Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey

BackgroundOne of the most common measures of society's health is mortality among neonates. Developing and developed countries still differ significantly in neonatal mortality rates. While there are about 18 neonatal deaths worldwide for every 1,000 live births during the first month of life, le...

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Main Authors: Alebachew Ferede Zegeye, Desale Bihonegn Asmamaw, Wubshet D. Negash, Tadele Biresaw Belachew, Elsa Awoke Fentie, Atitegeb Abera Kidie, Tsegaw Amare Baykeda, Samrawit Mihret Fetene, Banchlay Addis, Sisay Maru Wubante, Abel Endawkie, Tadesse Tarik Tamir
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1380913/full
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author Alebachew Ferede Zegeye
Desale Bihonegn Asmamaw
Wubshet D. Negash
Wubshet D. Negash
Tadele Biresaw Belachew
Elsa Awoke Fentie
Atitegeb Abera Kidie
Tsegaw Amare Baykeda
Samrawit Mihret Fetene
Banchlay Addis
Sisay Maru Wubante
Abel Endawkie
Tadesse Tarik Tamir
author_facet Alebachew Ferede Zegeye
Desale Bihonegn Asmamaw
Wubshet D. Negash
Wubshet D. Negash
Tadele Biresaw Belachew
Elsa Awoke Fentie
Atitegeb Abera Kidie
Tsegaw Amare Baykeda
Samrawit Mihret Fetene
Banchlay Addis
Sisay Maru Wubante
Abel Endawkie
Tadesse Tarik Tamir
author_sort Alebachew Ferede Zegeye
collection DOAJ
description BackgroundOne of the most common measures of society's health is mortality among neonates. Developing and developed countries still differ significantly in neonatal mortality rates. While there are about 18 neonatal deaths worldwide for every 1,000 live births during the first month of life, less is known about neonatal mortality in developing countries, especially in East Africa. Understanding the extent of mortality during the post-neonatal period and its determinants is crucial for developing appropriate policies and strategies that could help solve the issue. Thus, the aim of this study was to identify the prevalence of post-neonatal mortality in East African countries and the factors that are associated with it.MethodsSecondary data analysis was conducted using data from the most recent Demographic and Health Surveys, which included 11 East African countries between 2014 and 2022. A weighted sample of 225,635 live births had been used in the study. STATA/SE 14 was used for data analysis. The multilevel mixed-effects logistic regression model was applied to determine the factors associated with post-neonatal mortality. In the multilevel logistic regression model, significant factors were deemed to be associated with post-neonatal mortality at p-values <0.05. The data were interpreted using the adjusted odds ratio (AOR) and confidence interval (CI). The best-fit model has been found to be the one with the lowest deviance and highest logliklihood ratio.ResultsIn East Africa, post-neonatal mortality was found to be 15 per 1,000 live births. Pregnancy type (AOR = 3.09, 95% CI: 2.30, 4.13), birth weight (AOR = 1.58, 95% CI: 1.25, 2.01), maternal age (AOR = 1.58, 95% CI: 1.32, 1.90), maternal education (AOR = 1.82, 95% CI: 1.14, 2.92), tetanus shots prior to delivery (AOR = 1.23; 95% CI: 1.06–1.42), birth order (AOR = 5.68, 95% CI: 4.48, 7.24), those born in Uganda (AOR = 1.33, 95% CI: 1.03, 1.73), and Burundi (AOR = 1.48, 95% CI: 1.11, 1.98) had the highest odds of post-neonatal death.ConclusionAccording to this study, post-neonatal mortality is higher in developing countries, particularly in East Africa. It was discovered that factors at the individual and community levels associated with post-neonatal mortality. Consequently, focus should be paid to babies born to mothers in the lowest age group, those born of multiple pregnancies, without formal educations, who did not receive tetanus shots prior to birth, and who were born in the first birth order.
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spelling doaj-art-6e5fa4dc395349abbabeef5b9b2e13fb2025-01-23T06:56:42ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011310.3389/fped.2025.13809131380913Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health surveyAlebachew Ferede Zegeye0Desale Bihonegn Asmamaw1Wubshet D. Negash2Wubshet D. Negash3Tadele Biresaw Belachew4Elsa Awoke Fentie5Atitegeb Abera Kidie6Tsegaw Amare Baykeda7Samrawit Mihret Fetene8Banchlay Addis9Sisay Maru Wubante10Abel Endawkie11Tadesse Tarik Tamir12Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences University of Gondar, Gondar, EthiopiaDepartment of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaNational Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, AustraliaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaSchool of Public Health, College of Health Science, Woldia University, Woldia, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Wollo, EthiopiaDepartment of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaBackgroundOne of the most common measures of society's health is mortality among neonates. Developing and developed countries still differ significantly in neonatal mortality rates. While there are about 18 neonatal deaths worldwide for every 1,000 live births during the first month of life, less is known about neonatal mortality in developing countries, especially in East Africa. Understanding the extent of mortality during the post-neonatal period and its determinants is crucial for developing appropriate policies and strategies that could help solve the issue. Thus, the aim of this study was to identify the prevalence of post-neonatal mortality in East African countries and the factors that are associated with it.MethodsSecondary data analysis was conducted using data from the most recent Demographic and Health Surveys, which included 11 East African countries between 2014 and 2022. A weighted sample of 225,635 live births had been used in the study. STATA/SE 14 was used for data analysis. The multilevel mixed-effects logistic regression model was applied to determine the factors associated with post-neonatal mortality. In the multilevel logistic regression model, significant factors were deemed to be associated with post-neonatal mortality at p-values <0.05. The data were interpreted using the adjusted odds ratio (AOR) and confidence interval (CI). The best-fit model has been found to be the one with the lowest deviance and highest logliklihood ratio.ResultsIn East Africa, post-neonatal mortality was found to be 15 per 1,000 live births. Pregnancy type (AOR = 3.09, 95% CI: 2.30, 4.13), birth weight (AOR = 1.58, 95% CI: 1.25, 2.01), maternal age (AOR = 1.58, 95% CI: 1.32, 1.90), maternal education (AOR = 1.82, 95% CI: 1.14, 2.92), tetanus shots prior to delivery (AOR = 1.23; 95% CI: 1.06–1.42), birth order (AOR = 5.68, 95% CI: 4.48, 7.24), those born in Uganda (AOR = 1.33, 95% CI: 1.03, 1.73), and Burundi (AOR = 1.48, 95% CI: 1.11, 1.98) had the highest odds of post-neonatal death.ConclusionAccording to this study, post-neonatal mortality is higher in developing countries, particularly in East Africa. It was discovered that factors at the individual and community levels associated with post-neonatal mortality. Consequently, focus should be paid to babies born to mothers in the lowest age group, those born of multiple pregnancies, without formal educations, who did not receive tetanus shots prior to birth, and who were born in the first birth order.https://www.frontiersin.org/articles/10.3389/fped.2025.1380913/fulldeterminantsEast Africamortalitypost-neonatalprevalence
spellingShingle Alebachew Ferede Zegeye
Desale Bihonegn Asmamaw
Wubshet D. Negash
Wubshet D. Negash
Tadele Biresaw Belachew
Elsa Awoke Fentie
Atitegeb Abera Kidie
Tsegaw Amare Baykeda
Samrawit Mihret Fetene
Banchlay Addis
Sisay Maru Wubante
Abel Endawkie
Tadesse Tarik Tamir
Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
Frontiers in Pediatrics
determinants
East Africa
mortality
post-neonatal
prevalence
title Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
title_full Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
title_fullStr Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
title_full_unstemmed Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
title_short Prevalence and determinants of post-neonatal mortality in East Africa: a multilevel analysis of the recent demographic and health survey
title_sort prevalence and determinants of post neonatal mortality in east africa a multilevel analysis of the recent demographic and health survey
topic determinants
East Africa
mortality
post-neonatal
prevalence
url https://www.frontiersin.org/articles/10.3389/fped.2025.1380913/full
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