Factors influencing the likelihood of first-day neonatal mortality in Uganda

Abstract

The objective of this study was to investigate the socio-demographic, healthcare-related and obstetric factors associated with the first-day neonatal mortality in Uganda. The study utilized the UDHS 2016 child dataset, comprising of 15,522 cases. In order to minimize recall bias, the study was limited to children who died within three years prior to the 2016 survey, resulting in a sample size of 9,650. The research employed Chi-square tests and a complementary log log model to establish the relationship between the socio-demographic, healthcare-related, obstetric factors and first-day neonatal mortality Among socio-demographic factors, both the mother's age at childbirth and the child's birth weight emerged as significant contributors to first-day neonatal mortality. The study also revealed that healthcare-related factors associated with first-day neonatal mortality included the quality of care received rather than just accessibility to a health centre and whether the child was immediately placed on the mother's or care-giver's bare chest. Concerning obstetric factors, parity was found to be associated with first-day neonatal mortality. However, abortion history and mode of delivery showed no significant association with first-day neonatal mortality. Particularly, early motherhood (OR=0.503; CI=0.269, 0.942; P=0.032), high parity (OR=2.480; CI=1.765, 3.84; P<0.05), and a child born with low birth weight (OR=1.689; CI=1.130, 2.526; P=0.011) significantly increase the first-day neonatal mortality of children. Conversely, practices such as immediate skin-to-skin contact (OR=0.377; CI=0.251, 0.567; P<0.05) and receiving quality care at the health facility rather than just accessibility (OR=1.811; CI=1.232, 20662; P=0.003) significantly reduce the likelihood of first-day neonatal mortality. The research suggests that both the government and other stakeholders should implement targeted programs to effectively address and mitigate these identified factors.