ABSTRACT
Introduction: The high neonatal mortality rate in low- and middle-income countries (LMICs) such as Nigeria has lasted for more than 30â years to date with associated nursing fatigue. Despite prominent hard work, technological improvements, and many publications released from the country since 1990, the problem has persisted, perhaps due to a lack of intervention scale-up. Could there be neglected discoveries unwittingly abandoned by Nigerian policymakers over the years, perhaps locked up in previous publications? A careful review may reveal these insights to alert policymakers, inspire researchers, and refocus in-country research efforts towards impactful directions for improving neonatal survival rates. The focus was to determine the prevailed effectiveness of LMIC medical academia in creating solutions to end the high neonatal mortality rate. Methods: An unconventional systematic review protocol structure following the PRISMA 2020 checklist was designed and registered at INPLASY (registration number: INPLASY202380096, doi: 10.37766/inplasy2023.8.0096). A jury of paediatricians was assembled and observed by a team of legal professionals. The jury searched the literature from 1990 to the end of 2022, extracted newborn-related articles about Nigeria, and assessed and debated them against expected criteria for solution creation, translation, scale-up, sustainability, and national coverage. Each juror used preset criteria to produce a verdict on the possibility of a published novel idea being a potential game-changer for improving the survival rate of Nigerian neonates. Results: A summation of the results showed that 19 out of 4,286 publications were assessed to possess potential strategies or interventions to reduce neonatal mortality. Fourteen were fully developed but not appropriately scaled up across the country, hence denying neonates proper access to these interventions. Conclusion: Nigeria may already have the required game-changing ideas to strategically scale up across the nation to accelerate neonatal survival. Therefore, LMIC healthcare systems may have to look inward to strengthen what they already possess. Systematic Review Registration: https://inplasy.com/, identifier (INPLASY202380096).
ABSTRACT
Early neonatal death, which occurs during the prenatal period, is defined as the death of a newborn between 0 and 7 days after birth. It is one of the major public health problems in several developing countries. This study aimed to determine the early neonatal mortality rate and identify determinants of early neonatal mortality in Somalia region of Ethiopia. Methods: The data used for this study were drawn from the 2019 Ethiopia Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was used to identify the determinants of early neonatal mortality. Adjusted odds ratio (AOR) with 95% CI was used to examine the association of factors with early neonatal mortality. Results: A total of 637 live births were included in this study. The early neonatal mortality rate in the study was 44 (95% CI: 31, 65) deaths per 1000 live births. Male babies (AOR: 1.628; 95% CI: 1.152-4.895), babies delivered at home (AOR: 2.288; 95% CI: 1.194-6.593), and babies born from uneducated mothers (AOR: 2.130; 95% CI: 1.744-6.100) were at increased risk of death in the first 7 days of life after birth. Contrarily, decreased risk of death of babies in the first 7 days of life after birth was associated with urban residence (AOR: 0.669; 95% CI: 0.033-0.721) and singleton (AOR: 0.345; 95% CI: 0.070-0.609). Conclusion: The early neonatal mortality rate in the region was high. The study revealed that sex of child, place of residence, birth type, mother's educational level, and place of delivery were the determinants of the death of babies in the first 7 days of life after birth. Hence, providing health education to uneducated mothers and enhancing institutional delivery is recommended to minimize the early neonatal mortality rate in the region.