DETERMINANTS OF NEONATAL MORTALITY AMONG NEWBORNS ADMITTED IN NEONATAL INTENSIVE CARE UNIT AT DILLA UNIVERSITY REFERRAL HOSPITAL IN GEDEO ZONE SOUTHERN ETHIOPIA, 2020: UNMATCHED CASE CONTROL STUDY

Abstract Introduction: Globally around two and half million neonatal mortality occurred in 2017, especially in developing countries. In Ethiopia, about 87,000 neonates die each year. Also, the recent Ethiopia mini demographic health survey of 2019 indicated that 30 deaths per 1000 live births. However, there are few studies on determinants of neonatal mortality at the institution level in Ethiopian intensive care units. Objective: To assess the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia, 2020. Methods: An unmatched case-control study was conducted from February, 24 to March 6, 2020. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by SPSS Version 22. Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95% CI and P-values <0.05 were used to declare statistical significance. Result: In this study, a total of 304 cases were assessed with 100% reviewed rate. It was found that referrals from other health facilities, AORs = 2.43, 95% CI (1.14, 5.22), gestational age <37 weeks, AORs = 2.50, 95% CI (1.12, 5.58), the weight of newborn <2500g, AORs = 2.44, 95% CI (1.13, 5.28), neonates positive for sepsis, AORs = 2.45, 95% CI (1.11, 5.41) and neonates who not breastfed within first hour after delivery, AORs =5.24, 95% CI (2.42, 11.37) were statistically significant determinants to neonatal mortality. Conclusion: Referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. Therefore, most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care.