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Assessing Antenatal Care and Newborn Survival in Sub-Saharan Africa within the Context of Renewed Commitments to Save Newborn Lives

World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, 11371, Egypt

Antenatal care (ANC) is one of the key interventions of the Every Newborn action plan to improve newborn health and prevent stillbirths by 2035. However, little is known about its relationship with neonatal mortality in sub-Saharan Africa since the 1990s. We use data from 54 Demographic and Health Survey (DHS) from 27 countries to make comparisons of neonatal mortality by ANC attendance. Each country had two surveys that were categorized as ‘earliest surveys’ (i.e. conducted since 1990 but before 2010) and ‘latest surveys’ (from 2010 to 2014). Multi-level logistic regression model and meta-analysis were applied on 1.1 million births that occurred among women in the 5 years preceding the surveys. Overall neonatal mortality rate (NMR) was 37.7 (95% CI, 37.4–38.1) deaths per 1000 live births; NMR in the earliest surveys were 46.0 (95% CI, 45.4–46.7) and 33.4 (95% CI, 33.0–33.8) deaths per 1000 live births in the latest surveys. The overall NMR was also 10% higher than expected NMR (37.7 vs 34.3 deaths per 1000 live births). NMR was 2.2 times higher among births of women with no ANC compared to those who had at least one ANC visit (42.5 vs 19.6 per 1000 live births). After adjusting for place of delivery, maternal age at birth, relative household wealth, residence, mother’s education, marital status, birth order, sex of child, and period of survey, the overall odds ratio (OR) demonstrated that women with at least one ANC visit were 48% less likely to report neonatal deaths (OR: 0.52; 95% CI: 0.47–0.57) than women who did not receive ANC. NMR was 27% less likely to occur during the latest surveys than during the earliest surveys (OR: 0.73; 95% CI: 0.71–0.75). We discuss these results within the context of calls for continued efforts to deploy interventions aimed at improving the quality of maternal and newborn care.
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Keywords antenatal care; neonatal mortality; newborn care; quality care; sub-Saharan Africa

Citation: Henry V. Doctor. Assessing Antenatal Care and Newborn Survival in Sub-Saharan Africa within the Context of Renewed Commitments to Save Newborn Lives. AIMS Public Health , 2016, 3(3): 432-447. doi: 10.3934/publichealth.2016.3.432

References

  • 1. Darmstadt GL, Bhutta ZA, Cousens S, et al. (2005) Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 365(9463): 977-88.
  • 2. WHO. (2014) Every Newborn: an action plan to end preventable deaths. Executive Summary. Geneva, Switzerland: World Health Organization.
  • 3. Singh A, Pallikadavath S, Ram F, et al. (2014) Do antenatal care interventions improve neonatal survival in India? Health Policy Plan 29(7): 842-8.
  • 4. WHO. Provision of Effective Antenatal Care: Integrated Management of Pregnancy and Child Birth (IMPAC). Geneva, Switzerland: Standards for Maternal and Neonatal care (1.6), Department of Making Pregnancy Safer, World Health Organization, 2006. Available from: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/effective_antenatal_care.pdf; accessed 23 May 2016.
  • 5. Barros FC, Victora CG, Barros AJD, et al. (2005) The challenge of reducing neonatal mortality in middle-income countries: findings from three Brazilian births cohorts in 1982, 1993, and 2004. Lancet 365(9462): 847-54.
  • 6. Gabrysch S, Campbell OMR. (2009) Still too far to walk: Literature review of the determinants of delivery service use. BMC Pregnancy Childbirth 9: 34.
  • 7. Wall LL. (1998) Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Fam Plann 29: 341-59.    
  • 8. Uzondu CA, Doctor HV, Findley SE, et al. (2015) Female health workers at the doorstep: a pilot of community-based maternal, newborn, and child health service delivery in northern Nigeria. Glob Health Sci Pract 3(1): 97-108.
  • 9. UNICEF. (2015) Levels and Trends in Child Mortality. Report on Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF.
  • 10. Fink G, Gunter I, Hill K. (2011) The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986–2007. Int J Epidemiol 40: 1196-204.
  • 11. Gwatkin DR, Rutstein S, Johnson K, et al. (2000) Socio-economic differences in health, nutrition, and population. HNP/Poverty Thematic Group. Washington, D.C.: World Bank.
  • 12. Nattey C, Masanja H, Klipstein-Grobusch K. (2013) Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania. Glob Health Action 6(2): 1-8.
  • 13. Higgins JP, Thompson SG, Deeks JJ, et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327: 557-60.
  • 14. Deeks JJ, Higgins JP, Altman DG. (2011) Analysing data and undertaking meta-analyses. In: Higgins JP, Green S, eds. Cochrane handbook for systematic reviews of interventions (version 5.1.0). The Cochrane Collaboration, 243-96.
  • 15. Garenne M. (2002) Sex ratios at birth in African populations. A review of the survey data. Hum Biol 74(6): 889-900.
  • 16. WHO. (2016) World health statistics 2016: monitoring health for the SDGs, sustainable development goals. Geneva, Switzerland: World Health Organization.
  • 17. WHO AFRO. (2014) The Health of the People: What Works — the African Regional Health Report 2014. Brazzaville, Republic of Congo: WHO Regional Office for Africa (AFRO).
  • 18. Zimba E, Kinney MV, Kachale F, et al. (2012) Newborn survival in Malawi: a decade of change and future implications. Health Policy Plan 27(Suppl 3): 88-103.
  • 19. Bergh A-M, Kerber K, Abwao S, et al. (2014) Implementing facility-based kangaroo mother care services: lessons from a multi-country study in Africa. BMC Health Serv Res 14: 293.
  • 20. Binka FN, Nazzar AK, Phillips JF. (1995) The Navrongo Community Health and Family Planning Project. Stud Fam Plann 26(3): 121-39.
  • 21. Engmann C, Walega P, Aborigo RA, et al. (2012) Stillbirths and early neonatal mortality in rural Northern Ghana. Trop Med Int Health 17(3): 272-82.
  • 22. Binka FN, Bawah AA, Phillips JF, et al. (2007) Rapid achievement of the child survival millennium development goal: evidence from the Navrongo experiment in Northern Ghana. Trop Med Int Health 12(5): 578-83.
  • 23. Savigny DD, Kasale H, Mbuya C, et al. (2002) Tanzania essential health interventions project: an overview of TEHIP interventions. Discussion paper. no. 2 (Version 1.3).
  • 24. Sines E, Tinker A, Ruben J. (2006) The Maternal-Newborn-Child Health Continuum of Care: A Collective Effort to Save Lives. Population Reference Bureau and Save the Children. Available from: http://www.prb.org/pdf06/snl-contofcare_eng.pdf; Last accessed 9 March 2016.
  • 25. Mishra V, Bignami-Van Assche, Greener R, et al. (2014) HIV infection does not disproportionately affect the poorer in sub-Saharan Africa. AIDS 21(Suppl 7): S17-S28.
  • 26. Rutstein SO, Johnson K. (2004) The DHS Wealth Asset Index. DHS Comparative Report No. 6. Calverton, Maryland, USA: ORC Macro.

 

This article has been cited by

  • 1. Amsalu Taye Wondemagegn, Animut Alebel, Cheru Tesema, Worku Abie, The effect of antenatal care follow-up on neonatal health outcomes: a systematic review and meta-analysis, Public Health Reviews, 2018, 39, 1, 10.1186/s40985-018-0110-y

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Copyright Info: 2016, Henry V. Doctor, licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

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