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Background: Globally, 240,000 babies die in the neonatal period annually due to congenital anomalies (CA). Malta reports the highest neonatal mortality rate (NMR) among EU (European Union) Countries, constituting a public health concern. Objectives: This study describes the contribution of CA to NMR in Malta, investigating possible associations with known maternal risk factors of maternal age, nationality, and education. Additionally, it provides an update on the contribution of CA to neonatal deaths in Malta and other EU countries. Methods: Anonymous data for births and neonatal deaths were obtained for 2006–2020 from the National Obstetrics Information System (NOIS) in Malta. Regression analyses adjusting for maternal risk factors were run on this data to explore possible associations with NMR. NMRs published by EUROSTAT 2011–2020 were used to compare mortality by underlying cause of death (CA or non‐CA causes) for Malta and other EU countries. Results: Between 2006 and 2020, 63,890 live births with 283 neonatal deaths were registered in Malta, (NMR 4.4 per 1000 live births). CA accounted for 39.6% of neonatal deaths. No time trends were observed in either total NMR, NMR attributed to CA or mortality due to non‐CA causes. Adjusted variables revealed associations for women hailing from non‐EU, low‐income countries. Malta registered high NMRs compared to EU countries, most marked for deaths attributed to CA. Conclusions: Between 2006 and 2020, Malta's NMR remained stable. Maternal Nationality, from non‐EU low‐income countries, was associated with higher neonatal mortality. The influx of such migrants may play a partial role in the high NMRs experienced. Malta's high NMR was primarily driven by early neonatal deaths, which included high proportions of deaths due to CA and is linked to the fact that termination of pregnancy is illegal in Malta. [ABSTRACT FROM AUTHOR]

Abstract The long-term trends in maternal and child health (MCH) in China and the national-level factors that may be associated with these changes have been poorly explored. This study aimed to assess trends in MCH indicators nationally and separately in urban and rural areas and the impact of public policies over a 30‒year period. An ecological study was conducted using data on neonatal mortality rate (NMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and maternal mortality ratio (MMR) nationally and separately in urban and rural areas in China from 1991 to 2020. Joinpoint regression models were used to estimate the annual percentage changes (APC), average annual percentage changes (AAPC) with 95% confidence intervals (CIs), and mortality differences between urban and rural areas. From 1991 to 2020, maternal and child mortalities in China gradually declined (national AAPC [95% CI]: NMRs − 7.7% [− 8.6%, − 6.8%], IMRs − 7.5% [− 8.4%, − 6.6%], U5MRs − 7.5% [− 8.5%, − 6.5%], MMRs − 5.0% [− 5.7%, − 4.4%]). However, the rate of decline nationally in child mortality slowed after 2005, and in maternal mortality after 2013. For all indicators, the decline in mortality was greater in rural areas than in urban areas. The AAPCs in rate differences between rural and urban areas were − 8.5% for NMRs, − 8.6% for IMRs, − 7.7% for U5MRs, and − 9.6% for MMRs. The AAPCs in rate ratios (rural vs. urban) were − 1.2 for NMRs, − 2.1 for IMRs, − 1.7 for U5MRs, and − 1.9 for MMRs. After 2010, urban‒rural disparity in MMR did not diminish and in NMR, IMR, and U5MR, it gradually narrowed but persisted. MCH indicators have declined at the national level as well as separately in urban and rural areas but may have reached a plateau. Urban‒rural disparities in MCH indicators have narrowed but still exist. Regular analyses of temporal trends in MCH are necessary to assess the effectiveness of measures for timely adjustments.

Objectives: This study compared the neonatal mortality rates (NMRs) and certification behaviors between New Taipei City (NTC) and other cities/counties in Taiwan. Methods: We first examined the NMR trends for days <28 and day 0 for each city or county for the years 2002 to 2022. Joinpoint regression was performed to identify significant changes in the trends. We then linked five population-based data sets to calculate the proportion of day-0 deaths for which the death certificate was issued by an obstetrician and to examine the related characteristics. Finally, we reviewed the charts for 50 day-0 deaths in NTC in 2021 and interviewed hospital managers regarding the regulation of certification behaviors. Results: Only the day 0 NMR trends for NTC and Kaohsiung City (KC) exhibited a decline-and-rise pattern. The annual percent change was 11.4% since 2012 for NTC and 8.1% since 2006 for KC. In total, 788 day-0 deaths occurred between 2018 and 2021, and the death certificates of 404 (52%) were issued by obstetricians. The percentage of day-0 deaths with obstetrician-issued death certificates was 72% in NTC, which was higher than those of other cities/counties (approximately 55%), and a rising trend was also identified (63% in 2018, 73% in 2019, 74% in 2020, and 78% in 2022). More than nine-tenths of these deaths involved a gestational age of <24 weeks, and most of them were the result of artificial abortions. The interviewed hospital managers indicated that various regulations for certification behaviors have been introduced. Conclusions: The higher NMRs and rising NMR trend in NTC compared with other cities/counties were partially due to certification-related behavioral artifacts. To properly interpret the regional variations in NMRs we should first remove this behavioral artifact. [ABSTRACT FROM AUTHOR]

IntroductionAddressing neonatal mortality is an important priority for improving the health and well-being of newborns. Almost two-thirds of infant deaths occur in the first month of life; among these, more than two-thirds die in their first week. Therefore, the aim of this study was to assess the mortality rate and predictors of mortality among neonates admitted to the neonatal intensive care unit (NICU) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, in 2023.MethodsAn institutional-based retrospective follow-up study was conducted using 459 neonates who were admitted to the NICU at Tikur Anbessa Specialized Hospital from January 2020 to December 2022. The data were extracted from randomly selected charts using a pretested data extraction checklist. The Nelson Alan curve with log-rank test was used to compare the presence of differences in the mortality rate of different groups over different categorical variables. The cox proportional hazards analysis model was used to identify predictors of neonatal death. The presence and absence of statistical significance was considered at a p-value of less than 0.05 and the strength of association was measured using AHR.ResultsThe neonatal mortality rate was 3.1 (95% CI: 1.3–4.9) per 1,000 neonate-days. Low birth weight (AHR = 1.44: 95% CI: 1.06–3.13), exclusive breast-feeding (AHR = 0.74: 95% CI: 0.35–0.95), and time of exclusive breast-feeding (AHR = 0.92: 95% CI: 0.49–0.99) were the identified predictors of newborn mortality.ConclusionThe neonatal mortality rate was high. Low birth weight of the neonate, exclusive breast-feeding initiation, and time of exclusive breast-feeding were independent predictors of neonatal death. Therefore, empowering mothers to exclusively breastfeed their children, which is a cost-effective, safe, and realistic option, can significantly minimize infant mortality.

Background: Neonatal Mortality Rate (NMR) is a value which plays a vital role in gauging the effectiveness and advancement in healthcare pertaining to newborns. The alarmingly high rate promotes the need of further development of better medical facilities. One such facility is the Special Newborn Care Unit (SNCU). Objective: This study targets the analysis of factors contributing to the mortality of neonates and aims at coming up with solution to tackle the issue Methodology: A facility based retrospective study was carried out based on information from medical records of neonates admitted to the SNCU from a tertiary care hospital. Results: The 1038 neonates admitted it was found that nearly half of the neonates admitted had low birth weight (48.2%) contrary to maturity where 37.9 % were preterm. Most of the admissions were due to neonatal jaundice (46.6%) followed by low birth weight (15.2%) and respiratory distress syndrome (10.3%). Of the 85 neonates who expired, the leading causes were respiratory distress syndrome (21.2%), sepsis (14.9%), Hypoxic Ischemic Encephalopathy (12.9%), major congenital malformations (12.9%) and extreme low birth weight 11 (12.9%). Conclusion: The expansion of services and technology provided by SNCUs is of great importance in the development of healthcare for the nation. The growth of better antenatal health care, seamless referral systems along with identification of alarming conditions requiring admission to SNCUs immediately after birth form the pillars of confronting the goal of decreasing the NMR.

Background: The neonatal period is the riskiest time for child survival. Globally, 2.4 million children died in the first month of life in 2020, and there are approximately 6,700 newborn deaths every day. In this study, the authors have evaluated the causes of death among infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, Mashhad, Iran, for five years, since 2015. Methods: A cross-sectional study was conducted on all neonates who died in the NICU under study. Data were collected through one of the proposed questionnaires of the Ministry of Health and Medical Education (NOHME), known as the “Green Questionnaire for the Study of the Dead Infant”. The data were recorded regarding asphyxia, congenital anomalies, sepsis or infection, respiratory distress syndrome (RDS), disseminated intravascular coagulation, pneumothorax, seizures, and the date of death. The extracted data were categorized and analyzed by the SPSS software (version 16). Babies who died at more than 28 days of age were excluded. Results: Totally, 501 out of 4,348 NICU admissions died (11.52%), 54.5% of whom were male and 45.5% female. The mean birth weight was 1,658±1,018 grams, and the mean gestational age was 32±6 weeks. Most of them were between days one to six. The most common causes of NICU-Mortality Rate (MR) were RDS, congenital heart disease, and congenital anomalies, in descending order. The hospital under study recently expanded to a referral center for congenital heart disease in the east of Iran, which affected the NICU-MR in the ward under study. After the omission of congenital heart disease, the NICU-MR was 10.1%. Conclusion: The NICU-MR was 10.1-11.5% in this study. After RDS, the second cause of death was congenital heart disease. As it is a new division in the hospital under study, it is hoped to get better improvement in congenital heart disease management.

Background: The neonatal period is the riskiest time for child survival. Globally, 2.4 million children died in the first month of life in 2020, and there are approximately 6,700 newborn deaths every day. In this study, the authors have evaluated the causes of death among infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital, Mashhad, Iran, for five years, since 2015. Methods: A cross-sectional study was conducted on all neonates who died in the NICU under study. Data were collected through one of the proposed questionnaires of the Ministry of Health and Medical Education (NOHME), known as the “Green Questionnaire for the Study of the Dead Infant”. The data were recorded regarding asphyxia, congenital anomalies, sepsis or infection, respiratory distress syndrome (RDS), disseminated intravascular coagulation, pneumothorax, seizures, and the date of death. The extracted data were categorized and analyzed by the SPSS software (version 16). Babies who died at more than 28 days of age were excluded. Results: Totally, 501 out of 4,348 NICU admissions died (11.52%), 54.5% of whom were male and 45.5% female. The mean birth weight was 1,658±1,018 grams, and the mean gestational age was 32±6 weeks. Most of them were between days one to six. The most common causes of NICU-Mortality Rate (MR) were RDS, congenital heart disease, and congenital anomalies, in descending order. The hospital under study recently expanded to a referral center for congenital heart disease in the east of Iran, which affected the NICU-MR in the ward under study. After the omission of congenital heart disease, the NICU-MR was 10.1%. Conclusion: The NICU-MR was 10.1-11.5% in this study. After RDS, the second cause of death was congenital heart disease. As it is a new division in the hospital under study, it is hoped to get better improvement in congenital heart disease management. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to summarize how child mortality—a Sustainable Development Goal stated by the United Nations—has been explicitly addressed in the context of innovations.Methods: A scoping review following the PRISMA-ScR Statement was performed analysing indexed and non-indexed literature.Results: Empirical and non-disruptive innovation in the context of process targeting under-five mortality rate was the main subset of literature included in this article. The increment of literature on innovation in the context of SDGs over the last years denotes its growing importance and even though innovation aiming to reduce child mortality is currently being done, a significant part of it is not published in indexed databases but as grey literature.Conclusion: Empirical, disruptive innovation under a structural approach and empirical, non-disruptive innovation under a project point of view are the main types of innovation addressed in the literature and would be of utmost potential to reduce child mortality rate. A systematic review of the methods used for the measures of evaluation of applied innovations, their quality and results would be of great importance in the future.

Neonatal mortality is an index for newborn care and maternal health care. It is a useful indicator for obstetrical and neonatal healthcare services quality and availability. It is influenced by environmental, economic and social factors. Therefore, it is a measure of socio-economic status and health system. The study was a cross sectional one. It was conducted at Al Resafa side in Baghdad city. The requested data were reviewed from medical records (sex, cause of death, etc.). Chi-square was used to show the impact of dependent variables (death causes) on the independent variables (sex, and type of neonatal death). P value < 0.05 was considered statistically significant. The results showed number of neonatal deaths per 1000 livebirths ranged from 19.30-19.08 per 1000 livebirths between 2015 – 2019 respectively. Males had the highest neonatal deaths through studied years (54.8%, 54.5%, 56.4%, 57.2%, and 59 respectively). Prematurity (487, 32.1%), and respiratory distress syndrome (387, 25.5%) were significantly the common causes of early neonatal deaths. Sepsis (216, 30.1%), and respiratory distress syndrome (149, 20.8%) were significantly the main late neonatal deaths causes (χ 2= 429.582, p value = 0.001). Both males and females mainly died from prematurity (340, 285; 27%, 29.2% respectively). The distribution of causes of neonatal death were significantly varied between sexes (χ2= 20.782, p value= 0.001). In conclusions, neonatal mortality rate is high in the studied period. Two thirds of neonatal death occurred early. [ABSTRACT FROM AUTHOR]

Introduction: Home-based newborn care (HBNC) is a strategy adopted by government of India to overcome the burden of newborn deaths in the first week of life, it provides continuum of care for newborn and post-natal mothers. HBNC introduced since 2011 is centred around Accredited Social Health Activist (ASHA) and it is the main community-based approach to newborn health. Aims and Objectives: The objective of the present study was to assess the HBNC during HBNC visit in rural area of Lucknow, Uttar Pradesh (U.P.). Materials and Methods: The present cross-sectional study was carried out in the field practice area of Primary Health Centre Sarojini Nagar, Lucknow UP. A total of 200 mothers of newborn (age 03 days to 60 days) born in the catchment area of PHC Sarojini Nagar during 8 months period were included in cross-sectional study. Results: The result of study showed that majority of newborns got all the age appropriate home visit. None of the mothers had knowledge and awareness about the HBNC provision for home visits and the number of home visit by ASHA decreases as age of baby increases. All the ASHAs were aware about the schedule of home visit, the number of home visit in case of home delivery and institutional delivery. Conclusion and Recommendation: ASHA was found to be the major facilitator for HBNC programme. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training.

Introduction: Facility Based Newborn Care (FBNC) is a critical intervention to improve child survival & to reduce neonatal mortality rate Neonatal Mortality Rate (NMR) is major challenge.Objectives: Toanalyze morbidity profile of neonates admitted in special newborn care units of a tertiary level hospitals and medical college attached hospitals of Gujarat State. Method: A cross sectional descriptive study where record based secondary data collected & analysed for key indicators from all Govt. supported Sick Newborn Care Unit (SNCUs) which are in Medical college attached hospitals, district hospitals and grant in aid trust hospitals. April 2014 to March 2016 was the study period. Results: The study found near proportions of (53%) inborn, (47%) out born admission and 44% admission of female. Out of 69,662 admissions, 67% were discharged, 16% died, 10% leaving against medical advice, and 7% referred to higher centers. Major reasons for admission were respiratory distress syndrome (RDS) (22%) and infection (21%). Conclusion: Strengthening of appropriate facility care is essential to address neonatal mortality. The health interventions needed to tackle NMR differ from those needed for infant mortality rate and under-five mortality rate.

Background & aim: Neonatal mortality rate (NMR) is an important health index, which reflects the socio-economic and health status of a community. According to the literature, almost 20% of NMR can be prevented through the implementation of simple resuscitative interventions. This study was conducted to review the neonatal outcomes and resuscitation rate of neonates. Methods: This record review was carried out using records of 4683 birth from March 2016 to March 2017 in Imam Reza Hospital, Mashhad, Iran. The variables reviewed included the birth conditions, neonatal outcomes and resuscitation interventions. The data were collected using a self-structured record form and analyzed using descriptive statistics. Results: The findings showed 179 neonatal deaths out of 4683 births (including those who were born dead or the ones who died shortly after birth in delivery rooms). NMR was 3.8% in the current study. The rate of cesarean deliveries was 5% higher than normal vaginal delivery rate. Moreover, 18% of births were related to the gestational age lower than 36 weeks. The rate of low and very low birth weight infants was 6.42% of births. Approximately, 20% of the newly born infants were resuscitated. Conclusion: The results of this study revealed that Imam Reza Hospital of Mashhad, Iran was not in a good condition compared to the developed countries, in terms of the status of births, mortality rate, and resuscitation interventions.Background & aim: Neonatal mortality rate (NMR) is an important health index, which reflects the socio-economic and health status of a community. According to the literature, almost 20% of NMR can be prevented through the implementation of simple resuscitative interventions. This study was conducted to review the neonatal outcomes and resuscitation rate of neonates. Methods: This record review was carried out using records of 4683 birth from March 2016 to March 2017 in Imam Reza Hospital, Mashhad, Iran. The variables reviewed included the birth conditions, neonatal outcomes and resuscitation interventions. The data were collected using a self-structured record form and analyzed using descriptive statistics. Results: The findings showed 179 neonatal deaths out of 4683 births (including those who were born dead or the ones who died shortly after birth in delivery rooms). NMR was 3.8% in the current study. The rate of cesarean deliveries was 5% higher than normal vaginal delivery rate. Moreover, 18% of births were related to the gestational age lower than 36 weeks. The rate of low and very low birth weight infants was 6.42% of births. Approximately, 20% of the newly born infants were resuscitated. Conclusion: The results of this study revealed that Imam Reza Hospital of Mashhad, Iran was not in a good condition compared to the developed countries, in terms of the status of births, mortality rate, and resuscitation interventions.

Background: Similar to Indonesia, Aceh Province also showed a slight decline in neonatal mortality rate. However, the rate is still high compared to other provinces. Efforts to reduce neonatal mortality rate are essential because neonatal deaths contributed up to 71% of all under-five deaths in 2017 in Aceh. Antenatal care and low birth weight are known to be associated with neonatal mortality. The purpose of this study was to map district-level neonatal mortality rate and its determinants (antenatal care and low birth weight) in Aceh to inform policymakers in planning the interventions. Methods: This was a cross-sectional study using publicly available secondary data obtained from Aceh Provincial Health Office. The study used the 2017 data of neonatal mortality rate, percent of 4th antenatal care visit and percent of low birth weight at district level. Thematic maps were produced using ArcMap (V.10.5). The correlation was analyzed using the Spearman rank test. Results: The results indicated the regional variation of neonatal mortality rate across Aceh Province. Districts in the Southern region had lower neonatal mortality rates compared to others. Low birth weight was positively correlated with neonatal mortality rate at district level (Spearman’s Rho=0.545, P=0.007). However, the percent of 4th antenatal care visit at district level was not correlated with neonatal mortality rate (Spearman’s Rho= -0.35, P=0.097). Conclusion: The study identified regional variations of neonatal mortality rate, low birth weight and ante natal care visit.

Abstract Objectives Neonatal mortality is a global public health problem, and the efforts to reduce child mortality is one of the goals of the 2030 Agenda for Sustainable Development, launched in 2015 by the United Nations. The availability of historical neonatal mortality rates (NMR) data in Brazilian municipalities is crucial to evaluate trends at local, regional and national level, identifying gaps and vulnerable territories. Therefore, the objective of this article is to offer an integrated dataset containing monthly data in a historical series from 1996 to 2017 with information on all births, neonatal deaths, and NMR (total, early and late components) enriched with information related to the municipality. Data description It is a dataset of historical data with information on the number of births, the number of neonatal deaths, the neonatal mortality rate (including early and late), and geographic information for each month (between January 1996 and December 2017) and Brazilian municipality.

Introduction: Home-based newborn care (HBNC) is a strategy adopted by government of India to overcome the burden of newborn deaths in the first week of life, it provides continuum of care for newborn and post-natal mothers. HBNC introduced since 2011 is centred around Accredited Social Health Activist (ASHA) and it is the main community-based approach to newborn health. Aims and Objectives: The objective of the present study was to assess the HBNC during HBNC visit in rural area of Lucknow, Uttar Pradesh (U.P.). Materials and Methods: The present cross-sectional study was carried out in the field practice area of Primary Health Centre Sarojini Nagar, Lucknow UP. A total of 200 mothers of newborn (age 03 days to 60 days) born in the catchment area of PHC Sarojini Nagar during 8 months period were included in cross-sectional study. Results: The result of study showed that majority of newborns got all the age appropriate home visit. None of the mothers had knowledge and awareness about the HBNC provision for home visits and the number of home visit by ASHA decreases as age of baby increases. All the ASHAs were aware about the schedule of home visit, the number of home visit in case of home delivery and institutional delivery. Conclusion and Recommendation: ASHA was found to be the major facilitator for HBNC programme. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training. [ABSTRACT FROM AUTHOR]

Background: The first 28 days of life - the neonatal period - is the most vulnerable time for a child's survival. Children face the highest risk of dying in their first month of life at an average global rate of (17) deaths per (1,000) live births in 2019. Objectives: To find out the neonatal mortality rate at maternity wards in Baghdad City's Hospital for the year 2019, and to assess the causes of neonatal mortality rate. Methods The study included a non-probability (convenient) sample of (150) Neonate who have beendyingin ten hospitals in Baghdad City. The study subjects are recruited from 10 teaching hospitals. Data is collected from neonatal medical records in the Department of Statistics; data are analyzed using descriptive and inferential data analysis process. The Results: The results of the current study indicate that the neonatal mortality ratefor the year of 2019 is (0.636).The highest number of causes of neonatal mortality is accounted for asphyxia (57.7%) and congenital anomalies (29.6%).Most of the neonates are (1-5) day of age (83.8%); Males (64.1%); (3000-3.999) gm of weight (42.9%); urban residents (60.6%); are born at early term (37 to 38+6 days) (35.9 %) and in hospital (95.8%) through cesarean section (64.8%). There is no significant relationship between neonates' age and the causes of neonatal mortality. Conclusion: The neonatal mortality rate is (0.636) for the year of 2019 on the maternity wards in Baghdad City's hospitals per 1000 of the population at risk for the same year; The most accounted cause of neonate mortality is asphyxia and congenital anomalies. [ABSTRACT FROM AUTHOR]

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Background Reducing neonatal mortality rates (NMR) in developing countries is a key global health goal, but weak registration systems in the region stifle public health efforts. Objective To calculate NMRs, investigate modifiable risk factors, and explore neonatal deaths by place of birth and death, and cause of death in two administrative areas in Ghana. Methods Data on livebirths were extracted from the health and demographic surveillance systems in Navrongo (2004–2012) and Kintampo (2005–2010). Cause of death was determined from neonatal verbal autopsy forms. Univariable and multivariable logistic regression were used to analyse factors associated with neonatal death. Multiple imputations were used to address missing data. Results The overall NMR was 18.8 in Navrongo (17,016 live births, 320 deaths) and 12.5 in Kintampo (11,207 live births, 140 deaths). The annual NMR declined in both areas. 54.7% of the births occurred in health facilities. 70.9% of deaths occurred in the first week. The main causes of death were infection (NMR 4.3), asphyxia (NMR 3.7) and prematurity (NMR 2.2). The risk of death was higher among hospital births than home births: Navrongo (adjusted OR 1.14, 95% CI: 1.03–1.25, p = 0.01); Kintampo (adjusted OR 1.76, 95% CI: 1.55–2.00, p

Reducing neonatal mortality rates (NMR) in developing countries is a key global health goal, but weak registration systems in the region stifle public health efforts. To calculate NMRs, investigate modifiable risk factors, and explore neonatal deaths by place of birth and death, and cause of death in two administrative areas in Ghana. Data on livebirths were extracted from the health and demographic surveillance systems in Navrongo (2004–2012) and Kintampo (2005–2010). Cause of death was determined from neonatal verbal autopsy forms. Univariable and multivariable logistic regression were used to analyse factors associated with neonatal death. Multiple imputations were used to address missing data. The overall NMR was 18.8 in Navrongo (17,016 live births, 320 deaths) and 12.5 in Kintampo (11,207 live births, 140 deaths). The annual NMR declined in both areas. 54.7% of the births occurred in health facilities. 70.9% of deaths occurred in the first week. The main causes of death were infection (NMR 4.3), asphyxia (NMR 3.7) and prematurity (NMR 2.2). The risk of death was higher among hospital births than home births: Navrongo (adjusted OR 1.14, 95% CI: 1.03–1.25, p = 0.01); Kintampo (adjusted OR 1.76, 95% CI: 1.55–2.00, p < 0.01). However, a majority of deaths occurred at home (Navrongo 61.3%; Kintampo 50.7%). Among hospital births dying in hospital, the leading cause of death was asphyxia; among hospital and home births dying at home, it was infection. The NMR in these two areas of Ghana reduced over time. Preventing deaths by asphyxia and infection should be prioritised, centred respectively on improving post-delivery care in health facilities and subsequent post-natal care at home. [ABSTRACT FROM AUTHOR]

Background and aims: Twin birth may account for higher mortality rates in infants and neonates. To investigate the potential relationship between twin birth and infant and neonatal mortality rates (NMRs), a systematic review was conducted. Methods: To gather the evidence for the relationship between twin birth and its potential effect on mortality during infancy and neonatal periods, a systematic review was conducted. The most important used databases were PubMed, Google Scholar, Web of Science, Scopus, ProQuest, Cochrane and Springer. Then, the databases were searched by appropriate keywords. After reviewing and evaluating the collected studies, trends in the different countries were compared. Results: A total of 13 790 related studies were found, of which 128 studies were selected in the first step. The studies which were not related to the subject, in addition to repetitive studies, were excluded from the search in the second step based on inclusion and exclusion criteria by reviewing the abstract and, in some cases, the full article. Finally, 7 studies entered the last step. Conclusion: This study showed that the mortality could be higher among twins than among non-twins, especially among boys

Context: Facility Based Newborn Care (FBNC) is a key strategy to improve child survival, especially in newborn care where neonatal mortality rate (NMR) is stagnant in declining. Gujarat has achieved considerable amount of reduction in child deaths, but neonatal health requires attention. The study was aimed to assess the admission pattern of Special Newborn Care Units (SNCUs) which supports decision-making. Settings and Design: A cross-sectional descriptive analysis was done from secondary data of the SNCU reports on the aspects of admission patterns, morbidity, and mortality pattern. The reports had been analyzed on various critical variables. Results: In 2015–2016, Gujarat has operationalized forty SNCUs by saturating each district with at least one SNCU. The study found near proportions of (53%) inborn – (47%) outborn admission and 44% admission of female. Out of 69,662 admissions, 67% were discharged, 16% died, 10% leaving against medical advice, and 7% referred to higher centers. Major reasons for admission were respiratory distress syndrome (RDS) (22%) and infection (21%). Similar pattern in mortality found as final diagnosis of deaths was RDS (23%) and infection (21%). The proportion of neonatal deaths in outborn was high compared to inborn. Conclusion: Strengthening of FBNC is essential to address neonatal mortality. NMR is of prime focus because the health interventions needed to tackle NMR differ from those needed for infant mortality rate and under-five mortality rate. This accentuates the need for focused attention on facility- and community-based child health interventions along with quality maternal health services and robust referral mechanisms to all delivery points.

Introduction: Addressing neonatal mortality is an important priority for improving the health and well-being of newborns. Almost two-thirds of infant deaths occur in the first month of life; among these, more than two-thirds die in their first week. Therefore, the aim of this study was to assess the mortality rate and predictors of mortality among neonates admitted to the neonatal intensive care unit (NICU) at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, in 2023., Methods: An institutional-based retrospective follow-up study was conducted using 459 neonates who were admitted to the NICU at Tikur Anbessa Specialized Hospital from January 2020 to December 2022. The data were extracted from randomly selected charts using a pretested data extraction checklist. The Nelson Alan curve with log-rank test was used to compare the presence of differences in the mortality rate of different groups over different categorical variables. The cox proportional hazards analysis model was used to identify predictors of neonatal death. The presence and absence of statistical significance was considered at a p -value of less than 0.05 and the strength of association was measured using AHR., Results: The neonatal mortality rate was 3.1 (95% CI: 1.3-4.9) per 1,000 neonate-days. Low birth weight (AHR = 1.44: 95% CI: 1.06-3.13), exclusive breast-feeding (AHR = 0.74: 95% CI: 0.35-0.95), and time of exclusive breast-feeding (AHR = 0.92: 95% CI: 0.49-0.99) were the identified predictors of newborn mortality., Conclusion: The neonatal mortality rate was high. Low birth weight of the neonate, exclusive breast-feeding initiation, and time of exclusive breast-feeding were independent predictors of neonatal death. Therefore, empowering mothers to exclusively breastfeed their children, which is a cost-effective, safe, and realistic option, can significantly minimize infant mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Getahun, Beyene, Afework, Desalegn, Jemberie and Shitemaw.)

Objectives: Neonatal mortality is a global public health problem, and the efforts to reduce child mortality is one of the goals of the 2030 Agenda for Sustainable Development, launched in 2015 by the United Nations. The availability of historical neonatal mortality rates (NMR) data in Brazilian municipalities is crucial to evaluate trends at local, regional and national level, identifying gaps and vulnerable territories. Therefore, the objective of this article is to offer an integrated dataset containing monthly data in a historical series from 1996 to 2017 with information on all births, neonatal deaths, and NMR (total, early and late components) enriched with information related to the municipality. Data description: It is a dataset of historical data with information on the number of births, the number of neonatal deaths, the neonatal mortality rate (including early and late), and geographic information for each month (between January 1996 and December 2017) and Brazilian municipality. [ABSTRACT FROM AUTHOR]

Background: Neonatal mortality is the major proportion of children mortality under five years and it is considered as the main health indicator in the first year of life. This paper has aimed to review the neonatal mortality in the numbers recorded at the Iranian Perinatal Mortality Surveillance System (IPMSS) by Iran Ministry of Health and Medical Education. Methods: A descriptive study was done in 2014. For assessment of sampling quality and quantity, 24 hospitals randomly were selected. Recorded information, related to perinatal mortality (deaths from 22 completed weeks of gestation until 30 completed days after birth inclusive of stillbirths and neonatal mortality) from selected hospitals, was compared with recorded data in IPMSS. Results: Results showed that, out of 1,725 perinatal deaths occurred in hospitals, 1,480 (85.80%) deaths were recorded in IPMSS. Of 1,041 neonatal deaths that occurred in hospitals (in hospital wards and delivery rooms), 875 (84.05%) were in IPMSS. It shows that a correction coefficient for hospital neonatal mortality was 1.1904. Based on analyzing process, correction coefficients for stillbirth reported by hospitals, stillbirth for all over the country and perinatal death were 1.130, 1.1775 and 1.2443, respectively. Considering these correction coefficients – that enabled to calculate 15,130 neonatal deaths – and 1,421,689 live births (according to Statistics Center) in 2012, neonatal mortality rate was 10.64 in 1,000 live births. Conclusion: Our data showed some problems in the registration system. Although implementation and supervision of such Surveillance System are not easy, they are essential and provide valuable data in perinatal audit and neonatal health care practices.

Background: Although many efforts made for the advancement of medical science, it is distributed inequitably despite of all existing financial and human resources facilities. Children as the most important and vulnerable groups of society are influenced by these inequities. The Objective of this study is comparison of children health indices in rich and poor rural zones in Mashhad/Iran. Methods: This is a cross sectional study, We considered a poor (Andad) and a rich (Toos) zones to compared for some health indices. We compared some indices like: maternal mortality rate (MMR), neonatal mortality rate (NMR), children under 1 (IMR) and under 5 years mortality rate (U5MR), low birth weight prevalence (LBW), exclusive breast feeding (EBF) and fertility rate. Data collected with check list and analyzed by SPSS-11.5. Results: in our study in two poor (Andad) and rich (Toos) zones we have: Neonatal mortality rate (zero versus 5.46) (P=0.00); breast feeding indices like exclusive breast feeding indices up to 6 month (54.4% versus 79%) (P=0.01); have significant differences between two zones. But fertility rate indices like total fertility rate (2.09 versus 1.95) (p=0.98) and Mean children mortality rates during 2011-2013 like children less than 5 years mortality (18.65 versus 12.13 per thousand live birth) (p=0.29) does not have statistically significant differences. Conclusion: This study shows that health indices in rich and poor zones, have significant differences

Introduction Nigeria contributes more obstetric, postpartum and neonatal deaths and stillbirths globally than any other country. The Clinton Health Access Initiative in partnership with the Nigerian Federal Ministry of Health and the state Governments of Kano, Katsina, and Kaduna implemented an integrated Maternal and Neonatal Health program from July 2014. Up to 90% women deliver at home in Northern Nigeria, where maternal mortality ratio and neonatal mortality rates (MMR and NMR) are high and severe challenges to improving survival exist. Methods Community-based leaders (“key informants”) reported monthly vital events. Pre-post comparisons of later (months 16-18) with conservative baseline (months 7-9) rates were used to assess change in MMR, NMR, perinatal mortality (PMR) and stillbirth. Two-tailed cross-tabulations and unadjusted and adjusted logistic regression analyses were conducted. Results Data on 147,455 births (144,641 livebirths and 4275 stillbirths) were analyzed. At endline (months 16-18), MMR declined 37% (OR 0.629, 95% CI 0.490-0.806, p ≤ 0.0003) vs. baseline 440/100,000 births (months 7-9). NMR declined 43% (OR 0.574, 95% CI 0.503-0.655, p < 0.0001 vs. baseline 15.2/1000 livebirths. Stillbirth rates declined 15% (OR 0.850, 95% CI 0.768-0.941, p = 0.0018) vs. baseline 21.1/1000 births. PMR declined 27% (OR 0.733, 95% CI 0.676-0.795, p < 0.0001) vs. baseline 36.0/1000 births. Adjusted results were similar. Discussion The findings are similar to the Cochrane Review effects of community-based interventions and indicate large survival improvements compared to much slower global and flat national trends. Key informant data have limitations, however, their limitations would have little effect on the results magnitude or significance. [ABSTRACT FROM AUTHOR]

Objective This study was conducted to assess the neonatal mortality rate in Baghdad city during the last 10 years (2008-2017). Methods This study was conducted at Al-Elwaya maternity hospital in Baghdad city: The retrospective study last 10 years ago (2008-2017) regarding neonatal mortality rate. This study was started in October 2017 to February 2018. The data regarding neonatal mortality rate was achieved from the data recorded in the Statistical Department in the hospital. Results The result shows meaningful S-shaped auto-regression model tested in two-tailed alternative statistical hypothesis for two factors, time sequence per (years) factor as (Independent), and number of dead birth factor as (Dependent). Slope value was estimated and indicated that increasing with inverse transformation of one lagged period factor (1 year), occurring with a positive increment on natural logarithm transformation of the unit of dead birth number, and that estimated by (-0.95284), and the increment was recorded as highly significant and positive effectiveness at P < 0.01, as well as strong and highly significant correlation ship at P < 0.01 between studied factors and accounted (0.69863), with meaning determination coefficient of R-square (48.808%), which explanation disturbances among the numbers of dead birth along with the studied periods. Conclusion The results of this study show that the neonatal mortality rate increased with the time sequence for the last 10 years (2008-2017) in Al-Elwaya maternity hospital in Baghdad city. [ABSTRACT FROM AUTHOR]

Context: Facility Based Newborn Care (FBNC) is a key strategy to improve child survival, especially in newborn care where neonatal mortality rate (NMR) is stagnant in declining. Gujarat has achieved considerable amount of reduction in child deaths, but neonatal health requires attention. The study was aimed to assess the admission pattern of Special Newborn Care Units (SNCUs) which supports decision-making. Settings and Design: A cross-sectional descriptive analysis was done from secondary data of the SNCU reports on the aspects of admission patterns, morbidity, and mortality pattern. The reports had been analyzed on various critical variables. Results: In 2015-2016, Gujarat has operationalized forty SNCUs by saturating each district with at least one SNCU. The study found near proportions of (53%) inborn - (47%) outborn admission and 44% admission of female. Out of 69,662 admissions, 67% were discharged, 16% died, 10% leaving against medical advice, and 7% referred to higher centers. Major reasons for admission were respiratory distress syndrome (RDS) (22%) and infection (21%). Similar pattern in mortality found as final diagnosis of deaths was RDS (23%) and infection (21%). The proportion of neonatal deaths in outborn was high compared to inborn. Conclusion: Strengthening of FBNC is essential to address neonatal mortality. NMR is of prime focus because the health interventions needed to tackle NMR differ from those needed for infant mortality rate and under-five mortality rate. This accentuates the need for focused attention on facility- and community-based child health interventions along with quality maternal health services and robust referral mechanisms to all delivery points. [ABSTRACT FROM AUTHOR]

Background: Neonatal deaths stand for almost two-thirds of all deaths occurring in infants under one year of age. Congenital anomalies are responsible for 24.5% of these cases forming a highly important issue for health policy-makers.Methods: We studied the pre-, peri- and post-natal conditions of 77 patients with multiple congenital anomalies (MCA) through genetic counseling at Several university Hospitals, in Tehran, Iran. The collected data were subsequently analyzed using SPSS software. Results: The patients did not have a good prognosis, demonstrating the need for the diagnosis of such diseases early in pregnancy to be of utmost importance. We screened for trisomy and nuchal translucency, which the first showed a low risk and the second showed normal results in most cases.Conclusion: Establishment of standards for prenatal diagnosis of congenital anomalies and monitoring their implementation seem to be necessary for the reduction of deaths due to congenital anomalies and infant mortality rate (IMR).

Background: Data on the impact of neonatal and total pediatric admissions volume on neonatal mortality are sparse. Objectives: This study is done to estimate the neonatal mortality in relation to neonatal admissions and to total hospital admissions in Al-Alwyia Pediatric Teaching Hospital through years 2005-2012 Type of the study: A retrospective study.Methods: statistical records of all cases admitted to APTH were studied during 2005-2012.Results: Neonatal mortality decreased to the nadir at last year of study period (2012) and reached 6.1% of neonatal admissions compared to 2005 level which was 9.7 %. Mortality rate among premature and low birth weight (LBW) infants decreased also. The study also reveals that neonatal mortality constitute significant a contribution to childhood mortality (61.4 %) and morbidity (28.3%) throughout the study years. With a highly significant p value parallel to increasing number of neonatal admissions (case over load) , there is a trend of neonatal mortality rate to be decreased Case fatality rate also decreased among overall children to 3.5% in 2005 and to 3.3% in 2013 in spite of 2.4 times increase in neonatal admission during the study period.This neonatal overload is more than overall pediatric over load, because the total hospital admissions are increased just 1.2 times.Conclusions: The neonatal admissions case overload is high and increasing and constitutes a significant proportion of total childhood mortality. Neonatal mortality including premature and (LBW) infants is decreasing .Further actions are needed to meet global goals.

Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implemented community based programs which were piloted and then scaled up based on lessons learned. These programs include, but are not limited to, ensuring safe motherhood, birth preparedness package, community based newborn care package and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included inadequate policy environment, funding gaps, inadequate procurement and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision making as well as working in partnership with communities to facilitate the utilization of available services.