NEONATAL MORTALITY :A CHALLENGE TOWARDS THE ACHIEVEMENT OF MDG-4

7/31/2019 NEONATAL MORTALITY :A CHALLENGE TOWARDS THE ACHIEVEMENT OF MDG-4

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PRESENTED BY:

Group C2

BHARATI KC(09)

SAMJHANA SHRESTHA(31)

SEEMA GIRI(32)

SUNIL KOIRALA(36)

NEONATAL MORTALITY :A

CHALLENGE TOWARDS THE

ACHIEVEMENT OF MDG-4


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INTRODUCTION

The term neonate is used for the newborn infant during 28 daysperiod. Neonatal mortality refers to the probability of dying within

the first month of life.

Although being new born is not a disease, large number of childrendies soon after birth: many of them in first four weeks of life

(neonatal deaths) and most of those during the first week of life

(early neonatal deaths).

The major causes of newborn deaths in Nepal are infection, birth

asphyxia, preterm birth and hypothermia


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Neonatal mortality and Millennium Development

Goal-4

MDGs provide a framework for theentire international community to work

together towards a common end

making sure that human development

reaches everyone, everywhere.

Goal 4: Reduce child mortality

Target

Reduce by two-thirds, between 1990

and 2015, the under five mortality

rate


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Cont..

Neonatal mortality levels play an increasingly important role in

child mortality.

The proportion of child deaths that occurs in the neonatal period

greatly influence the Millennium Development Goal-4 .

Neonatal mortality is a serious concern in Nepal, accounting for 69

per cent of IMR and 54 per cent of U5MR in 2006 (DOHS 2008).

Hence MDGs of child survival cannot be met without substantial

reductions in neonatal mortality


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STATEMENT OF PROBLEM

30,000 children die each yearin Nepal during their first month of life.

2/3rd20,000 child dies in their firstweek of birth

2/3rd

16,000 child dies within

24hrs of their birth

About 3-4neonates

dies each

hour in

Nepal

(National Neonatal

Strategy 2004).


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OBJECTIVES

General Objective:

To study the situation of neonatal mortality as a challenge

towards achieving MDG-4.

Specific Objectives:

To assess the trend of neonatal mortality from the year 1996

to 2010 A.D.

To assess the required difference to meet MDG-4 2015

target.To determine the challenges influencing neonatal mortality (

Exclusive breastfeeding , safe motherhood services: ANC,

place of delivery, PNC, Birth interval, Birth size)


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METHODOLOGY

Study AreaThe study area was Nepal.

Study design

The study design was cross-sectional descriptive type done

with the help of secondary data.

Study duration

The study was conducted from the 25th November to 15th

December.

Data Collection Procedure

The data were collected through systematic review secondary

sources, including research, internet, journals and various

reports


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Cont..

Data Analysis Technique

The collected data were analyzed in MS-EXCEL (Version 7)and represented in bar diagrams and tables using number and

percentage.

Limitation of the study

The study was solely based on secondary data.


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FINDINGS


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Trend of Neonatal Mortality Rate in Nepal

50

39

33 33

0

10

20

30

40

50

60

1991-1995 1996-2000 2001-2005 2006-2010

rate/1000

liv

ebirths

Trend of NMR

Source: NDHS Report 1996 to 2011


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MDG Target for reducing Child Mortality Rate

Indicators Status at 1990 MDG Target to be

achieved by 2015

Infant Mortality Rate

(IMR)

108 per 1000 live births 34 per 1000 live births

Under-five Mortality Rate

(U5MR)

162 per 1000 live births 54 per 1000 live births

Neonatal mortality

Rate(NMR)

(accounts for 69 per cent of

IMR and54 per cent of

U5MR)

50 per thousand live births 16 per thousand live

births


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Trends of reduction in Neonatal mortality Rate

(1990-2010)

Mortality

Indicators

per

thousand

live births

Differences between the years per

1000 live births

Required

difference to meet

the MDG target

2010-2015(16)1991-1995

(50)

1996-2000

(39)

2001-2005

(33)

2006-2010

(33)

Neonatal

Mortality

Rate

11 6 6 0 17


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Factors influencingNMR


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NMR by birth size

56

27

0

10

20

30

40

50

60

Small/Very small Average/Large

per1000

live

births

Source :NDHS 2006


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NMR trend by birth interval

Source :NDHS 2006


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Factors influencing NMR: presenting challenges towards

the achievement of MDG-4

0

20

40

60

80

ANC(any) Births at health

facility

PNC Initiation of

breast feeding

within 1Hrs

72

18

23

35

percentage

Challenge

-1

Challenge-2

Source: DHS 2006


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DISCUSSION

The trend of neonatal mortality has been decreased from50/1000 live births in 1996 to 39/1000 live births in 2001

while the NMR remained constant from 2006 to 2011.

While comparing our study with analysis of demographic

and health survey from around developing world we

found that neonatal mortality is reduced for preceding

birth intervals of 3 years as compared with intervals of lessthan 2 years.


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Cont..

Similarly while comparing our study findings with the

evaluation study on Neonatal Mortality of Low Births

Infants conducted in Bangladesh, we found that small

birth size babies have higher risk of deaths influencing

NMR

Across 40 countries with DHS data between 1995 and

2003, more than 50% of neonatal deaths arose after ahome birth with no skilled care while in our study only

18% of the child birth took place at health institution.


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CONCLUSION

The trend of NMR remained almost constant without anyslight reduction during the gap of four years presenting

challenge towards the achievement of MDG-4 since

reduction of child mortality largely depends on saving

more new born lives.

The trends in reduction of neonatal mortality followed

decelerating pace but still 17% reduction in NMR isrequired to achieve the MDG target by 2015 i.e with in

four years.

C


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Cont..

Various factors such as birth size, birth interval, safemotherhood services (ANC, delivery services by health

workers, PNC, breastfeeding) influenced NMR, thereby

presenting challenges towards the achievement of MDG


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RECCOMENDATIONS

A single approach focusing on reducing child mortality is

not sufficient enough. DOHs should focus towards the

improvement of new born health through employing

integrated approach combining safe motherhood andfamily planning services.

The focus should be given towards the improving neonatalhealth since MDG-4 couldnt be achieved without

reducing NMR.


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REFRENCES

Millennium Development Goals Indicators: The Official

United Nations Site for MDG Indicators.

[http://www.mdgs.un.org/unsd/mdg/Data.aspx].

UNICEF. State of the Worlds Children 2009. New York:

UNICEF, 2009. NDHS ,2006 ,2011

ANNUAL REPORT 2066/67
http://www.mdgs.un.org/unsd/mdg/Data.aspxhttp://www.mdgs.un.org/unsd/mdg/Data.aspx


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Knowing is not enough, we

must apply;Willing is not enough, we

must do.

Thank you

NEONATAL MORTALITY :A CHALLENGE TOWARDS THE ACHIEVEMENT OF MDG-4

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