Determinants of Neonatal Mortality in Ethiopia: A Case Control Study, 2013

Introduction: Neonatal mortality is an obstacle to the continued step down of under-five mortality and the attainment of the Millennium Development Goal four. In Ethiopia, the neonatal mortality rate is decreased from 49 in 2000 to 39 deaths per 1000 live births in 2005, remaining stable at 37 deaths per 1000 live births in 2011 accounting for about 42% of under-five mortality. The aim of the study was to identify determinants of neonatal mortality in Ethiopia. Methods: Unmatched case-control study design was used to identify determinants of neonatal mortality in Ethiopia from February to June 2013 using the 2011 EDHS data. Cases were all died neonates and controls were all survived live births born within the last five years prior to 2011 EDHS. The total sample size was 11,195 with 2239 cases and 8956 controls. Logistic regression was used to identify determinants of neonatal mortality. Odds ratios with 95% CI and p-value was computed to measure the associations between the outcome variable and the independent variables. A p-value of less than 0.05 was considered as a significant result. Result: A total of 2239 (20%) cases and 8956 (80%) controls were included in this study. Mothers with no education (AOR = 1.89, CI: 1.32 2.72), short birth interval (AOR = 2.85, CI: 2.28 3.56), age of mother at birth (AOR = 0.18, CI: 0.04 0.86), multiple birth (AOR = 5.89, CI: 4.23 8.20), unemployed mothers (AOR = 1.39, CI: 1.07 1.67), unemployed fathers (AOR = 5.50, CI: 3.20 9.44) and place of residence (AOR = 1.63, CI: 1.42 1.87) were found to be determinants of neonatal mortality. Conclusion: The major determinants of neonatal mortality were maternal education, birth interval, multiple birth, and age at birth, maternal and paternal employment and place of residence. Emphasis needs to be given on women’s education, access to family planning, health education on consequences of early marriage and child bearing, and creating job opportunities to improve neonatal survival.