| Comparing socioeconomic inequalities between early neonatal mortality and facility delivery: Cross-sectional data from 72 low- and middle-income countries |
| Authors: |
Terhi J. Lohela, Robin C. Nesbitt, Juha Pekkanen, and Sabine Gabrysch |
| Source: |
Scientific Reports, 9(1): 9786; DOI: 10.1038/s41598-019-45148-5 |
| Topic(s): |
Child health
Delivery care
Institutional births
Maternal health
Neonatal mortality
|
| Country: |
More than one region
Multiple Regions
|
| Published: |
JUL 2019 |
| Abstract: |
Facility delivery should reduce early neonatal mortality. We used the Slope Index of Inequality and
logistic regression to quantify absolute and relative socioeconomic inequalities in early neonatal
mortality (0 to 6 days) and facility delivery among 679,818 live births from 72 countries with
Demographic and Health Surveys. The inequalities in early neonatal mortality were compared with
inequalities in postneonatal infant mortality (28 days to 1 year), which is not related to childbirth.
Newborns of the richest mothers had a small survival advantage over the poorest in unadjusted
analyses (-2.9 deaths/1,000; OR 0.86) and the most educated had a small survival advantage over
the least educated (-3.9 deaths/1,000; OR 0.77), while inequalities in postneonatal infant mortality
were more than double that in absolute terms. The proportion of births in health facilities was an
absolute 43% higher among the richest and 37% higher among the most educated compared to the
poorest and least educated mothers. A higher proportion of facility delivery in the sampling cluster
(e.g. village) was only associated with a small decrease in early neonatal mortality. In conclusion, while
socioeconomically advantaged mothers had much higher use of a health facility at birth, this did not
appear to convey a comparable survival advantage. |
| Web: |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611781/ |