PT  - JOURNAL ARTICLE
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
TI  - Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India
AID  - 10.1136/archdischild-2014-307636
DP  - 2015 Sep 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F439--F447
VI  - 100
IP  - 5
4099  - http://fn.bmj.com/content/100/5/F439.short
4100  - http://fn.bmj.com/content/100/5/F439.full
SO  - Arch Dis Child Fetal Neonatal Ed2015 Sep 01; 100
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.