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
. 2021 Feb 17:2021:7478108.
doi: 10.1155/2021/7478108. eCollection 2021.

The Magnitude of Neonatal Mortality and Its Predictors in Ethiopia: A Systematic Review and Meta-Analysis

Yared Asmare Aynalem  1 , Wondimeneh Shibabaw Shiferaw  1 , Tadesse Yirga Akalu  2 , Abate Dargie  1 , Hilina Ketema Assefa  1 , Tesfa Dejenie Habtewold  1   3
Affiliations

The Magnitude of Neonatal Mortality and Its Predictors in Ethiopia: A Systematic Review and Meta-Analysis

Yared Asmare Aynalem et al. Int J Pediatr. .

Abstract

Background: Although neonatal death is a global burden, it is the highest in sub-Saharan African countries such as Ethiopia. Moreover, there is disparity in the prevalence and associated factors of studies. Therefore, this study was aimed at providing pooled national prevalence and predictors of neonatal mortality in Ethiopia.

Methods: The following databases were systematically explored to search for articles: Boolean operator, Cochrane Library, PubMed, EMBASE, Hinari, and Google Scholar. Selection, screening, reviewing, and data extraction were done by two reviewers independently using Microsoft Excel spreadsheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence. All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included. Data were extracted using Microsoft Excel spreadsheet software and imported into Stata version 14s for further analysis. Publication bias was checked using funnel plots and Egger's and Begg's tests. Heterogeneity was also checked by Higgins's method. A random effects meta-analysis model with 95% confidence interval was computed to estimate the pooled effect size (i.e., prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size, and study design was done.

Results: After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. Pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 12.1, 20.6, I 2 = 98.8%). The subgroup analysis indicated that the highest prevalence was observed in the Amhara region, 20.3% (95% CI: 9.6, 31.1), followed by Oromia, 18.8% (95% CI: 11.9, 49.4). Gestational age [AOR: 1.32 (95% CI: 1.07, 1.58)], neonatal sepsis [AOR: 1.23 (95% CI: 1.05, 1.4)], respiratory distress syndromes (RDS) [AOR: 1.18 (95% CI: 0.87, 1.49)], and place of residency [AOR: 1.93 (95% CI: 1.13, 2.73)] were the most important predictors.

Conclusions: Neonatal mortality in Ethiopia was significantly decreased. There was evidence that neonatal sepsis, gestational age, and place of residency were the significant predictors. RDS were also a main predictor of mortality even if not statistically significant. We strongly recommended that health care workers should give a priority for preterm neonates with diagnosis with sepsis and RDS.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram for showing screening and selection process of duties.
Figure 2
Figure 2
Forest plot of the pooled prevalence of neonatal mortality.
Figure 3
Figure 3
Funnel plot to show the distribution of 12 studies.
Figure 4
Figure 4
The pooled odds ratio of the association between GA and neonatal mortality.
Figure 5
Figure 5
The pooled odds ratio of the association between residency and neonatal mortality.
Figure 6
Figure 6
The pooled odds ratio of the association between RDS and neonatal mortality.
Figure 7
Figure 7
Pooled odds ratio of the association between neonatal sepsis and neonatal mortality.
Figure 8
Figure 8
Result of sensitivity analysis of the 24 studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kliegman R. M., St Geme J. W., Schor N. F., Behrman R. E. Chapter 93, Overview of Mortality and Morbidity. 20th. Canada: Robert M. Kliegman; 2016. Nelson Textbook of Pediatrics; pp. 789–793.
    1. You D., Hug L., Ejdemyr S., et al. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet. 2015;386(10010):2275–2286. - PubMed
    1. Mekonnen Y., Tensou B., Telake D. S., Degefie T., Bekele A. Neonatal mortality in Ethiopia: trends and determinants. BMC Public Health. 2013;13(1):p. 483. doi: 10.1186/1471-2458-13-483. - DOI - PMC - PubMed
    1. Institute EPH, ICF. Ethiopia mini demographic and health survey 2019: key indicators. Rockville, Maryland, USA: EPHI and ICF; 2019.
    1. Angela G., Zulfiqar B., Lulu B., Aly G. S., Dennis J. G. R., Anwar H., et al. Pediatric disease burden and vaccination recommendations: understanding local differences. International Journal of Infectious Diseases. 2010;30(30):1019–1029.

LinkOut - more resources