Epidemiology of neonatal near miss in Ethiopia: A systematic review and meta-analysis

Background: In many low-resource countries, progress toward reducing neonatal mortality is slow. This scenario is particularly prevalent in Sub-Saharan Africa and Ethiopia. Neonates who nearly died due to severe complications during birth or the neonatal period constitute neonatal near-miss cases. However, no pooled data exists to quantify the magnitude of neonatal near-misses in Ethiopia. As a result, the goal of this study was to identify national burden of NNM and associated factors in Ethiopia. Methods: This systematic review and meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was registered on PROSPERO (CRD42022303477). A comprehensive search of literature was carried out using PubMed/Medline, HINARI, African Journal Online, Science Direct, and Google Scholar. From 2010 to 2020, all lists of eligible studies' references were also identified and retrieved. The pooled estimate with a (95% CI) was calculated using a random-effects model in STATA 14.1-version. I2and meta-bias statistics were used to assess heterogeneity of the included studies. Results: From those included studies, (9 articles) with a total of 6437 neonates were included in the meta-analysis. The pooled prevalence of NNM in Ethiopia was 14% (95% CI: 13–15). Neonates who were born by Caesarean section, neonates whose mothers had pregnancy-induced hypertension and premature ruptured-membranes had higher odds of NNM. Conclusions: In Ethiopia, one out of every seven neonates suffers from NNM. Cesarean section, Pregnancy-induced hypertension and premature ruptures of the membrane are risk factors for NNM. Improving maternal health-care utilization would reduce the burden of NNM