RT Journal Article
SR Electronic
T1 Cause-specific neonatal mortality: analysis of 3772 neonatal deaths in Nepal, Bangladesh, Malawi and India
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F439
OP F447
DO 10.1136/archdischild-2014-307636
VO 100
IS 5
A1 Fottrell, Edward
A1 Osrin, David
A1 Alcock, Glyn
A1 Azad, Kishwar
A1 Bapat, Ujwala
A1 Beard, James
A1 Bondo, Austin
A1 Colbourn, Tim
A1 Das, Sushmita
A1 King, Carina
A1 Manandhar, Dharma
A1 Manandhar, Sunil
A1 Morrison, Joanna
A1 Mwansambo, Charles
A1 Nair, Nirmala
A1 Nambiar, Bejoy
A1 Neuman, Melissa
A1 Phiri, Tambosi
A1 Saville, Naomi
A1 Sen, Aman
A1 Seward, Nadine
A1 Shah Moore, Neena
A1 Shrestha, Bhim Prasad
A1 Singini, Bright
A1 Tumbahangphe, Kirti Man
A1 Costello, Anthony
A1 Prost, Audrey
YR 2015
UL http://fn.bmj.com/content/100/5/F439.abstract
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.