Indian Pediatrics

, Volume 49, Issue 4, pp 291–294 | Cite as

Determinants of neonatal mortality in Rural Haryana: A retrospective population based study

  • R. P. Upadhyay
  • P. R. Dwivedi
  • S. K. Rai
  • P. Misra
  • M. Kalaivani
  • Anand Krishnan
Research Paper

Abstract

Objective

To identify the determinants of neonatal mortality.

Study design

Nested case-control study.

Study setting

28 villages under the intensive field practice area of Comprehensive Rural Health Services Project, Ballabgarh, Haryana serving a population of 87,016, as on 31st December 2009. The study period was from 2005 to 2009.

Methods

The data were obtained from Health Management Information System and analyzed using multivariate logistic regression analysis. A hierarchical approach was used to analyze the factors associated with neonatal deaths, using community level factors, socio-economic status and biological determinants. The population attributable fractions were estimated for significant variables.

Results

The total live births during the study period were 10392 and neonatal deaths were 248. The infant and neonatal mortality rates during the study period were 45.6 and 23.8 per 1000 live births, respectively. Socio-economic determinants (Low educational status of parents [OR 2.1, 95% CI; 1.4, 3.3]; father’s occupation [OR 1.8, 95% CI; 1.0, 3.0]; Rajput caste [OR 2.0, 95% CI; 1.2, 3.4] appeared to explain a major fraction (45.7%) of neonatal deaths. Community level factors (villages with no health facility [OR 1.5, 95% CI; 1.0, 2.1]; villages with population >6000 [OR 1.7, 95% CI; 1.2, 2.5]) were associated with 27.3% of all neonatal deaths. Proximate determinants (early childbearing age of mother (<20 years) [OR 2.0, 95% CI; 1.2, 3.2]) were least important. All the three level of variables seemed to act independently with little mediation among them.

Conclusion

Neonatal mortality is affected by socioeconomic, community level and proximate biological determinants.

Key words

Determinants India Neonate Mortality Rural Prevention 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Supplementary material

13312_2012_44_MOESM1_ESM.pdf (209 kb)
Supplementary material, approximately 209 KB.

References

  1. 1.
    International Institute for Population Sciences, Macro International. National Family Health Survey (NFHS- 3), 2005–06, India. Mumbai: Volume I, International Institute for Population Sciences; 2007.p. 228.Google Scholar
  2. 2.
    Mann V, Eble A, Frost C, Premkumar R, Boone P. Retrospective comparative evaluation of the lasting impact of a community-based primary health care programme on under-5 mortality in villages around Jamkhed, India. Bull World Health Organ. 2010;88:727–736.PubMedCrossRefGoogle Scholar
  3. 3.
    Mosley WH, Chen LC. An analytical framework for the study of child survival in developing countries. Population and Development Review. 1984;10(Suppl):25–45.CrossRefGoogle Scholar
  4. 4.
    Mosley WH, Becker S. Demographic models for child survival and implications for health intervention programmes. Health Policy and Planning. 1991;6:218–233.CrossRefGoogle Scholar
  5. 5.
    Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373–1379.PubMedCrossRefGoogle Scholar
  6. 6.
    Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. Am J Public Health. 1998;88:15–19.PubMedCrossRefGoogle Scholar
  7. 7.
    Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcome. JAMA. 1998;280:1690–1691.PubMedCrossRefGoogle Scholar
  8. 8.
    Natarajan S, Lipsitz SR, Rimm E. A simple method of determining confidence intervals for population attributable risk from complex surveys. Stat Med. 2007; 26:3229–3239.PubMedCrossRefGoogle Scholar
  9. 9.
    Rowe AK, Powell KE, Flanders WD. Why population attributable fraction can sum to more than one. Am J Prev Med. 2004;26:243–249.PubMedCrossRefGoogle Scholar
  10. 10.
    Bruzzi P, Green SB, Brinton LA, Schairer C. Estimating the population attributable risk for multiple risk factors using case control data. Am J Epidemiol. 1995;122:904–914.Google Scholar
  11. 11.
    Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al. Neonatal mortality, risk factors and causes: a prospective population based cohort study in urban Pakistan. Bull World Health Organ. 2009;87:130–138.PubMedCrossRefGoogle Scholar
  12. 12.
    Sharma V, Katz J, Mullany LC, Khatry SK, LeClerq SC, Shreshta SR, et al. Young maternal age and the risk of neonatal mortality in rural Nepal. Arch Pediatr Adolesc Med. 2008;162:828–835.PubMedCrossRefGoogle Scholar
  13. 13.
    Gazi R, Goodburn L, Chowdhury AMR. Risk factors for perinatal deaths in rural Bangladesh. J Health Popul Dev Ctries. 1999;2:70–77.PubMedGoogle Scholar

Copyright information

© Indian Academy of Pediatrics 2012

Authors and Affiliations

  • R. P. Upadhyay
    • 1
  • P. R. Dwivedi
    • 1
  • S. K. Rai
    • 1
  • P. Misra
    • 1
  • M. Kalaivani
    • 2
  • Anand Krishnan
    • 1
    • 3
  1. 1.Centre for Community MedicineAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of BiostatisticsAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Centre for Community MedicineAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations