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When, Where, and Why Are Babies Dying?: Neonatal Death Surveillance and Review in Bangladesh
Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Örebro University, School of Health Sciences. Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 8, article id e0159388Article in journal (Refereed) Published
Abstract [en]

Background: Better data on cause of, and factors contributing to, neonatal deaths are needed to improve interventions aimed at reducing neonatal mortality in low-and middle-income countries.

Methods: Community surveillance to identify all neonatal deaths across four districts in Bangladesh. Verbal autopsy for every fifth case and InterVA-4 used to assign likely cause of death.

Findings: 6748 neonatal deaths identified, giving a neonatal mortality rate of 24.4 per 1000 live births. Of these, 51.3% occurred in the community and 48.7% at or on the way to a health facility. Almost half (46.1%) occurred within 24 hours of birth with 83.6% of all deaths occurring in the first seven days of life. Birth asphyxia was the leading cause of death (43%), followed by infections (29.3%), and prematurity (22.2%). In 68.3% of cases, care had been provided at a health facility before death occurred. Care-seeking was significantly higher among mothers who were educated (RR 1.18, 95% CI: 1.04-1.35) or who delivered at a health facility (RR 1.48, 95% CI 1.37-1.60) and lower among mothers who had 2-4 previous births (RR 0.89, 95% CI 0.82-0.96), for baby girls (RR 0.87, 95% CI 0.80-0.93), and for low birth weight babies (RR 0.89, 95% CI 0.82-0.96).

Interpretation: Most parents of neonates who died had accessed and received care from a qualified health-care provider. To further reduce neonatal mortality, it is important that the quality of care provided, particularly skilled birth attendance, emergency obstetric care, and neonatal care during the first month of life is improved, such that it is timely, safe, and effective.

Place, publisher, year, edition, pages
Public Library of Science , 2016. Vol. 11, no 8, article id e0159388
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
URN: urn:nbn:se:oru:diva-52508DOI: 10.1371/journal.pone.0159388ISI: 000381110300011PubMedID: 27478900Scopus ID: 2-s2.0-84982136517OAI: oai:DiVA.org:oru-52508DiVA, id: diva2:974321
Note

Funding Agency:

DFID 202945-101    PCA-UNICEF/PCA/2011/015    PCA-UNICEF/PCA/2012/009 

Available from: 2016-09-26 Created: 2016-09-26 Last updated: 2017-11-21Bibliographically approved

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Biswas, Animesh

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