Predictors of neonatal mortality in Tigray Regional State, Northern Ethiopia: a comparison of parametric survival models’ approaches

Background: The neonatal age is the most vulnerable time for survival in which children appeare at the highest risk of dying in their lives.Ethiopia has pledged to lower under-five child mortality rates since 2015 despite being one of the SSA nations to have achieved the fourth Millennium Development Goal (MDG4). The neonatal mortality rate (NMR) is still a significant public health issue in Ethiopia, and it is getting worse in the Tigray region. Neonatal mortality dataset from retrospective cross-sectional study research is also scarce.

Objective:  This study was aimed to assess the predictors of neonatal mortality in the Tigray region of northern Ethiopia.

Method: A retrospective cross-sectional study design was conducted from 18, January, 2016 to 27, June 2016. In this study a total of 716 neonates were selected. Neonatal mortality risk factors include predictor variables such as neonate and mother demographics, health, and environmental factors. The study used descriptive statistics, Kaplan-Meier comparisons, and parametric survival models, and comparisons were also performed to select suitable forecasting model analyses.

Result:The overall NMR experienced was 4.3 neonatal deaths per 100 total live births. The estimated mean follow-up time of neonates was 10.0 days [95% CI: 9.67, 10.30] in the Tigray region. The multivariable Weibull-regression model analysis revealed that predictors being multiple birth type (AHR = 10.9, 95% CI: 3.4, 35.5) and home delivery (AHR = 10.5, 95% CI: 3.0, 36.6) were critically important risk predictors associated with a higher NMR.

Conclusion: The prevalence of NMR showed that the NMR in the Tigray region was greater than the national average.The current study identified the multiple birth type and home delivery of the neonates as crucial predictor factors for NMR. Interventions should be improved to these factors that significantly decrease the NMR problem among neonates.