity and mothers without healthcare decision autonomy.