Factors contributing to neonatal mortality rates in Macao: evidence from 1957-2006 data

The aim of this study was to examine the relationship between the neonatal mortality rate (NMR) and demographic changes, economic instability, and health resource availability in Macao. A retrospective design was used, where yearly data from Macao were collected for the period of 1957-2006. The NMR was the dependent variable and the demographic factors, socioeconomic status, and health resources were the three main explanatory variables. The results showed that higher unemployment rates, higher levels of educated women, and a greater supply of nurses are associated with a lower NMR. The results also indicated that socioeconomically disadvantaged groups are at a significantly higher risk of neonatal mortality. In contrast, increasing the number of nurses in health care significantly reduces the risk of neonatal mortality. Further international evidence suggested that greater efforts should be directed towards removing the barriers that impede access to health-care services and increasing preventive care for disadvantaged populations, particularly during economic downturns.