Determinants and Risk Factors of Neonatal Mortality in Gaza Governorates in the Year 2008.
Imad Ismael Mahmood El Awoor
عماد اسماعيل محمد العوور
Universally, neonatal mortality accounts for almost 40 % of under-five child mortality. The overall aim of the study was to determine the major risk factors contributing to neonatal mortality in the Gaza Strip, in order to provide scientific evidence for future preventive strategies to promote child and maternal health. The study was carried out in all Gaza Governorates at the house hold level. A case control design was adopted and interviewed questionnaire was completed by 715 eligible mothers. Of the respondents, 220 were cases who unfortunately experienced neonatal deaths and 495 controls with corresponding a live baby matched by sex, locality and nearest one week of birth date. Response rate was 95%. Cross tabulation, odds ratio, and multilevel bivariate logistic regression was done to explore the risk factors associated with neonatal mortality. The odds of neonatal mortality was higher among low birth weight babies than of the normal weight group (P=0.001, OR= 9.08) and premature babies than the full term ones (P=0.01, OR=2.83). In addition, the odds of neonatal mortality was also higher among neonates whose mother had a history of prolonged labor (P=0.01, OR=0.52), or caesarean section delivery (P=0.03) and/or previous history of neonatal death (OR=5.64, P=0.002). In addition, the study clarified that, consanguineous marriage was a predictor for neonatal mortality (P= 0.04, OR= 1.20). Also, the influence of domestic violence against mother during pregnancy on neonatal mortality was prominent more among cases than controls (P= 0.02, OR= 1.58). Unconsciousness status of the newborn after delivery, and previous history of neonatal death were found to be strong risk factors for the neonatal mortality, while adherence to colostrums feeding, type of vaccine given to the new born early initiation of breast feeding and breast feeding exclusivity were found to be protective factors for the neonatal mortality. The study concluded that, public health interventions at all levels, community awareness, with the help of all stakeholders including MOH, UNRWA, UNICEF and other NGO s and improvement of secondary and tertiary care could help in reducing neonatal mortality.