Risk factors of neonatal mortality in Ethiopia

Background: An understanding of risk factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to reduce neonatal deaths.Objective: This study aimed to identify risk factors of neonatal mortality in Ethiopia.Methods: The data source for the study was the 2011 Ethiopian Demographic and Health Survey. The survival information of a total of 8,651 live-born neonates born five years before the survey was examined. Stratified Cox-proportional hazards model was employed to identify risk factors associated with neonatal deaths.Results: About 71% of the neonatal deaths occurred within the first week after birth and, the cumulative death rate reached 79% in the second week. The estimated hazard ratios of mortality were higher for twins or multiple births (HR=3.73, 95% CI: 2.81-4.94), first order birth (HR=1.68, 95% CI: 1.25-2.24), male sex (HR=1.26, 95% CI: 1.06-1.50), birth interval shorter than 24 months (HR=1.63, 95% CI:1.31-2.03), very small and vary large size neonates born to mothers younger than 20 years of age and above 34 years (HR=1.38, 95% CI:1.05-1.82) and (HR=1.32, 95% CI 0.06-2.80), respectively, and neonates whose mothers had a history of pregnancy complications (HR=1.73, 95% CI: 1.27-2.24) compared to their respective counterparts. The risk of dying was lower for neonates whose mothers attended antenatal visits (HR=0.72, 95% CI: 0.59-0.89) and neonates put to breast immediately upon birth (HR=0.83, 95% CI: 0.59-0.99).Conclusion: Public health interventions directed at reducing neonatal death should address the demographic factors mentioned above and maternal healt