Trend and factors associated with neonatal mortality among neonates admitted at the women and newborn hospital of the university teaching hospitals, Lusaka, Zambia.

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Tembo, Deborah
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The University of Zambia
Neonatal mortality is a global problem especially in resource-poor settings such as sub-Saharan African Countries. Trends and factors associated with neonatal mortality vary in different settings. The study sought to investigate the trends and factors that are associated with increased neonatal mortality amongst neonates admitted to Neonatal Intensive Care Unit (NICU) at Women and New-born Hospital with a view of identifying pointers that can be modified to help improve neonatal survival. Medical records of all neonates admitted to the NICU in 2018 and 2019 were reviewed using a cross-sectional study. The Mortality rates were calculated using WHO standard and Microsoft excel 2010 was used to construct monthly trends analysis using monthly totals. Univariate and multivariate logistic regression analysis was used to determine the factors associated with neonatal deaths at the tertiary facility using Stata version 14.2. Model fit was evaluated using Hosmer and Lemeshow test (chi2=13.90, P =0.0845), implies the model’s estimates fit the data at an acceptable level. A total of 7,581 admissions were seen and 2340 files were extracted for analysis, of which 940 (40.2%) died. The overall Neonatal mortality percentage during the study period was 31.8%. There was relatively similar trends overtime in neonatal mortality during the study period with differences in case fatality rates as 2019 had increased case fatality rate compared to 2018. Factors associated with an increased odds of dying were not attending antenatal care (AOR=2.09, 95% CI [1.46 - 2.99] p <0.0001), parity (AOR=1.09, 95% CI [1.02 – 1.16] p=0.0013) and age of the neonate in days (AOR=0.92, 95% CI [0.91- 0.94] p <0.0001). Neonatal mortality is high among hospitalized neonates at the Women and New-born Hospital in Zambia. Associated Factors included antenatal attendance, parity, and age of the neonate. This can lead to lagging on the Sustainable Development Goals No 3 of 2030 on neonatal health, hence emphasis is on early Antenatal Care for easy monitoring of mother and neonates for fast actions in case of complications
Thesis of Master of Science in Public Health Epidemiology.