Back to browse results
Prenatal care associated with reduction of neonatal mortality in Sub-Saharan Africa: evidence from Demographic and Health Surveys
Authors: McCurdy RJ, Kjerulff KH, and Zhu J.
Source: Acta Obstetricia et Gynecologica Scandinavica, 90(7):779-90. doi: 10.1111/j.1600-0412.2011.01133.x.
Topic(s): Maternal health
Neonatal mortality
Country: Africa
  Multiple African Countries
Published: JUL 2011
Abstract: Objective. To determine whether prenatal care by a skilled provider (physician, nurse or midwife) and specific prenatal interventions were associated with decreased neonatal mortality. Design. Mothers’ reports in nationally representative surveys (conducted 2003–2009) about their most recent delivery were analyzed. Setting. Sub-Saharan Africa, 17 least developed countries (UN designation). Population. 89 655 women aged 15–49 years with a singleton birth within 3 years prior to survey. Methods. Logistic regression models were used to measure the associations between having a skilled prenatal provider, as well as specific interventions, and neonatal mortality. Main Outcome Measures. Neonatal mortality, defined as a live birth ending in death at less than one month of age. Results. Overall, 70.7% of women saw a skilled prenatal provider during their previous pregnancy. Prenatal care from a skilled provider was associated with a decreased neonatal mortality risk compared with no provider [adjusted odds ratio (AOR) 0.70, 95% confidence interval (CI) 0.62–0.80] and compared with an unskilled provider (AOR 0.81, 95% CI 0.68–0.96). The most effective prenatal interventions were weight (AOR 0.71, 95% CI 0.64–0.80) and blood pressure measurements (AOR 0.77, 95% CI 0.69–0.86), and two or more tetanus immunizations (AOR 0.78, 95% CI 0.70–0.86). Four or more prenatal visits compared with none were associated with decreased neonatal mortality risk (AOR 0.68, 95% CI 0.59–0.79). Conclusions. Prenatal care provided by skilled providers, at least four prenatal visits, weight and blood pressure assessment, and two or more tetanus immunizations were associated with decreased neonatal mortality in Sub-Saharan African countries. Keywords: prenatal care, neonatal mortality, skilled prenatal provider, sub-Saharan Africa, demographic and health surveys