The Occurrence and Correlating Elements of Newborn Mortality in Jinja District, Uganda
Mbito Chindoro Mongo
Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda
In Uganda, the neonatal mortality rate remains high, standing at 27 deaths per 1000 live births. However, there’s a lack of comprehensive data concerning the prevalence and factors associated with neonatal mortality in Jinja district, Uganda. This study aimed to fill this gap by assessing the prevalence and identifying associated risk factors for neonatal mortality in the area. Using a pretested survey questionnaire, data from the electronic database of Jinja district on maternal and newborn interventions were collected, focusing on 245 women who had given birth within the past year, irrespective of birth outcomes. The collected data underwent analysis using SPSS version 25, employing chi-squared analysis at a significance level of p=0.05 to discern factors linked with neonatal mortality. The study revealed a neonatal mortality rate of 12.2%. Factors contributing to increased neonatal mortality included mothers with an education level below secondary, residing in rural areas, male infants, neonates aged 2-7 days, preterm birth, and low birth weight. Notably, the neonatal mortality rate observed in this study was lower than the national average. The findings suggest that employing community-based initiatives to educate and raise awareness within households about appropriate maternal and newborn care practices could significantly contribute to reducing neonatal mortality rates.
The neonatal period is the most hazardous period in the child’s life because the risk of dying is highest during this period . Globally, it was estimated that in 2017, 6.3 million children and young adolescents died, mostly from preventable causes. Of these deaths, approximately 85% occurred in the first five years of life and nearly half (47%) of those under-five deaths occurred in the first month of life . This brought the global prevalence of neonatal death in 2017 to 18 deaths per 1,000 live births. While there have been improvements in child mortality over the last two decades, the rates of neonatal mortality did not decline substantially in the same period. For instance, globally, the neonatal mortality rate fell by 51% from 37 deaths per 1000 live births in 1990 to 18 deaths per 1000 live births in 2017. However, the change in neonatal mortality was not as significant as the change in child mortality for children aged 1-59 months (63%) . Africa contributed to one-third of the world’s neonatal mortality burden. In this region, about 75% of deaths occurred during the first week of life, and almost half were within the first 24 hours [4-6]. Among the Sustainable Development Goals (SDG) regions, Sub-Saharan Africa had the highest neonatal mortality rate in 2017 at 27 deaths per 1000 live births . According to the Uganda Demographic Health Survey (UDHS), the neonatal mortality rate was 27 deaths per 1000 live births in 2016. In other words, in Uganda 1 in every 37 children dies within the first month. The UDHS 2016 report further shows that under-5 mortality rates have declined over time, from 116 deaths per 1,000 live births in 2006 to 64 deaths per 1,000 live births in 2016 . The major causes of neonatal mortality in Uganda, like other Sub-Saharan African countries, include; birth asphyxia, prematurity, anemia, and sepsis [9, 10]. Neonatal mortality in Eastern Uganda is not well known due to the limited availability of data. However, a study to determine neonatal mortality and its risk factors in selected rural communities from districts of Kamuli, Pallisa, and Kibuku in Eastern Uganda in 2016 reported a prevalence of 34 deaths per 1000 live births, and factors associated with increased neonatal deaths were parity of 5+ (adj. RR =2.53, 95 % CI =1.14–5.65), newborn low birth weight (adj. RR = 3.10, 95 % CI = 1.47–6.56) and presence of newborn danger signs (adj. RR = 2.42, 95 % CI = 1.04–5.62) .
In the year 2000, 189 countries committed to reducing child mortality through Millennium Development Goals (MDGs) specifically goal number 4; where each country had to reduce child mortality by 2/3 by 2015 . However, this goal to reduce the child mortality rate by two-thirds was not met by many countries including Uganda . A global response adopted in 2015 by the United Nations (UN) set 17 new Sustainable Development Goals (SDGs). The SDGs were designed to maintain and improve upon what was achieved in the last fifteen years through the MDGs . According to the UN, the third SDG target 3.2 is to end preventable deaths of newborns and children under five by the year 2030. Despite global efforts, neonatal mortality has remained on the rise in some countries. It is estimated that 2 million newborns die on the day they are born and 3 million more die within seven days of birth . As with many health issues, the highest neonatal mortality (99%) occurs in low- and middle-income countries. Sub-Saharan Africa and Southeast Asia have had the least progress in reducing neonatal deaths [14, 15].
In Uganda, neonatal mortality is the number one cause of under-five mortality (Uganda Ministry of Health (MoH)). According to MoH; most neonatal deaths (72%) are due to avoidable causes like birth asphyxia, prematurity, and neonatal sepsis . A study in Eastern Uganda reported a neonatal mortality of 34 which is higher than the national prevalence of 27 . No study had been done in the Jinja district regarding neonatal mortality and results from studies elsewhere could not be assumed to be the same for the Jinja district. Thus, this study was aimed at determining neonatal mortality in the Jinja district and the factors associated with it.
In conclusion, this study found that neonatal mortality was lower compared to many other previous studies. Factors which were associated with neonatal mortality were; lower education level, male sex, preterm birth, and low birth weight.
Based on the findings of this study, the researcher recommends that early detection and anticipating high-risk pregnancies and high-risk newborns and the provision of timely and appropriate intervention could reduce neonatal mortalities. Furthermore, it is important that further studies be conducted on a larger scale to broaden the understanding obtained from this study.
- Levels and Trends in Child Mortality – UNICEF DATA, 2019.
- Pneumonia in children – UNICEF Data, 2017.
- World Health Organization (WHO). Neonatal mortality rate, 2018.
- Obeagu, E. I., Neema, B. G., Getrude Obeagu, G. U., Alum. E. U. and Ugwu, O. P. C. (2023). A Review of Incidence and Clinical Outcomes of Neonate with False Tooth Extraction. IAA Journal of Scientific Research, 10(1):25-27. https://doi.org/10.5281/zenodo.7810456
- Egesa, W. I., Odong, R. J., Kalubi, P., Yamile, E. A. O., Atwine, D., Turyasiima, M. and Ssebuufu, R. (2020). Preterm Neonatal Mortality and Its Determinants at a Tertiary Hospital in Western Uganda: A Prospective Cohort Study. Pediatric health, medicine and therapeutics, 11, 409-420.
- Misrach Z. L., Vempati P., Vulli V. R. and Suberu S. A. (2018). The Effect of Fenugreek Seed powder in Augmenting Expressed Breast Milk Volume from Mothers of Preterm Infants at Tikur Anbessa Neonatal Intensive Care Unit. Global Journal for Research Analysis, 7 (3).
- Wang, H., Bhutta, Z. A., Coates, M. M., Coggeshall, M., Dandona, L., Diallo, K. and Hay, S. I. (2016). Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1725-1774.
- Demographic and Health Survey, 2017. Retrieved from www.ubos.org
- Obeagu, E. I., Nimo, O. M., Bunu, U. M., Ugwu, O. P.C. and Alum, E.U. (2023). Anaemia in children under five years: African perspectives. Int. J. Curr. Res. Biol. Med., (1): 1-7. DOI: http://dx.doi.org/10.22192/ijcrbm.2023.08.01.001.
- Kananura, R.M., Tetui, M., Mutebi, A. et al.(2016). The neonatal mortality and its determinants in rural communities of Eastern Uganda. Reprod Health, 13, 13. https://doi.org/10.1186/s12978-016-0119-y
- Grady, S. C., Frake, A. N., Zhang, Q., Bene, M., Jordan, D. R., Vertalka, J., et al. (2017). Neonatal mortality in East Africa and West Africa: a geographic analysis of district-level demographic and health survey data. Geospat Health, 12(1):501. doi: 10.4081/gh.2017.501.
- United Nations Sustainable Development Goals Report, 2017.
- Guerrera, G. (2015). Neonatal and pediatric healthcare worldwide: A report from UNICEF. Clin Chim Acta, 451(Pt A):4-8. doi: 10.1016/j.cca.2015.03.004.
- Golding, N., Burstein, R., Longbottom, J., Browne, A. J., Fullman, N., Osgood-Zimmerman, A. and Dwyer-Lindgren, L. (2017). Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals. The Lancet, 390(10108), 2171-2182.
- Turyasiima, M., Nduwimana, M., Andres, S. M., Kiconco, G., Egesa, W. I., Maren, B. M. and Ssebuufu, R. (2020). Neonatal Umbilical Cord Infections: Incidence, Associated Factors and Cord Care Practices by Nursing Mothers at a Tertiary Hospital in Western Uganda. Open Journal of Pediatrics, 10(2): 288-301.
- Uganda Ministry of Health (MoH). Annual Health Performance Report, 2017.
- Wiegand, H. and Kish, L. (1968). Survey Sampling. John Wiley & Sons, Inc., New York, London 1965, IX + 643 S., 31 Abb., 56 Tab., Preis 83 s. Biometrische Zeitschrift. 10, 88–89. https://doi.org/10.1002/bimj.19680100122
- Abdullah, A., Hort, K., Butu, Y. and Simpson, L. (2016). Risk factors associated with neonatal deaths: a matched case–control study in Indonesia. Global health action, 9(1), 30445.
- Jabiri, A., Wella, H. L., Semiono, A., Saria, A. and Protas, J. (2016). Prevalence and factors associated with neonatal sepsis among neonates in Temeke and Mwananyamala Hospitals in Dar es Salaam, Tanzania. Tanzania Journal of Health Research, 18(4).
- Walker, O., Kenny, C. B., and Goel, N. (2019). Neonatal sepsis. Paediatrics and Child Health, 29(6): 263-268
CITE AS: Mbito Chindoro Mongo (2023). The Occurrence and Correlating Elements of Newborn Mortality in Jinja District, Uganda. INOSR Experimental Sciences 12(2):33-41. https://doi.org/10.59298/INOSRES/2023/2.3.1000