Levels, Timing and Causes of Neonatal Mortality in Rural Ethiopian Communities

Background: Despite a remarkable reduction in under five mortality over the last decade in Ethiopia, there has been little progress towards reducing neonatal morality. Over fifty percent of infant and forty percent of under five deaths in Ethiopia are neonatal.

Methods: A baseline census was conducted in 22 rural health center catchment communities, 132 total kebeles (villages), of Sidama Zone, Southern Nations Nationalities and People’s (SNNP) Region and E. Shoa and W. Arsi Zones, Oromia Region, Ethiopia.  The census includes data from a total of 119,352 households and 115,230 women of reproductive age and focused on three groups of respondents:  (1) Heads of households, (2) women of reproductive age (15-49 years), and (3) women who had a delivery within sixty days prior to the survey.   

Results: The overall neonatal mortality rate (NMR) across all sites during the one year prior to the survey was 35 per 1,000 live births. Verbal autopsy technique using hierarchal computer algorithm was used to determine the timing and cause of 474 newborn deaths.  Sepsis/infection attributed to 41.8%, asphyxia 13.7%, birth injury 13.7%, tetanus 7.8%, preterm 3.6%, congenital malformations 2.3% and unknown cause in 17.1% of cases. Seventy four percent of the deaths occurred during early neonatal period, 0-6 days, while 24% occurred in late neonatal period, 7-28days.

Conclusion: Addressing neonatal death must be given new emphasis to reduce child deaths and reach MDG 4. The management of infection, asphyxia and birth injuries are priority interventions to decrease NMR.