Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India

Edward Fottrell; David Osrin; Glyn Alcock; Kishwar Azad; Ujwala Bapat; James Beard; Austin Bondo; Tim Colbourn; Sushmita Das; Carina King; Dharma Manandhar; Sunil Manandhar; Joanna Morrison; Charles Mwansambo; Nirmala Nair; Bejoy Nambiar; Melissa Neuman; Tambosi Phiri; Naomi Saville; Aman Sen; Nadine Seward; Neena Shah Moore; Bhim Prasad Shrestha; Bright Singini; Kirti Man Tumbahangphe; Anthony Costello; Audrey Prost

doi:10.1136/archdischild-2014-307636

Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India

Edward Fottrell, David Osrin, Glyn Alcock, Kishwar Azad, Ujwala Bapat, James Beard, Austin Bondo, Tim Colbourn, Sushmita Das, Carina King, Dharma Manandhar, Sunil Manandhar, Joanna Morrison, Charles Mwansambo, Nirmala Nair, Bejoy Nambiar, Melissa Neuman, Tambosi Phiri, Naomi Saville, Aman SenNadine Seward, Neena Shah Moore, Bhim Prasad Shrestha, Bright Singini, Kirti Man Tumbahangphe, Anthony Costello, Audrey Prost

Health Service & Population Research

Research output: Contribution to journal › Article › peer-review

46 Citations (Scopus)

Abstract

OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data.

DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site.

RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting.

CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care.

Original language	English
Pages (from-to)	F439-47
Journal	ADC Fetal & Neonatal
Volume	100
Issue number	5
DOIs	https://doi.org/10.1136/archdischild-2014-307636
Publication status	Published - Sept 2015

Keywords

Autopsy/methods
Bangladesh/epidemiology
Cause of Death
Female
Humans
India/epidemiology
Infant
Infant Mortality
Malawi/epidemiology
Male
Nepal/epidemiology
Population Surveillance/methods
Prospective Studies
Sex Distribution

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/archdischild-2014-307636

Cite this

Fottrell, E., Osrin, D., Alcock, G., Azad, K., Bapat, U., Beard, J., Bondo, A., Colbourn, T., Das, S., King, C., Manandhar, D., Manandhar, S., Morrison, J., Mwansambo, C., Nair, N., Nambiar, B., Neuman, M., Phiri, T., Saville, N., ... Prost, A. (2015). Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India. ADC Fetal & Neonatal, 100(5), F439-47. https://doi.org/10.1136/archdischild-2014-307636

@article{0b034acbf4ab4abc8b5e62a3d799150a,

title = "Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India",

abstract = "OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data.DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site.RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting.CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care.",

keywords = "Autopsy/methods, Bangladesh/epidemiology, Cause of Death, Female, Humans, India/epidemiology, Infant, Infant Mortality, Malawi/epidemiology, Male, Nepal/epidemiology, Population Surveillance/methods, Prospective Studies, Sex Distribution",

author = "Edward Fottrell and David Osrin and Glyn Alcock and Kishwar Azad and Ujwala Bapat and James Beard and Austin Bondo and Tim Colbourn and Sushmita Das and Carina King and Dharma Manandhar and Sunil Manandhar and Joanna Morrison and Charles Mwansambo and Nirmala Nair and Bejoy Nambiar and Melissa Neuman and Tambosi Phiri and Naomi Saville and Aman Sen and Nadine Seward and {Shah Moore}, Neena and Shrestha, {Bhim Prasad} and Bright Singini and Tumbahangphe, {Kirti Man} and Anthony Costello and Audrey Prost",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2015",

month = sep,

doi = "10.1136/archdischild-2014-307636",

language = "English",

volume = "100",

pages = "F439--47",

journal = "ADC Fetal & Neonatal",

issn = "1468-2052",

publisher = "BMJ Publishing Group",

number = "5",

}

Fottrell, E, Osrin, D, Alcock, G, Azad, K, Bapat, U, Beard, J, Bondo, A, Colbourn, T, Das, S, King, C, Manandhar, D, Manandhar, S, Morrison, J, Mwansambo, C, Nair, N, Nambiar, B, Neuman, M, Phiri, T, Saville, N, Sen, A, Seward, N, Shah Moore, N, Shrestha, BP, Singini, B, Tumbahangphe, KM, Costello, A & Prost, A 2015, 'Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India', ADC Fetal & Neonatal, vol. 100, no. 5, pp. F439-47. https://doi.org/10.1136/archdischild-2014-307636

TY - JOUR

T1 - Cause-specific neonatal mortality

T2 - analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India

AU - Fottrell, Edward

AU - Osrin, David

AU - Alcock, Glyn

AU - Azad, Kishwar

AU - Bapat, Ujwala

AU - Beard, James

AU - Bondo, Austin

AU - Colbourn, Tim

AU - Das, Sushmita

AU - King, Carina

AU - Manandhar, Dharma

AU - Manandhar, Sunil

AU - Morrison, Joanna

AU - Mwansambo, Charles

AU - Nair, Nirmala

AU - Nambiar, Bejoy

AU - Neuman, Melissa

AU - Phiri, Tambosi

AU - Saville, Naomi

AU - Sen, Aman

AU - Seward, Nadine

AU - Shah Moore, Neena

AU - Shrestha, Bhim Prasad

AU - Singini, Bright

AU - Tumbahangphe, Kirti Man

AU - Costello, Anthony

AU - Prost, Audrey

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2015/9

Y1 - 2015/9

N2 - OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data.DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site.RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting.CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care.

AB - OBJECTIVE: Understanding the causes of death is key to tackling the burden of three million annual neonatal deaths. Resource-poor settings lack effective vital registration systems for births, deaths and causes of death. We set out to describe cause-specific neonatal mortality in rural areas of Malawi, Bangladesh, Nepal and rural and urban India using verbal autopsy (VA) data.DESIGN: We prospectively recorded births, neonatal deaths and stillbirths in seven population surveillance sites. VAs were carried out to ascertain cause of death. We applied descriptive epidemiological techniques and the InterVA method to characterise the burden, timing and causes of neonatal mortality at each site.RESULTS: Analysis included 3772 neonatal deaths and 3256 stillbirths. Between 63% and 82% of neonatal deaths occurred in the first week of life, and males were more likely to die than females. Prematurity, birth asphyxia and infections accounted for most neonatal deaths, but important subnational and regional differences were observed. More than one-third of deaths in urban India were attributed to asphyxia, making it the leading cause of death in this setting.CONCLUSIONS: Population-based VA methods can fill information gaps on the burden and causes of neonatal mortality in resource-poor and data-poor settings. Local data should be used to inform and monitor the implementation of interventions to improve newborn health. High rates of home births demand a particular focus on community interventions to improve hygienic delivery and essential newborn care.

KW - Autopsy/methods

KW - Bangladesh/epidemiology

KW - Cause of Death

KW - Female

KW - Humans

KW - India/epidemiology

KW - Infant

KW - Infant Mortality

KW - Malawi/epidemiology

KW - Male

KW - Nepal/epidemiology

KW - Population Surveillance/methods

KW - Prospective Studies

KW - Sex Distribution

U2 - 10.1136/archdischild-2014-307636

DO - 10.1136/archdischild-2014-307636

M3 - Article

C2 - 25972443

SN - 1468-2052

VL - 100

SP - F439-47

JO - ADC Fetal & Neonatal

JF - ADC Fetal & Neonatal

IS - 5

ER -

Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this