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Predictors of perinatal mortality in emerging regions of Ethiopia: Evidence from EDHS 2016
Fikreab Desta1, Girma Beressa1, Biniyam Sahiledengle1,2
1Department Public Health, Madda Walabu University, Goba Referral Hospital, Goba, Ethiopia.
Insights
Perinatal mortality is high in Ethiopia
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Neonatal Medicine
Background:
- Perinatal mortality is a key indicator of healthcare quality, disproportionately affecting low-income countries.
- Ethiopia faces high perinatal mortality rates despite efforts to improve maternal and child health services.
- No prior studies have investigated perinatal mortality in Ethiopia's emerging regions.
Purpose of the Study:
- To assess factors contributing to perinatal mortality in Ethiopia's emerging regions (Afar, Gambela, Somali, Benishangul Gumuz).
Main Methods:
- Utilized data from the 2016 Ethiopian Demographic and Health Survey (EDHS).
- Analyzed 4,070 pregnancies with gestational age ≥7 months.
- Employed multi-level mixed logistic regression to identify individual and community-level predictors.
Main Results:
- The perinatal mortality rate in emerging regions was 36 deaths per 1,000 pregnancies.
- Significant factors associated with increased perinatal mortality included birth intervals <2 years, maternal age ≥35, and unimproved water sources.
- Maternal education was found to be a protective factor.
Conclusions:
- Perinatal mortality in Ethiopia's emerging regions exceeds the national average.
- Maternal age, water source quality, and birth interval are critical factors influencing perinatal deaths.
- Targeted interventions addressing these determinants are crucial for reducing perinatal mortality in these regions.
Background:
Perinatal mortality rate is one of indictors used to measure the quality of obstetric and pediatric services globally. Compared to developed settings, perinatal mortality rate is higher in low-income countries, indicating societal inequities in health care and a scarcity of prenatal services. It is responsible for roughly 42% of all stillbirth in Sub-Saharan Africa, and 41% of newborn death globally. Despite Ethiopia's efforts to reduce perinatal mortality by improving the quality of care for maternal and child health, perinatal mortality rate is still very high, and as to our search of pieces of literature there is no study in Emerging regions of the country. Therefore, this study aimed to assess the factors that contribute to perinatal mortality rate in emerging region (Afar, Gambela, Somali, and Benishangul Gumuz) of Ethiopia's.
Methods:
This study relied on data from the 2016 Ethiopian Demographic and Health Survey (EDHS). The analysis included the outcomes of 4, 070 pregnancies with a gestational age of 7 months or more. A multi-level mixed logistic regression analysis was used to examine individual and community-level predictors, accounting for the data's hierarchical structure. A statistically significant association was determined with a p-value of ≤ 0.05.
Results:
Of the 4,070 (weighted) pregnancies in total, 432 (57.36%) children were born to women with a mean age of 28.68 ± 6.53 (ages ± SD). The overall perinatal mortality rate in emerging regions of Ethiopia was 36 deaths per 1,000 pregnancies. The study found that having a birth interval < 2 years (AOR = 3.2, 95% CI: 1.51, 6.59), maternal age greater than or equal to 35 (AOR = 4.3, 95% CI: 1.84, 10.14), drinking an unimproved water source (AOR = 2.7, 95% CI: 1.14, 6.27), and mothers with no education (AOR = 0.33, 95% CI: 0.13, 0.86) were factors significantly associated with a high odds of perinatal mortality rate.
Conclusion:
This study revealed a higher perinatal mortality rate as compared to national average. Maternal age, drinking an unimproved water source, and birth interval were significantly associated with perinatal deaths. Despite the enhanced effort to improve maternal and child services, there is still a need for more attention to these interconnected issues helps to reduce effectively the perinatal mortality rate in emerging regions of Ethiopia. Future researchers may benefit from focusing on strong study designs to investigate further the determinants of perinatal mortality, and policymakers good to pay special attention to incorporating the findings into policy.
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