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2015 ; 100
(5
): F439-47
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Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal,
Bangladesh, Malawi and India
#MMPMID25972443
Fottrell E
; Osrin D
; Alcock G
; Azad K
; Bapat U
; Beard J
; Bondo A
; Colbourn T
; Das S
; King C
; Manandhar D
; Manandhar S
; Morrison J
; Mwansambo C
; Nair N
; Nambiar B
; Neuman M
; Phiri T
; Saville N
; Sen A
; Seward N
; Shah Moore N
; Shrestha BP
; Singini B
; Tumbahangphe KM
; Costello A
; Prost A
Arch Dis Child Fetal Neonatal Ed
2015[Sep]; 100
(5
): F439-47
PMID25972443
show ga
OBJECTIVE: Understanding the causes of death is key to tackling the burden of
three million annual neonatal deaths. Resource-poor settings lack effective vital
registration systems for births, deaths and causes of death. We set out to
describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh,
Nepal and rural and urban India using verbal autopsy (VA) data. DESIGN: We
prospectively recorded births, neonatal deaths and stillbirths in seven
population surveillance sites. VAs were carried out to ascertain cause of death.
We applied descriptive epidemiological techniques and the InterVA method to
characterise the burden, timing and causes of neonatal mortality at each site.
RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63%
and 82% of neonatal deaths occurred in the first week of life, and males were
more likely to die than females. Prematurity, birth asphyxia and infections
accounted for most neonatal deaths, but important subnational and regional
differences were observed. More than one-third of deaths in urban India were
attributed to asphyxia, making it the leading cause of death in this setting.
CONCLUSIONS: Population-based VA methods can fill information gaps on the burden
and causes of neonatal mortality in resource-poor and data-poor settings. Local
data should be used to inform and monitor the implementation of interventions to
improve newborn health. High rates of home births demand a particular focus on
community interventions to improve hygienic delivery and essential newborn care.