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Effectiveness of antenatal care services in reducing neonatal mortality in Kenya : Analysis of national survey data

Arunda, Malachi; Emmelin, Anders LU and Asamoah, Benedict Oppong LU (2017) In Global Health Action 10(1).
Abstract

Background: Although global neonatal mortality declined by about 40 percent from 1990 to 2013, it still accounted for about 2.6 million deaths globally and constituted 42 percent of global under-five deaths. Most of these deaths occur in developing countries. Antenatal care (ANC) is a globally recommended strategy used to prevent neonatal deaths. In Kenya, over 90 percent of pregnant women attend at least one ANC visit during pregnancy. However, Kenya is currently among the 10 countries that contribute the most neonatal deaths globally. Objective: The aim of this study is to examine the effectiveness of ANC services in reducing neonatal mortality in Kenya. Methods: We used binary logistic regression to analyse cross-sectional data from... (More)

Background: Although global neonatal mortality declined by about 40 percent from 1990 to 2013, it still accounted for about 2.6 million deaths globally and constituted 42 percent of global under-five deaths. Most of these deaths occur in developing countries. Antenatal care (ANC) is a globally recommended strategy used to prevent neonatal deaths. In Kenya, over 90 percent of pregnant women attend at least one ANC visit during pregnancy. However, Kenya is currently among the 10 countries that contribute the most neonatal deaths globally. Objective: The aim of this study is to examine the effectiveness of ANC services in reducing neonatal mortality in Kenya. Methods: We used binary logistic regression to analyse cross-sectional data from the 2014 Kenya Demographic and Health Survey to investigate the effectiveness of ANC services in reducing neonatal mortality in Kenya. We determined the population attributable neonatal mortality fraction for the lack of selected antenatal interventions. Results: The highest odds of neonatal mortality were among neonates whose mothers did not attend any ANC visit (adjusted odds ratio [aOR] 4.0, 95% confidence interval [CI] 1.7-9.1) and whose mothers lacked skilled ANC attendance during pregnancy (aOR 3.0, 95% CI 1.4- 6.1). Lack of tetanus injection relative to one tetanus injection was significantly associated with neonatal mortality (aOR 2.5, 95% CI 1.0-6.0). About 38 percent of all neonatal deaths in Kenya were attributable to lack of check-ups for pregnancy complications. Conclusions: Lack of check-ups for pregnancy complications, unskilled ANC provision and lack of tetanus injection were associated with neonatal mortality in Kenya. Integrating community ANC outreach programmes in the national policy strategy and training geared towards early detection of complications can have positive implications for neonatal survival.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antenatal care, Neonatal mortality, Population attributable fraction, Tetanus toxoid
in
Global Health Action
volume
10
issue
1
publisher
Co-action Publishing
external identifiers
  • scopus:85028565178
  • wos:000403499700001
ISSN
1654-9716
DOI
10.1080/16549716.2017.1328796
language
English
LU publication?
yes
id
4a9ccfe2-dcdd-4258-907f-2503af5d9647
date added to LUP
2017-10-04 16:21:32
date last changed
2018-02-04 04:32:10
@article{4a9ccfe2-dcdd-4258-907f-2503af5d9647,
  abstract     = {<p>Background: Although global neonatal mortality declined by about 40 percent from 1990 to 2013, it still accounted for about 2.6 million deaths globally and constituted 42 percent of global under-five deaths. Most of these deaths occur in developing countries. Antenatal care (ANC) is a globally recommended strategy used to prevent neonatal deaths. In Kenya, over 90 percent of pregnant women attend at least one ANC visit during pregnancy. However, Kenya is currently among the 10 countries that contribute the most neonatal deaths globally. Objective: The aim of this study is to examine the effectiveness of ANC services in reducing neonatal mortality in Kenya. Methods: We used binary logistic regression to analyse cross-sectional data from the 2014 Kenya Demographic and Health Survey to investigate the effectiveness of ANC services in reducing neonatal mortality in Kenya. We determined the population attributable neonatal mortality fraction for the lack of selected antenatal interventions. Results: The highest odds of neonatal mortality were among neonates whose mothers did not attend any ANC visit (adjusted odds ratio [aOR] 4.0, 95% confidence interval [CI] 1.7-9.1) and whose mothers lacked skilled ANC attendance during pregnancy (aOR 3.0, 95% CI 1.4- 6.1). Lack of tetanus injection relative to one tetanus injection was significantly associated with neonatal mortality (aOR 2.5, 95% CI 1.0-6.0). About 38 percent of all neonatal deaths in Kenya were attributable to lack of check-ups for pregnancy complications. Conclusions: Lack of check-ups for pregnancy complications, unskilled ANC provision and lack of tetanus injection were associated with neonatal mortality in Kenya. Integrating community ANC outreach programmes in the national policy strategy and training geared towards early detection of complications can have positive implications for neonatal survival.</p>},
  articleno    = {1328796},
  author       = {Arunda, Malachi and Emmelin, Anders and Asamoah, Benedict Oppong},
  issn         = {1654-9716},
  keyword      = {Antenatal care,Neonatal mortality,Population attributable fraction,Tetanus toxoid},
  language     = {eng},
  number       = {1},
  publisher    = {Co-action Publishing},
  series       = {Global Health Action},
  title        = {Effectiveness of antenatal care services in reducing neonatal mortality in Kenya : Analysis of national survey data},
  url          = {http://dx.doi.org/10.1080/16549716.2017.1328796},
  volume       = {10},
  year         = {2017},
}