Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006-07
Globally 7.6 million children died in 2010 before reaching their fifth birthday and 40% of these deaths occur in the neonatal period. Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important...
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| Veröffentlicht in: | BMC public health 2014-06, Vol.14 (1), p.663-663, Article 663 |
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| description | Globally 7.6 million children died in 2010 before reaching their fifth birthday and 40% of these deaths occur in the neonatal period. Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important to investigate factors associated with neonatal mortality. The aim of the current study was to identify determinants of neonatal mortality in Pakistan.
Data was derived from the Pakistan Demographic and Health Survey 2006-07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality.
A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan.
To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan. |
| doi_str_mv | 10.1186/1471-2458-14-663 |
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Data was derived from the Pakistan Demographic and Health Survey 2006-07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality.
A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan.
To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/1471-2458-14-663</identifier><identifier>PMID: 24972633</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Babies ; Birth Weight ; Births ; Child, Preschool ; Childbirth ; Demography ; Female ; Health aspects ; Health care industry ; Health facilities ; Health Surveys ; Humans ; Infant ; Infant Mortality ; Low income areas ; Male ; Mothers ; Multivariate Analysis ; Neonatal care ; Neonates ; Obstetric Labor Complications ; Pakistan - epidemiology ; Pregnancy ; Prenatal Care ; Proportional Hazards Models ; Secondary analysis ; Social Class ; Surveys</subject><ispartof>BMC public health, 2014-06, Vol.14 (1), p.663-663, Article 663</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Nisar and Dibley; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Nisar and Dibley; licensee BioMed Central Ltd. 2014 Nisar and Dibley; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b584t-8a43ecd97c9ea0094b103750572f5f80b130aa6af291dafb86c3a001f4b79fff3</citedby><cites>FETCH-LOGICAL-b584t-8a43ecd97c9ea0094b103750572f5f80b130aa6af291dafb86c3a001f4b79fff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4082298/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4082298/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24972633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nisar, Yasir Bin</creatorcontrib><creatorcontrib>Dibley, Michael J</creatorcontrib><title>Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006-07</title><title>BMC public health</title><addtitle>BMC Public Health</addtitle><description>Globally 7.6 million children died in 2010 before reaching their fifth birthday and 40% of these deaths occur in the neonatal period. Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important to investigate factors associated with neonatal mortality. The aim of the current study was to identify determinants of neonatal mortality in Pakistan.
Data was derived from the Pakistan Demographic and Health Survey 2006-07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality.
A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan.
To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan.</description><subject>Adult</subject><subject>Babies</subject><subject>Birth Weight</subject><subject>Births</subject><subject>Child, Preschool</subject><subject>Childbirth</subject><subject>Demography</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care industry</subject><subject>Health facilities</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Low income areas</subject><subject>Male</subject><subject>Mothers</subject><subject>Multivariate Analysis</subject><subject>Neonatal care</subject><subject>Neonates</subject><subject>Obstetric Labor Complications</subject><subject>Pakistan - epidemiology</subject><subject>Pregnancy</subject><subject>Prenatal Care</subject><subject>Proportional Hazards Models</subject><subject>Secondary analysis</subject><subject>Social Class</subject><subject>Surveys</subject><issn>1471-2458</issn><issn>1471-2458</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNUt9rFDEQXkSxtfrukwR86cvW_N6sD0K5qhUKCupzmM0md6m7yZnsFe6_N-u1Z08qSB5mmPnmY_J9U1UvCT4jRMk3hDekplyomvBaSvaoOt6XHt_Lj6pnOV9jTBol6NPqiPK2oZKx42q6sJNNow8QpoyiQ8HGABMMaIypBD9tkQ_oC_zweYLwFmVrYughbREEGLbZ_56666MLO8ZlgvXKmwLo0aWFYVqhr5t0Y7eIYixr3DyvnjgYsn1xG0-q7x_ef1tc1lefP35anF_VnVB8qhVwZk3fNqa1gHHLO4JZI7BoqBNO4Y4wDCDB0Zb04DolDSs44njXtM45dlK92_GuN91oe2PDlGDQ6-TH8gEdwevDTvArvYw3mmNFaasKwWJH0Pn4D4LDjomjnlXXs-ol08WUwnJ6u0aKPzc2T3r02dhhgCL2JmsieKOkbIX8HyiTShA6s77-C3odN6l4skPhhlPO_6CWMFjtg4tlTzOT6nPBWtFSokhBnT2AKq-3oy9-W-dL_WAA7wZMijkn6_aaEKzn03xIhVf3zdgP3N0i-wWBiN3w</recordid><startdate>20140628</startdate><enddate>20140628</enddate><creator>Nisar, Yasir Bin</creator><creator>Dibley, Michael J</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M1P</scope><scope>M7S</scope><scope>PATMY</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>7X8</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>20140628</creationdate><title>Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006-07</title><author>Nisar, Yasir Bin ; 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Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important to investigate factors associated with neonatal mortality. The aim of the current study was to identify determinants of neonatal mortality in Pakistan.
Data was derived from the Pakistan Demographic and Health Survey 2006-07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality.
A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan.
To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24972633</pmid><doi>10.1186/1471-2458-14-663</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Babies Birth Weight Births Child, Preschool Childbirth Demography Female Health aspects Health care industry Health facilities Health Surveys Humans Infant Infant Mortality Low income areas Male Mothers Multivariate Analysis Neonatal care Neonates Obstetric Labor Complications Pakistan - epidemiology Pregnancy Prenatal Care Proportional Hazards Models Secondary analysis Social Class Surveys |
| title | Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006-07 |
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