Statistical analysis of neonatal mortality at Pumwani maternity Hospital Nairobi County

Abstract

Despite numerous interventions and action plans, very little evidence exists on why the infant and child mortality rates are increasing in Kenya. Most studies have focused on infant and child mortality putting neonatal mortality on the backseat. The development of focused and evidence- based health interventions to reduce neonatal mortality warrants an examination of factors and causes affecting it. Therefore, this study attempts to examine individual socioeconomic, bio-dernographic, health care variables affecting neonatal mortality in Pumwani maternity hospital as well as the causes of neonatal mortality. The study is analytical cross-sectional study through secondary data analysis where information from 600 live births out of 2519 live births were analyzed from the records ofPumwani maternity hospital for the period January 2011- December 2011 after exclusion and inclusion criteria was met. Cross tabulation and two levels logistic regression was performed to analyze the factors! predictors associated with neonatal deaths and the causes of deaths. The significance for each selected predictor variable was tested using the Wald' s test statistic, and the factors were rank ordered according to their overall p- values. The odds of neonatal death were found to be higher for neonates born to mothers who did not utilize antenatal care (OR= 6.516, p-value =0.00) compared to those born to mothers who utilized the service. The odds of neonatal deaths were higher in neonates who weighed less than 2500 grams (OR=43,pvalue= O.OO). A progressive reduction in the odds occurred as the level of mothers education increased. The odds of neonatal deaths were found to be lower for infants born to employed mothers (OR= 0.576, p-value= 0.027) compared to those who were unemployed. Neonates born of adolescent mothers (15-19 years) seem to be less likely to die with a mortality rate of 1.5%, young adults (20-34 years) 6.5%, and adults (35 and above) 4.8%. Mothers in the age group 20-34 need further investigation. The risk of neonatal death increases if the mother of the child is of Other, Protestant and Catholics faith with, [OR=9.56, CI= 3.39- 26.88; OR= 37.69, CI= 3.92-359.57; OR=2.827, CI=l.17-6.81] than those of Muslim faith respectively. Among the causes, respiratory distress syndrome (49.4%), asphyxia (1l.7%) and prematurity (18.2%) were the major causes of neonatal mortality accounting for over 75% of the total deaths. In order to lower neonatal mortality at Pumwani maternity hospital, it is essential to give attention to women with little education targeting of the vulnerable groups like Protestants, others, Catholics and the unemployed. Emphasize the need to antenatal care during pregnancy. Provide expectant women with essential nutrition during antenatal period and after birth. Improvement in perinatal and intrapartum care.