Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Nov 10;78(1):114.
doi: 10.1186/s13690-020-00499-8.

Impact of antenatal care on neonatal mortality among neonates in Ethiopia: a systematic review and meta-analysis

Tadesse Tolossa  1 , Ginenus Fekadu  2 , Belayneh Mengist  3 , Diriba Mulisa  4 , Getahun Fetensa  4 , Daniel Bekele  5
Affiliations
Review

Impact of antenatal care on neonatal mortality among neonates in Ethiopia: a systematic review and meta-analysis

Tadesse Tolossa et al. Arch Public Health. .

Abstract

Background: As compared to other regions of the world, Sub Saharan Africa (SSA) is the region with the highest neonatal mortality and is the region showing the least progress in the reduction of newborn death. Despite better progress made in reducing neonatal mortality, Ethiopia contributes the highest rate of neonatal death in Africa. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the impact of antenatal care on neonatal mortality among mother-neonate pairs in Ethiopia.

Methods: Published articles from various electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science, and Google Scholar were accessed. Also, unpublished studies from library catalogs were identified. All observational studies that were conducted on the association between antenatal care follow-up and neonatal mortality among neonates in Ethiopia were included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled impact on antenatal care on neonatal mortality. The presence of publication bias was assessed by funnel plots and Egger's statistical tests.

Results: Initially, a total of 345 studies were accessed. Finally, 28 full-text studies were reviewed and fourteen studies fulfilled inclusion criteria and included in the final meta-analysis. The overall pooled estimate indicates the odds of neonatal death among neonates from women with antenatal care were 65% lower than those neonates from women who had no antenatal care follow-up (OR: 0.35, 95% CI: 0.24, 0.51).

Conclusions: In this systematic review and meta-analysis, lack of ANC follow-up increase the probability of neonatal mortality as compared to having ANC follow-up. Thus, we will recommend for more coverages of appropriate antenatal care where risk groups can best be identified and managed.

Keywords: Antenatal care; Ethiopia; Neonatal mortality; Neonates.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the studies included in the meta-analysis
Fig. 2
Fig. 2
Forest plot for pooled impact of ANC follow up on neonatal among neonates in Ethiopia, 2019
Fig. 3
Fig. 3
Funnel plot with 95% confidence limits of the pooled impact of ANC follow up on neonatal mortality in Ethiopia, 2019
Fig. 4
Fig. 4
Result of trim and fill analysis for adjusting publication bias of the 14 studies, 2019
Fig. 5
Fig. 5
Sub group analysis for impact of ANC follow up on neonatal mortality based on the region where the studies were conducted in Ethiopia, 2019
Fig. 6
Fig. 6
Sub group analysis for impact of ANC follow up on neonatal mortality based on the setting in Ethiopia, 2019
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. WHO and UNICEF . Levels & trends in child mortality: Report 2017. UNICEF, WHO, the World Bank, United Nations population division. New York: UNICEF on behalf of the UN Inter-agency Group for Child Mortality Estimation; 2017.
    1. Darroch JE, Sully E, Biddlecom A. Adding it up: investing in contraception and maternal and newborn health, 2017—supplementary tables. New York: The Guttmacher Institute; 2017.
    1. World Health Organization . Survive and thrive: transforming care for every small and sick newborn. 2019.
    1. Tekelab T, Akibu M, Tagesse N, Tilhaun T, Yohanes Y, Nepal S. Neonatal mortality in Ethiopia: a protocol for systematic review and meta-analysis. Syst Rev. 2019;8(1):1–4. - PMC - PubMed
    1. Rosati F, Faria LG. Addressing the SDGs in sustainability reports: the relationship with institutional factors. J Clean Prod. 2019;215:1312–1326.