Analysis Of Causes And Prevention Of Neonatal Mortality Rate

Medical And Health Science Project And Seminar Material

Analysis Of Causes And Prevention Of Neonatal Mortality Rate


 

Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Area of the Study
  • 3.3 Population of the Study
  • 3.4 Sample and Sampling Techniques
  • 3.5 Data Collection Instrumentation
  • 3.6 Validity of the Instrument
  • 3.7 Reliability of the Instrument
  • 3.8 Method of Data Collection
  • 3.9 Coding and Scoring of the Instrument
  • 3.10 Method of Data Analysis
  • 3.11 Ethical Consideration

Chapter Four:

Results

  • 4.1 General Description of Variables
  • 4.2 Result/data Presentation
  • 4.3 Discussion of Results

Chapter Five:

Summary Conclusion and Recommendations

  • 5.1 Summary of the Findings
  • 5.2 Conclusion
  • 5.3 Limitations of the Study
  • 5.4 Recommendations
  • 5.5 Suggestions for Further Studies
  • REFERENCES
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background to the Study

Globally, 2.5 million children die in the first month of life, almost 7,000 newborn deaths occur every day with 1 million dying on the first day of life, while nearly 1 million died within 6 days of life in 2017 (UNICEF, 2019). Also, a child’s risk of dying is extremely high in the first 28 days of life, during the neonatal period (Lawn et al., 2016). Although the world has made considerable progress in child survival since 1990, the number of neonatal deaths dropped from 5.0 million in 1990 to 2.5 million in 2017 globally (UNICEF, 2019), even though the reduction in neonatal mortality from 1990 to 2017 has not been meaningfully low, compared to post-neonatal under-5 mortality (Wang et al., 2019). Mortality among under-five was higher than neonatal mortality, even though there was decreased mortality in all regions globally (UNICEF, 2019). Generally, all over the world, the neonatal mortality rate fell by 51 per cent from 37 deaths per 1,000 live births in 1990 to 18 in 2017, a slighter reduction in mortality than among children aged 1-59 months (63 per cent) (UNICEF, 2019). With the exclusion of the highly developed countries, neonatal mortality has fallen more rapidly since the year 2000 than between years 1990-2000 (UNICEF, 2019).
Globally, as the neonatal mortality rate decreases over time, so the cause-specific risks decreases. The risk of death from each cause is higher in high-mortality settings, even for causes that dominate proportionally in low-mortality settings. The risks of death due to preterm birth, intrapartum complications, and sepsis are 10, 36, and 34 times greater, respectively, in settings with more than 30 neonatal deaths per 1000 live births compared to settings with less than 5 neonatal deaths per 1000 live births (Oza et al., 2016). Preterm birth is the leading cause of neonatal deaths in every MDG region, with the highest risks in southern Asia (11.9 per 1000 live births) and sub-Saharan Africa (9.5 per 1000 live births) (Liu, 2018).

In Oza et al.’s study, it was revealed that absolute risks of death as a result of preterm birth and intrapartum complications have been decreasing more in the early period than the late period. Between 2000 and 2013, the largest absolute risk reduction in the overall neonatal period was estimated for intrapartum complications, it dropped from 7.2 deaths (4.8–9.5) to 4.7 deaths (3.4–6.1) per 1000 live births, and the largest relative decrease in risk was predicted for neonatal tetanus, which dropped by 73% (from 1.1 deaths to 0.3 deaths per 1000 live births) between 2000 and 2013. The smallest relative decrease in risk was predicted for congenital disorders (13% decrease from 2.4 deaths to 2.1 deaths per 1000 live births) (Oza et al., 2016; Liu, 2018).

The neonatal period, i.e., the first 28 days of life, is the most vulnerable time for a child’s survival (UNICEF, 2019). In 2017, many children confronted the utmost risk of dying in their first month of life at an average global rate of 18 deaths per 1,000 live births (UNICEF, 2019). The probability of dying after the first month but before reaching age 1 was 12 compared to after age 1 but before age 5 was 10 (UNICEF, 2019). In 2017 alone, it was reported that 2.5 million children died in the first month of life, while approximately, 7,000 neonates died every day (UNICEF, 2019). Most of these deaths occurred in the first week with about 1 million dying on the first day and close to 1 million dying within the next six days (UNICEF, 2019).

Decreased under-five mortality is related to a higher concentration of under-five deaths occurring during the neonatal period (Wang et al., 2019). While neonatal deaths accounted for 47 per cent of global under-five deaths in 2017, part of neonatal deaths among under-five deaths is still somewhat low in sub-Saharan Africa (37 per cent), and it remains the region with the utmost under-five mortality rates (UNICEF, 2019). In regions where under-five mortality rates are relatively low, more than half of all under-five deaths occur during the neonatal period (Wang et al., 2019).

According to recent data from the World Health Organization (WHO), Nigeria has experienced some challenges in child mortality rates in recent years. In 2003, the infant mortality rate was estimated at 100 per 1000 births, while it was 87 in 1990 (WHO, 2020). Despite efforts to improve healthcare access, two-thirds of births in Nigeria still occur at home, indicating persisting low utilization of health facilities for childbirth (WHO, 2020). The lack of access to quality delivery services and the low presence of trained healthcare providers during childbirth exacerbate the high mortality rates in Nigeria (WHO, 2020). Only a little more than one-third of births are attended to by doctors, nurses, or midwives, highlighting a significant gap in skilled birth attendance (WHO, 2020). Various challenges contribute to the difficulty in accessing healthcare in Nigeria, including financial constraints, long distances to health facilities, and an ineffective transportation system (WHO, 2020). These barriers disproportionately affect maternal and child health outcomes in the country.

Moreover, the lack of trained healthcare providers attending to births is compounded by inadequate antenatal care services. Only six in ten mothers receive antenatal care from trained medical professionals, indicating a gap in prenatal healthcare access (WHO, 2020). Nurses and midwives are the most frequently utilized sources of healthcare in Nigeria, but their numbers are insufficient to meet the population’s needs (WHO, 2020). Adequate antenatal care for pregnant women can help prevent major causes of neonatal mortality in Nigeria, such as neonatal tetanus, sepsis, asphyxia, malaria, and maternal anemia (WHO, 2020). However, as of 2018, WHO statistics indicate that only 58 percent of pregnant women received iron supplements, and merely 39 percent received drugs to prevent malaria, indicating gaps in preventive healthcare services (WHO, 2020) hence the need for this study.


1.2 Statement of the Problem

Neonatal mortality remains a public health problem in the developing world. Globally, around 2.5 million neonatal deaths are reported annually with the highest mortality concentrated in sub-Saharan Africa and South Asia. In comparison with countries demonstrating the lowest neonatal mortality, the risk of mortality is over 30 times higher in sub-Saharan Africa.

Nigeria, in the last few years have experienced some deteriorating child mortality. This mortality can be partly due to the persisting low numbers of births occurring in health facilities as well as the low number of births attended to by trained healthcare service providers (Adewemimo et al., 2020). It was recorded that in 2003, two thirds of the births in Nigeria still occurred at home. Similarly, only slightly more than one-third of births are attended to by doctors, nurses, or midwives (Izugbara et al., 2017). Although, in year 2000, the maternal mortality ratio in Nigeria was 800 per 100 000 live births (Adewemimo et al., 2020). Even through it is obvious that the higher mortality rates are as a result of lack of access to or use of quality delivery services which is an issue of immense importance in Nigeria. Some of the many difficulties stated by women in describing difficulty with accessing healthcare in Nigeria are problems of obtaining money for treatment, distance to health facility and having to take transport (Fagbamigbe et al., 2020). Also, lack of trained health care professionals attending to births in Nigeria is complicated by the fact that only six in ten mothers receive antenatal care from a trained medical professional. Nurses and midwives are the most frequently used source of healthcare (Ononokpono et al., 2019).

Meanwhile, good antenatal care can prevent the major causes of neonatal mortality in Nigeria as well as other conditions like neonatal tetanus, malaria, and maternal anaemia. In addition, as of 2003 only 58 percent of pregnant women received iron supplements and only 39 received drugs to prevent malaria (Adekanmbi et al., 2019). Similarly, Nigeria is the African country with the lowest vaccination rate with 13% immunization rate for children between 12-23 months. The repercussions of the poor state of pregnant women in Nigeria are several and influence maternal as well as child mortality greatly. The under-five mortality ratio in Nigeria is 201 per 1000 live births meaning that one in five Nigerian children never reach the age of 5 and infant deaths, which account for half of child mortality have also increased from what they were in 1990.

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