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Causes of neonatal death: results from NeoKIP community-based trial in Quang Ninh province, Vietnam
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell barnhälsa och nutrition/Persson)
School of Public Health, Hanoi, Vietnam.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell barnhälsa och nutrition/Persson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell barnhälsa och nutrition/Persson)
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2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 4, 368-373 p.Article in journal (Refereed) Published
Abstract [en]

Aim: 

To ascertain the causes of neonatal death in a province in northern Vietnam and analyse their distribution over age at death, birth weight and place of delivery.

Methods: 

Verbal autopsy interviews using a questionnaire derived from WHO standard and adapted to Vietnamese conditions was performed on all neonatal deaths occurring in Quang Ninh province from July 2008 to June 2010. Three experienced paediatricians independently reviewed all verbal autopsy records (233) and assigned a main cause of death. In case of disagreement in the allocation of cause of death, a consensus process was initiated to decide on a final cause.

Results: 

Neonatal mortality rate within the study area was 16/1000 (238 neonatal deaths and 14 453 live births) over the study period. Prematurity/low birth-weight (37.8%), intrapartum-related neonatal deaths (birth asphyxia, 33.2%), infections (13.0%) and congenital malformation (6.7%) were the four leading causes of death. Four cases of neonatal tetanus were found. Intrapartum-related deaths dominated in the home delivery group, whereas prematurity was the most prominent cause of death at all facility levels. Most neonatal deaths occurred within the first 24 h after delivery (58.6%).

Conclusion: 

A high proportion of deaths due to prematurity and intrapartum-related causes, calls for improvements of delivery care and resuscitation practices at health facilities.

Place, publisher, year, edition, pages
2012. Vol. 101, no 4, 368-373 p.
Keyword [en]
Causes of death, Neonatal mortality, Verbal autopsy, Vietnam
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-164149DOI: 10.1111/j.1651-2227.2011.02513.xISI: 000300973200021PubMedID: 22107114OAI: oai:DiVA.org:uu-164149DiVA: diva2:466674
Available from: 2011-12-16 Created: 2011-12-16 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Neonatal Mortality in Vietnam: Challenges and Effects of a Community-Based Participatory Intervention
Open this publication in new window or tab >>Neonatal Mortality in Vietnam: Challenges and Effects of a Community-Based Participatory Intervention
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Globally neonatal mortality accounts for 40% of under-five deaths. Participatory interventions where the local problems are addressed have been successful in some settings.

The aim of this thesis was to describe challenges in perinatal health in a Vietnamese province, and to evaluate the effect of a facilitated intervention with local stakeholder groups that used a problem-solving approach to neonatal survival during three years.

The NeoKIP trial (Neonatal Knowledge Into Practice, ISRCTN44599712) had a cluster-randomized design (44 intervention communes, 46 control). Laywomen facilitated Maternal-and-Newborn Health Groups (MNHGs) and used Plan-Do-Study-Act cycles to address perinatal health problems. Births and neonatal deaths were monitored. Interviews were performed in households of neonatal deaths and randomly selected live births. Use of health services was mapped. The primary healthcare staff’s knowledge on newborn care was assessed before and after the intervention.

Neonatal mortality rate (NMR) was 16/1000 live births (variation 10 - 44/1000 between districts). Home deliveries accounted for one fifth of neonatal deaths, and health facilities with least deliveries had higher NMR. Main causes of death were prematurity/low birth-weight (37.8 %), intrapartum-related deaths (33.2 %) and infections (13.0 %). Annual NMR was 19.1, 19.0 and 11.6/1000 live births in intervention communes (18.0, 15.9 and 21.1 in control communes); adjusted OR 1.08 [0.66-1.77], 1.23 [0.75-2.01], and 0.51 [0.30-0.89], respectively. Women in intervention communes more frequently attended antenatal care, prepared for delivery and gave birth at institutions. Primary healthcare staff’s knowledge on newborn care increased slightly in intervention communes.

This model of facilitation of local stakeholder groups using a perinatal problem-solving approach was successful and may be feasible to scale-up in other settings.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 98 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 853
Keyword
Facilitation, Local stakeholder group, Maternal-and-Newborn Health Group, Neonatal mortality, Primary health care, Vietnam
National Category
Medical and Health Sciences
Research subject
International Health
Identifiers
urn:nbn:se:uu:diva-188252 (URN)978-91-554-8567-2 (ISBN)
Public defence
2013-02-05, Rosensalen, Akademiska Sjukhuset, Entrance 95/96 nbv, Uppsala, 09:15 (English)
Opponent
Supervisors
Projects
NeoKIP project in Vietnam
Available from: 2013-01-15 Created: 2012-12-14 Last updated: 2014-01-21Bibliographically approved

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Nga, Nguyen ThuMålqvist, MatsPersson, Lars-ÅkeEwald, Uwe

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