Neonatal mortality and associated factors at a provincial hospital, Western Province of Rwanda: A facility based cross-sectional study, 2019-2021

Introduction: Despite progress made towards United Nations SDG targets, neonatal mortality remains a significant challenge in Rwanda, especially in rural areas with a higher mortality rate (20 per 1000 live births) compared to urban regions (15 per 1000 live births). Bushenge Hospital, a rural facil...

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Main Authors: Christophe Nkundabaza, Gilbert Rukundo, Jean d’Amour Sinayobye, Joseph Ntaganira, Judith Mukamurigo
Format: Article
Language:English
Published: African Field Epidemiology Network 2024-06-01
Series:Journal of Interventional Epidemiology and Public Health
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Online Access:https://www.afenet-journal.net/content/series/7/3/3/full/
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Summary:Introduction: Despite progress made towards United Nations SDG targets, neonatal mortality remains a significant challenge in Rwanda, especially in rural areas with a higher mortality rate (20 per 1000 live births) compared to urban regions (15 per 1000 live births). Bushenge Hospital, a rural facility, receives numerous neonatal admissions, yet understanding of neonatal mortality and its determinants is limited. This study aimed to assess the prevalence and factors associated with neonatal mortality at Bushenge hospital. Methods: This is a hospital based cross-sectional study. Neonatal and maternal records from January 2019 to December 2021 were assessed and analysed using Epi Info 7.0. Records with missing data on cause of admission or outcome, and those with duplication, were excluded. Bivariate and multivariable logistic regression analyses were computed with corresponding 95% confidence intervals (95% CI) to assess associations between neonatal mortality and factors. Results: 1,483 medical records were reviewed. The prevalence of neonatal mortality was 8.9% (n=132/1483). Neonatal mortality was significantly associated with Trisomy 21(adjusted odds ratio(AOR): 20.7,95%CI:2.44–154.17),extreme low birth weight (AOR:14.4, 95% CI 6.6 – 31.8), length of hospital stay (AOR: 12.7, 95% CI 6.7 – 24.5), Apgar score ≤ 6 (AOR: 8.1, 95% C.I 3.6 – 18.4), prematurity (AOR: 6.1, 95% CI 3.4 – 11.1), very low birth weight (AOR: 5.6, 95% CI 2.6 – 12.3), Cyanotic Heart Disease(AOR:5.6,95%CI:1.34–20.18) asphyxia (AOR: 5.3, 95% C.I 2.6 – 11.0), neonatal infection (AOR: 3.8, 95% CI 1.9 – 7.6), infants aged ≤ 7 days (AOR: 3.5, 95% C.I 1.6 – 8.0),and caesarean section (AOR:1.6,95% C.I 1.0 – 2.8). Conclusion: This study revealed that Bushenge hospital had lower prevalence than other rural hospitals in Rwanda. Most factors associated with neonatal mortality can be avoided; hence preventive measures such as enhancing the utilization of antenatal care services and, early identification and referral of high-risk pregnancy and neonates could reduce the neonatal deaths.
ISSN:2664-2824