Muhamad, Norazlifah
(2016)
Preventable causes and associated factors of neonatal death in Kota Bharu district.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background of study: The Millennium Developmental Goal (MDG) target to
reduce the under-five death rate by two-thirds from 1990 to 2015 was not achieved.
Malaysia is expected to reduce the under-five death rate by year 2020. Neonatal
death was an important contributor to the delay in reduction of overall under-five
death rate.
Objective: The aim of the study was to study preventable causes and associated
factors of neonatal death in Kota Bharu district from January 2013 to September
2015.
Methodology: A case control study was conducted between January 2016 till May
2016 involving health clinics in Kota Bharu district. Cases were babies who died
during neonatal period and controls were babies who survived beyond the neonatal
period. The study used secondary data derived from ‘stillbirth and under five
mortality form’ and KIB 101 registration book as the source of data. The
descriptive, simple logistic regression and multiple logistic regression analysis were
applied to answer the objective of the study.
Results: A total of 503 subjects who fulfill the inclusion and exclusion criteria were
studied, in which 361 subjects were control and 142 were cases. This study showed
that 14.8% of the neonatal death was preventable, out of which 38.1% were
contributed by patient causes, 33.3% due to hospital causes and 28.6% were due to
health site causes. Further analysis showed that neonatal death was significantly
associated with maternal co-morbidities (Adj. OR 4.96, 95% CI: 2.09,11.75; p <
0.001), low birth weight (Adj. OR 11.04, 95% CI: 6.15, 19.81; p < 0.001) and
prematurity (Adj. OR 3.17, 95% CI: 1.62, 6.23; p = 0.001).
Conclusion: The number of preventable neonatal deaths is substantiated and it was
caused evenly by hospital, health site and patient’s causes. Factors such as maternal
co-morbidities, low birth weight and prematurity were significantly associated with
neonatal death. Despite the smaller percentage in preventable neonatal death, the
shortfalls in the management of mothers and newborn specifically in the antenatal,
intrapartum period and postnatal care were identified and hence may guide the health
practitioners for future intervention and improve the overall performance as part of
safe motherhood practice and newborn care.
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