Why Are Babies Dying in the First Month after Birth? A 7-Year Study of Neonatal Mortality in Northern Ghana

Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana.
PLoS ONE (Impact Factor: 3.23). 03/2013; 8(3):e58924. DOI: 10.1371/journal.pone.0058924
Source: PubMed


To determine the neonatal mortality rate in the Kassena-Nankana District (KND) of northern Ghana, and to identify the leading causes and timing of neonatal deaths.
The KND falls within the Navrongo Health Research Centre's Health and Demographic Surveillance System (HDSS), which uses trained field workers to gather and update health and demographic information from community members every four months. We utilized HDSS data from 2003-2009 to examine patterns of neonatal mortality.
A total of 17,751 live births between January 2003 and December 2009 were recorded, including 424 neonatal deaths 64.8%(275) of neonatal deaths occurred in the first week of life. The overall neonatal mortality rate was 24 per 1000 live births (95%CI 22 to 26) and early neonatal mortality rate was 16 per 1000 live births (95% CI 14 to 17). Neonatal mortality rates decreased over the period from 26 per 1000 live births in 2003 to 19 per 1000 live births in 2009. In all, 32%(137) of the neonatal deaths were from infections, 21%(88) from birth injury and asphyxia and 18%(76) from prematurity, making these three the leading causes of neonatal deaths in the area. Birth injury and asphyxia (31%) and prematurity (26%) were the leading causes of early neonatal deaths, while infection accounted for 59% of late neonatal deaths. Nearly 46% of all neonatal deaths occurred during the first three postnatal days. In multivariate analysis, multiple births, gestational age <32 weeks and first pregnancies conferred the highest odds of neonatal deaths.
Neonatal mortality rates are declining in rural northern Ghana, with majority of deaths occurring within the first week of life. This has major policy, programmatic and research implications. Further research is needed to better understand the social, cultural, and logistical factors that drive high mortality in the early days following delivery.

Download full-text


Available from: Raymond Akawire Aborigo,
  • Source
    • "Though poverty is well acclaimed as an essential factor influencing child mortality [4,14,19,20], findings on the effect of household socio economic differentials on child mortality have been mixed. A study in parts of rural Ghana and another in Tanzania did not find any significant effect of household socio economic status on child mortality [18,19] while a study using Nigeria Demographic and Health Survey for 2008, found that relatively prosperous households were less likely to experience child death than the poorest households in rural Nigeria [13]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background In spite of global decline in under-five mortality, the goal of achieving MDG 4 still remains largely unattained in low and middle income countries as the year 2015 closes-in. To accelerate the pace of mortality decline, proven interventions with high impact need to be implemented to help achieve the goal of drastically reducing childhood mortality. This paper explores the association between socio-economic and demographic factors and under-five mortality in an impoverished region in rural northern Ghana. Methods We used survey data on 3975 women aged 15–49 who have ever given birth. First, chi-square test was used to test the association of social, economic and demographic characteristics of mothers with the experience of under-five death. Subsequently, we ran a logistic regression model to estimate the relative association of factors that influence childhood mortality after excluding variables that were not significant at the bivariate level. Results Factors that significantly predict under-five mortality included mothers’ educational level, presence of co-wives, age and marital status. Mothers who have achieved primary or junior high school education were 45% less likely to experience under-five death than mothers with no formal education at all (OR = 0.55, p < 0.001). Monogamous women were 22% less likely to experience under-five deaths than mothers in polygamous marriages (OR = 0.78, p = 0.01). Similarly, mothers who were between the ages of 35 and 49 were about eleven times more likely to experience under-five deaths than those below the age of 20 years (OR = 11.44, p < 0.001). Also, women who were married had a 27% less likelihood (OR = 0.73, p = 0.01) of experiencing an under-five death than those who were single, divorced or widowed. Conclusion Taken independently, maternal education, age, marital status and presence of co-wives are associated with childhood mortality. The relationship of these indicators with women’s autonomy, health seeking behavior, and other factors that affect child survival merit further investigation so that interventions could be designed to foster reductions in child mortality by considering the needs and welfare of women including the need for female education, autonomy and socioeconomic well-being.
    BMC International Health and Human Rights 08/2014; 14(24). DOI:10.1186/1472-698X-14-24 · 1.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was conducted to determine the rate and to identify risk factors for neonatal mortality at Misurata Central Hospital, Libya. A descriptive, retrospective hospital-based study was conducted during the period from January through December 2012. The records of the newborn admitted to the neonatal unit were reviewed. The information retrieved were age, sex of baby, gestational age, parity of mother, maternal illness, and date and cause of death. Total infants delivered were 6520, 795 (12.1%) were admitted to the SCBU. Causes of admission were low birth weight [LBW] 210 (26.4%), infection 190 (23.8%), asphyxia 79 (9.9%). The neonatal mortality rate was 1.2%. Early neonatal death rate was 1.1%. Causes of deaths were prematurity (30; 37.5%), birth asphyxia (16, 20%), infection (15, 18%) congenital malformations (8, 10%) and other reasons (11, 13.7%). Maternal factors contributed for 45 (56%) of the neonatal deaths. These were: rupture of the membrane (16, 20%) antepartum hemorrhage (10, 12.5%), infections (9, 11.2%), pre-eclampsia (3, 3.7%) and others (8.7%) accounted.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The provision of maternal and neonatal health care in rural northern Ghana is pluralistic, consisting of traditional and allopathic providers. Although women often use these providers interchangeably, important differences exist. This study explored the differences in approaches to maternal and neonatal care provision by these two different types of providers. This research was part of the Stillbirth and Neonatal Death Study (SANDS), conducted in northern Ghana in 2010. Trained field staff of the Navrongo Health Research Centre conducted in-depth interviews with 13 allopathic and 8 traditional providers. Interviews were audio-recorded, transcribed, and analyzed using in vivo coding and discussion amongst the research team. Three overarching themes resulted: 1) many allopathic providers were isolated from the culture of the communities in which they practiced, while traditional providers were much more aware of the local cultural beliefs and practices. 2) Allopathic and traditional healthcare providers have different frameworks for understanding health and disease, with allopathic providers relying heavily on their biomedical knowledge, and traditional providers drawing on their knowledge of natural remedies. 3) All providers agreed that education directed at pregnant women, providers (both allopathic and traditional), and the community at large is needed to improve maternal and neonatal outcomes. Our findings suggest that, among other things, programmatic efforts need to be placed on the cultural education of allopathic providers.
    African Journal of Reproductive Health 06/2014; 18(2):36-45.
Show more