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Research Article
Mahendra Tri Arif Sampurna
Department of Pediatrics, Faculty of Medicine, Airlangga University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Neonatal mortality appears to be one of the most concerning problems to fulfill Sustainable Developmental Goals globally. Indonesia, as a developing country with uneven distribution of standardized health facilities over the archipelago, has been reported to be the country with the highest fatality cases of the newborn in Southeast Asia. To address this problem, we evaluate how substantive the socioeconomic spectrum and proximate determinants as a substantial predictor of the neonatal mortality rate in advance to maximize the health policies’ quality in reducing the rate of newborn death.
Method
The analysis was conducted using the data source of the 2017 Indonesia Demographic Health Survey from 11.965 live-born infants born from singleton pregnancy in the year of 2017. By using a hierarchical approach and logistic regression, the multilevel analysis was carried out to assess the possible contributing factors including socioeconomic, household, and proximate factors to neonatal mortality.
Results
At socioeconomic determinants, the odds of newborn death was significantly higher for those who born from mothers with poor education level (OR = 1.72, p = 0.03), insufficient antenatal visits (OR = 3.98, p = 0.01), and not being involved to postnatal care (OR = 6.60, p = 0.01). Regarding community factors, the variable of traditional birth attendants was significantly higher for the odds of newborn death (OR = 2.06, p = 0.01) as well as the delivery in government public hospitals (OR = 1.89, p = 0.01). In terms of proximate determinants, the odds of newborn death found to be higher for male infants (OR = 1.43, p = 0.03) and low birth (< 2.5 kg) weight infants (OR = 4.15, p = 0.01). After the adjustment of these covariates, the newborn death were associated to mothers with insufficient antenatal care (OR = 2.58, p = 0.01), not participating in postnatal care (OR = 5.66, p = 0.01), assisted by traditional birth attendants (OR = 1.46, p = 0.03), and neonatal factors such as male gender (OR = 5.66, p = 0.01 and low birth weight (OR = 4.37, p = 0.01).
Conclusion
In reducing neonatal death, public health interventions should be targeted to individual and community-level factors of socioeconomic determinants. Improving the quality and coverage of perinatal health services such as the utilization of either antenatal care or postnatal care, the availability of trained birth attendants, and the optimization in public hospitals’ services have a significant meaning for better infants’ lives.
Keywords
neonatal mortality, Indonesia, socioeconomic determinants
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CURRENT STATUS: Under Revision
Version 1
Posted 23 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 01 Apr, 2021
Review #5 received
Received 24 Mar, 2021
Review #7 received
Received 24 Mar, 2021
Review #3 received
Received 24 Mar, 2021
Review #6 received
Received 24 Mar, 2021
Review #4 received
Received 24 Mar, 2021
Review #1 received
Received 24 Mar, 2021
Review #2 received
Received 24 Mar, 2021
Reviewer #7 agreed
On 23 Mar, 2021
Reviewer #9 agreed
On 23 Mar, 2021
Reviewer #1 agreed
On 23 Mar, 2021
Reviewer #5 agreed
On 23 Mar, 2021
Reviewer #8 agreed
On 23 Mar, 2021
Reviewer #2 agreed
On 23 Mar, 2021
Reviewer #6 agreed
On 23 Mar, 2021
Reviewer #3 agreed
On 23 Mar, 2021
Reviewer #4 agreed
On 23 Mar, 2021
Reviewers invited
Invitations sent on 22 Mar, 2021
Editor assigned
On 22 Mar, 2021
Editor invited
On 22 Mar, 2021
Submission checks complete
On 22 Mar, 2021
First submitted
On 02 Mar, 2021
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Mahendra Tri Arif Sampurna
Department of Pediatrics, Faculty of Medicine, Airlangga University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 23 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 01 Apr, 2021
Review #5 received
Received 24 Mar, 2021
Review #7 received
Received 24 Mar, 2021
Review #3 received
Received 24 Mar, 2021
Review #6 received
Received 24 Mar, 2021
Review #4 received
Received 24 Mar, 2021
Review #1 received
Received 24 Mar, 2021
Review #2 received
Received 24 Mar, 2021
Reviewer #7 agreed
On 23 Mar, 2021
Reviewer #9 agreed
On 23 Mar, 2021
Reviewer #1 agreed
On 23 Mar, 2021
Reviewer #5 agreed
On 23 Mar, 2021
Reviewer #8 agreed
On 23 Mar, 2021
Reviewer #2 agreed
On 23 Mar, 2021
Reviewer #6 agreed
On 23 Mar, 2021
Reviewer #3 agreed
On 23 Mar, 2021
Reviewer #4 agreed
On 23 Mar, 2021
Reviewers invited
Invitations sent on 22 Mar, 2021
Editor assigned
On 22 Mar, 2021
Editor invited
On 22 Mar, 2021
Submission checks complete
On 22 Mar, 2021
First submitted
On 02 Mar, 2021
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Neonatal mortality appears to be one of the most concerning problems to fulfill Sustainable Developmental Goals globally. Indonesia, as a developing country with uneven distribution of standardized health facilities over the archipelago, has been reported to be the country with the highest fatality cases of the newborn in Southeast Asia. To address this problem, we evaluate how substantive the socioeconomic spectrum and proximate determinants as a substantial predictor of the neonatal mortality rate in advance to maximize the health policies’ quality in reducing the rate of newborn death.
Method
The analysis was conducted using the data source of the 2017 Indonesia Demographic Health Survey from 11.965 live-born infants born from singleton pregnancy in the year of 2017. By using a hierarchical approach and logistic regression, the multilevel analysis was carried out to assess the possible contributing factors including socioeconomic, household, and proximate factors to neonatal mortality.
Results
At socioeconomic determinants, the odds of newborn death was significantly higher for those who born from mothers with poor education level (OR = 1.72, p = 0.03), insufficient antenatal visits (OR = 3.98, p = 0.01), and not being involved to postnatal care (OR = 6.60, p = 0.01). Regarding community factors, the variable of traditional birth attendants was significantly higher for the odds of newborn death (OR = 2.06, p = 0.01) as well as the delivery in government public hospitals (OR = 1.89, p = 0.01). In terms of proximate determinants, the odds of newborn death found to be higher for male infants (OR = 1.43, p = 0.03) and low birth (< 2.5 kg) weight infants (OR = 4.15, p = 0.01). After the adjustment of these covariates, the newborn death were associated to mothers with insufficient antenatal care (OR = 2.58, p = 0.01), not participating in postnatal care (OR = 5.66, p = 0.01), assisted by traditional birth attendants (OR = 1.46, p = 0.03), and neonatal factors such as male gender (OR = 5.66, p = 0.01 and low birth weight (OR = 4.37, p = 0.01).
Conclusion
In reducing neonatal death, public health interventions should be targeted to individual and community-level factors of socioeconomic determinants. Improving the quality and coverage of perinatal health services such as the utilization of either antenatal care or postnatal care, the availability of trained birth attendants, and the optimization in public hospitals’ services have a significant meaning for better infants’ lives.
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