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Variation in neonatal mortality and its relation to country characteristics in sub-Saharan Africa : an ecological study

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Kayode, Gbenga Ayodele, Grobbee, Diederick E., Amoakoh-Coleman, Mary, Ansah, Evelyn, Uthman, Olalekan A. and Klipstein-Grobusch, Kerstin (2017) Variation in neonatal mortality and its relation to country characteristics in sub-Saharan Africa : an ecological study. BMJ Global Health, 2 (4). e000209. doi:10.1136/bmjgh-2016-000209 ISSN 2059-7908.

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Official URL: https://doi.org/10.1136/bmjgh-2016-000209

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Abstract

A substantial reduction in neonatal mortality is the main priority to reduce under-five mortality. A clear understanding of the variation in neonatal mortality and the underlying causes is important for targeted intervention. We aimed to explore variation in neonatal mortality and identify underlying causes of variation in neonatal mortality in sub-Saharan Africa (SSA).This ecological study used 2012 publicly available data from WHO, the US Agency for International Development and the World Bank. Variation in neonatal mortality across 49 SSA countries was examined using control chart and explanatory spatial data analysis. Associations between country-level characteristics and neonatal mortality were examined using linear regression analysis.The control chart showed that 28 (57%) SSA countries exhibited special-cause variation, 14 countries were below and 14 above the 99.8% control-limits. The remaining 21 (43%) SSA countries showed common-cause variation. No spatial clustering was observed for neonatal mortality (Global Moran's I statistic -0.10; p=0.74). Linear regression analysis showed HIV/AIDS prevalence among the population of reproductive age to be positively associated with neonatal mortality (β=0.463; 95% CI 0.135 to 0.790; p<0.01). Declining socioeconomic deprivation (β=-0.234; 95% CI -0.424 to -0.044; p<0.05) and high quality of healthcare governance (β=-1.327, 95% CI -2.073 to -0.580; p<0.01) were inversely associated with neonatal mortality.This study shows a wide variation in neonatal mortality in SSA. A substantial part of this variation can be explained by differences in the quality of healthcare governance, prevalence of HIV and socioeconomic deprivation. Future studies should validate our findings using more rigorous epidemiological study designs.

Item Type: Journal Article
Subjects: H Social Sciences > HB Economic Theory
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Newborn infants -- Mortality -- Statistics -- Africa, Infant health services -- Statistics -- Africa
Journal or Publication Title: BMJ Global Health
Publisher: British Medical Journal
ISSN: 2059-7908
Official Date: 25 October 2017
Dates:
DateEvent
25 October 2017Published
2 September 2017Accepted
Volume: 2
Number: 4
Article Number: e000209
DOI: 10.1136/bmjgh-2016-000209
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): ** From Europe PMC via Jisc Publications Router. ** Licence for this article: cc by
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 5 January 2018
Date of first compliant Open Access: 5 January 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNederlandse Organisatie voor Wetenschappelijk Onderzoekhttp://dx.doi.org/10.13039/501100003246
Related URLs:
  • http://europepmc.org/articles/PMC5663256...
  • http://europepmc.org/articles/PMC5663256

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