Correlates of neonatal mortality in Kenya

Abstract

Despite the acknowledged importance of neonatal mortality in terms of its critical contribution to one year deaths, very little attention has been paid to this in terms of the number of researches carried out at the Population studies and Research Institute, University of Nairobi. This is not surprising at all because neonatal deaths are believed to be mainly biologically caused for which social scientists have no remedial solutions to offer. Yet evidence emerging from other- developing countries indicates the overwhelming importance of socio-economic factors in reducing endogenous causes of mortality. Hence, there is a lot for social scientists to offer in terms of community based studies, using several sources of data. The general objective of this study is to explore the associations of socio-economic, socio-cultural, demographic, environmental and health factors with neonatal mortality. These associations are explored using information on birth histories of 7150 women in the reproductive age grcmp 15,-49. In total the study includes 198 neonates who are born and died during the five year, preceding the survey. A number of statistical techniques of analysis including descriptive statistics, multiple and logistic regression models and relative risk method were used. While some of the results are inconsistent with what is in the literature resume, this study has confirmed the universally accepted view that during the neonatal period endogenous rather than exogenous factors (i.e., socio-economic, socio-cultural, demographic, environment and health factors) are most important statistically in providing explanation of the variation in neonatal mortality. It should be emphasized that other exogenous factors such as paternal characteristics which have not been captured by the analysis could also be important predictors of neonatal mortality. Furthermore, this study has shown wide variation in the correlates of neonatal mortality across the five years preceding the survey. This suggests the aeas ona L nature .of the causes of neonatal mortality. Based on these findings the studies recommends the following: (1) Longitudinal rather than retrospective studies should be carried out with biological factors and .pat~rnal characteristics included, using logistics and multiple-regression models and data from several sources. (2) The actual causes of neonatal mortality and their periodicity of occurrence should be closely monitored and studied at the micro level (i.e.,.district level) and on monthly and yearly basis since planning process in the country is essentially district focused. -. (3) The present network of family planning programme should be strengthened through access to medical facilities and training and equipping nurses and traditional birth attendants in order to encourage or stimulate good social and economic behaviour. The same information can be passed through encouraging women education, bot~ formal and informal. Furthermore, immunization coverage should be extended to include all women in the reproductive age group 15-19. (4) The environment should be improved in general since environmental factors affect both the under fives and under ones.