Why are Neonates Dying? Socioeconomic and Proximate Determinants of Neonatal Mortality among Stable Low-Birth-Weight (LBW) Infants in Kenya

Abstract

Background: Neonatal mortality rates are very high in Kenya, like the rest of Sub-Saharan Africa. The sustainable development goals aim to reduce the current 21 neonatal deaths per 1,000 live births to below 12 deaths per 1,000 live births. The rate of decline in Neonatal mortality in many countries is very slow compared to other childhood mortality rates. The objective of this study was to determine the socioeconomic and proximate determinants of neonatal mortality in Kenya. Methodology: A cohort study was carried out at Pumwani Maternity hospital, Thika Level 5 hospital and Machakos Level 5 hospital in Kenya with a sample of 343 stable LBW infants (≤2000g). Informed by the concepts of the Mosley and Chen (1984) analytical framework, several socioeconomic and proximate characteristics were included in the study. Cross tabulations and multiple logistic regression analyses were done to determine the relationships between the determinants and neonatal mortality. Results: The mean birth weight was 1492.6 g (SD=275.3) and mean gestational age was 30.3 weeks. Most infants (59.8%, N=343) were female. Incidence of neonatal mortality was 8.5% (n=340). Household income, birth complications, birth weight, gestational age and multiple births were significant determinants of neonatal mortality among the LBW infants weighing £2000 grams. Conclusion and recommendations: The findings affirm the Mosley and Chen (1984) analytical framework on determinants of neonatal survival. The study provides useful information on determinants of neonatal mortality that is relevant to the Kenyan context and applicable to other low income countries.

Keywords: neonatal survival; neonatal mortality; socioeconomic determinants; proximate determinants; low-birth-weight infants