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Home births increase risk for neonatal mortality in Africa
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Countries in East and West Africa demonstrate the highest level of neonatal deaths due to home birth and lack of care teams, as well as the lowest decrease in neonatal deaths since 1990, according to research published in Geospatial Health.
The researchers wrote that one-third of all deaths of children younger than age of 5 in these regions are attributed to neonatal mortality.
“Future UN Sustainable Development Goal (SDG)-interventions may target [various] dimensions of need in priority high-risk districts and countries to further reduce the burden of neonatal mortality in Africa,” Sue C. Grady, PhD, MPH, from the department of geography, environment and spatial sciences as well as the Global Health and Geography Lab at Michigan State University, and colleagues wrote.
To determine where to target the UN’s Sustainable Development Goals for the purpose of reducing neonatal mortality in East and West Africa — including where to improve care around the time of delivery, where to increase mother’s education and where to further empower women — the researchers conducted a cross-sectional retrospective study.
After collecting birth and death data from these geographic areas through the Demographic and Health Survey, the researchers then estimated geographically weighted Poisson regression models to pair needs with specific districts.
Countries encompassed in the study include 69 districts within East Africa, including those in Ethiopia (n = 11), Kenya (n = 8), Malawi (n = 3), Mozambique (n = 10), Tanzania (n = 19), Zambia (n = 10) and Zimbabwe (n = 8). Sixty-two districts in West Africa were examined in the study, including from Benin (n = 12), Burkina Faso (n = 13), Ghana (n = 10), Guinea (n = 8), Mali (n = 6), Niger (n = 7) and Nigeria (n = 6).
According to study results, home births were significantly related to neonatal mortality in East Africa, in addition to the lack of maternal education and lack of female-led contraceptive practices. West African districts also saw a significant connection between home births and infant mortality, with added risk factors including mothers with a primary education and mothers who did not plan or want their previous child.
Maternal exposure to unprotected water sources explained neonatal mortality in many home births within East Africa, and infant mortality in West Africa could be explained by the older age of the mother and female sex of the infant.
“This study recommends that future SDG-interventions pertaining to neonatal mortality be incorporated into health and non-health goals in districts and countries in East Africa and West Africa,” Grady and colleagues wrote.
Disclosure: The researchers provide no relevant financial disclosures.
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