Factors Associated with Neonatal Mortality: A Comparative Study between Uganda and Rwanda

Abstract

The aim of this study is to compare factors associated with neonatal mortality between Uganda and Rwanda. A secondary analysis of 2016 Uganda Demographic Health Survey (UDHS) and 2014-15 Rwanda Demographic Health Survey (RDHS) was conducted. Data on 15,522 and 7,856 live births during the 3 years period preceding the 2016 UDHS and 2014-15 RDHS respectively were analyzed. Frequency and percentage distributions were used to describe neonates by selected factors. Chi square tests were used to establish the relationship between neonatal mortality and each independent variable, and lastly, a complementary log-log regression model was fitted using weighted data to identify and compare factors associated with neonatal mortality in Uganda and Rwanda. Results indicate that the NMR for Uganda was 26/1000 live births, and that for Rwanda was 20/1000 live births. Longer preceding birth intervals 2-4 and 5+ years relative to <2 years were significantly associated with higher risk of neonatal mortality in both countries. On the other hand, factors that significantly reduced risk of neonatal mortality in both Uganda and Rwanda were; neonates of 2nd – 4th birth order relative to 1st born, normal birth weight 2.5+ kilograms relative to <2.5 kilograms, being born to women aged 20-24 years relative teenagers 15-19 years and attending 1-3 and 4+ ANC relative to no ANC visit. For Uganda, parity of 5+ children relative to 1 child was significantly associated with higher risk of neonatal mortality (OR=3.541; CI: 1.556-8.059) and rural residence with reduced risk of neonatal mortality. In Rwanda, neonates born to employed women, and with unknown birth weight were associated with higher risk of neonatal mortality, whereas mothers’ age (25-29, 30-34 and 35-39 years) and use of modern contraceptives (OR=0.648; CI: 0.426-0.984) were significantly associated with lower risk of neonatal mortality. The study recommends that Uganda should focus efforts on increasing uptake of modern contraceptives in order to control high parity, and also programs aimed at reducing neonatal mortality need to be directed to women of reproductive age groups 25-29, 30-34 and 35-39 years. On the other hand, in Rwanda, interventions need to be designed to enable working Women take care of their newborns