{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:26:01Z","timestamp":1792592761854,"version":"4.5.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are, however, very few reports about the issue in sub-Saharan Africa. For the sake of developing appropriate policies and initiatives that could aid in addressing the issue, it is important to study the prevalence of mortality during the early neonatal period and associated factors. Thus, the aim of this study was to ascertain the prevalence of and pinpoint the contributing factors to early neonatal mortality in sub-Saharan Africa.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>Data from recent demographic and health surveys in sub-Saharan African countries was used for this study. The study included 262,763 live births in total. The determinants of early newborn mortality were identified using a multilevel mixed-effects logistic regression model. To determine the strength and significance of the association between outcome and explanatory variables, the adjusted odds ratio (AOR) at a 95% confidence interval (CI) was computed. Independent variables were deemed statistically significant when the p-value was less than the significance level (0.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>Early neonatal mortality in sub-Saharan Africa was 22.94 deaths per 1,000 live births. It was found to be significantly associated with maternal age over 35 years (AOR = 1.77, 95% CI: 1.34\u20132.33), low birth weight (AOR = 3.27, 95% CI: 2.16, 4.94), less than four ANC visits (AOR = 1.12, 95% CI: 1.01, 1.33), delivery with caesarean section (AOR = 1.81, 95% CI: 1.30\u20132.5), not having any complications during pregnancy (AOR = 0.76, 95% CI: 0.61, 94), and community poverty (AOR = 1.32, 95% CI: 1.05\u20131.65).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study found that about twenty-three neonates out of one thousand live births died within the first week of life in sub-Saharan Africa. The age of mothers, birth weight, antenatal care service utilization, mode of delivery, multiple pregnancy, complications during pregnancy, and community poverty should be considered while designing policies and strategies targeting early neonatal mortality in sub-Saharan Africa.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0304065","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T18:08:47Z","timestamp":1717783727000},"page":"e0304065","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Early neonatal mortality and determinants in sub-Saharan Africa: Findings from recent demographic and health survey data"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0760-1100","authenticated-orcid":true,"given":"Tadesse Tarik","family":"Tamir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yirgalem","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemneh Tadesse","family":"Kassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alebachew Ferede","family":"Zegeye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"key":"pone.0304065.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/j.siny.2017.02.006","article-title":"Early neonatal death: a challenge worldwide","volume-title":"Seminars in Fetal and Neonatal Medicine","author":"L. Lehtonen","year":"2017"},{"issue":"1","key":"pone.0304065.ref002","first-page":"1","article-title":"Determinants of early neonatal mortality in Afghanistan: an analysis of the Demographic and Health Survey 2015","volume":"14","author":"G.M.A. Kibria","year":"2018","journal-title":"Globalization and health"},{"issue":"5","key":"pone.0304065.ref003","doi-asserted-by":"crossref","DOI":"10.15406\/jpnc.2015.02.00089","article-title":"Determinants of early neonatal mortality in Nigeria: results from 2013 Nigeria DHS","volume":"2","author":"T. Dahiru","year":"2015","journal-title":"Journal of Pediatrics & Neonatal Care"},{"issue":"9938","key":"pone.0304065.ref004","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S0140-6736(14)60496-7","article-title":"Every Newborn: progress, priorities, and potential beyond survival","volume":"384","author":"J.E. Lawn","year":"2014","journal-title":"The lancet"},{"issue":"11","key":"pone.0304065.ref005","doi-asserted-by":"crossref","first-page":"e1186","DOI":"10.1016\/S2214-109X(18)30389-9","article-title":"Equity in antenatal care quality: an analysis of 91 national household surveys","volume":"6","author":"C. Arsenault","year":"2018","journal-title":"The Lancet Global Health"},{"key":"pone.0304065.ref006","unstructured":"Newborns, W., Improving survival and well-being. World Health Organization. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/newborns-reducing-mortality, 2020."},{"issue":"3","key":"pone.0304065.ref007","first-page":"30","article-title":"Facility-based delivery and maternal and early neonatal mortality in sub-Saharan Africa: a regional review of the literature","volume":"17","author":"C.A. Moyer","year":"2013","journal-title":"African journal of reproductive health"},{"key":"pone.0304065.ref008","unstructured":"Transforming our world Cf, O.,: the 2030 Agenda for Sustainable Development. United Nations: New York, NY, USA, 2015."},{"issue":"6","key":"pone.0304065.ref009","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1001\/jamapediatrics.2017.0261","article-title":"Importance of innovations in neonatal and adolescent health in reaching the sustainable development goals by 2030","volume":"171","author":"C.R. Sudfeld","year":"2017","journal-title":"JAMA pediatrics"},{"issue":"6","key":"pone.0304065.ref010","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.1016\/S2214-109X(19)30163-9","article-title":"National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis","volume":"7","author":"L. Hug","year":"2019","journal-title":"The Lancet Global Health"},{"issue":"2","key":"pone.0304065.ref011","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.07.020504","article-title":"Skilled attendant at birth and newborn survival in Sub\u2013Saharan Africa","volume":"7","author":"A. Amouzou","year":"2017","journal-title":"Journal of global health"},{"issue":"1","key":"pone.0304065.ref012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-8-232","article-title":"Determinants of neonatal mortality in Indonesia","volume":"8","author":"C.R. Titaley","year":"2008","journal-title":"BMC public health"},{"issue":"1","key":"pone.0304065.ref013","first-page":"42","article-title":"Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit","volume":"116","author":"J. Reyes","year":"2018","journal-title":"Arch Argent Pediatr"},{"issue":"1","key":"pone.0304065.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-2-27","article-title":"Assessing the determinants of stillbirths and early neonatal deaths using routinely collected data in an inner city area","volume":"2","author":"N.C. Smeeton","year":"2004","journal-title":"BMC medicine"},{"issue":"1","key":"pone.0304065.ref015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-019-4668-3","article-title":"Factors affecting neonatal mortality in the general population: evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)\u2014multilevel analysis","volume":"12","author":"H.F. Wolde","year":"2019","journal-title":"BMC research notes"},{"key":"pone.0304065.ref016","unstructured":"Organization, W.H., Reaching the every newborn national 2020 milestones: country progress, plans and moving forward. 2017."},{"issue":"1","key":"pone.0304065.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-015-0349-0","article-title":"Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics","volume":"15","author":"J.O. Akinyemi","year":"2015","journal-title":"BMC pediatrics"},{"issue":"4","key":"pone.0304065.ref018","doi-asserted-by":"crossref","first-page":"219","DOI":"10.15171\/ijhpm.2016.127","article-title":"Changes in socio-economic inequality in neonatal mortality in Iran between 1995\u20132000 and 2005\u20132010: an Oaxaca decomposition analysis","volume":"6","author":"M.A. Rarani","year":"2017","journal-title":"International journal of health policy and management"},{"issue":"4","key":"pone.0304065.ref019","doi-asserted-by":"crossref","first-page":"e96294","DOI":"10.1371\/journal.pone.0096294","article-title":"Maternal and neonatal mortality in south-west Ethiopia: estimates and socio-economic inequality","volume":"9","author":"Y. Yaya","year":"2014","journal-title":"PloS one"},{"issue":"1","key":"pone.0304065.ref020","first-page":"1","article-title":"Maternal age and risk of early neonatal mortality: a national cohort study","volume":"11","author":"Y.-N. Kim","year":"2021","journal-title":"Scientific reports"},{"issue":"2","key":"pone.0304065.ref021","doi-asserted-by":"crossref","first-page":"113","DOI":"10.22435\/hsji.v7i2.5587.113-117","article-title":"Low birth weights and risk of neonatal mortality in Indonesia","volume":"7","author":"S. Suparmi","year":"2016","journal-title":"Health Science Journal of Indonesia"},{"key":"pone.0304065.ref022","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1590\/0034-7167-2016-0586","article-title":"Early neonatal mortality and risk factors: a case-control study in Paran\u00e1 State","volume":"71","author":"M.T. Migoto","year":"2018","journal-title":"Revista Brasileira de Enfermagem"},{"key":"pone.0304065.ref023","first-page":"2","volume-title":"The global action report on preterm birth","author":"World Health Organization","year":"2012"},{"key":"pone.0304065.ref024","article-title":"Kangaroo mother care to reduce morbidity and mortality in low birthweight infants (Review)","volume-title":"The Cochrane Collaboration","author":"D.-R.J. Conde-AgudeloA","year":"2005"},{"key":"pone.0304065.ref025","unstructured":"Organization, W.H., Women and health: today\u2019s evidence tomorrow\u2019s agenda. 2009: World Health Organization."},{"issue":"9463","key":"pone.0304065.ref026","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0140-6736(05)71088-6","article-title":"Evidence-based, cost-effective interventions: how many newborn babies can we save?","volume":"365","author":"G.L. Darmstadt","year":"2005","journal-title":"The Lancet"},{"key":"pone.0304065.ref027","unstructured":"UNICEF, Global databases, 2016, based on Multiple Indicator Cluster Surveys (MICS). Demographic and Health Surveys (DHS) and other nationally representative sources, 2016."},{"issue":"9","key":"pone.0304065.ref028","doi-asserted-by":"crossref","first-page":"e0222566","DOI":"10.1371\/journal.pone.0222566","article-title":"The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis","volume":"14","author":"T. Tekelab","year":"2019","journal-title":"PloS one"},{"key":"pone.0304065.ref029","author":"V. Briand","year":"2012","journal-title":"Maternal and perinatal outcomes by mode of delivery in senegal and mali: a cross-sectional epidemiological survey"},{"issue":"01","key":"pone.0304065.ref030","doi-asserted-by":"crossref","first-page":"07","DOI":"10.1055\/s-0031-1285829","article-title":"Cesarean versus vaginal delivery: whose risks? Whose benefits?","volume":"29","author":"K.D. Gregory","year":"2012","journal-title":"American journal of perinatology"},{"issue":"4","key":"pone.0304065.ref031","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/j.1523-536X.2006.00118.x","article-title":"Cesarean section rates and maternal and neonatal mortality in low\u2010, medium\u2010, and high\u2010income countries: an ecological study","volume":"33","author":"F. Althabe","year":"2006","journal-title":"Birth"},{"issue":"Part 1","key":"pone.0304065.ref032","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/01.AOG.0000233154.62729.24","article-title":"Postpartum maternal mortality and cesarean delivery","volume":"108","author":"C. Deneux-Tharaux","year":"2006","journal-title":"Obstetrics & Gynecology"},{"issue":"7628","key":"pone.0304065.ref033","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1136\/bmj.39363.706956.55","article-title":"Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study","volume":"335","author":"J. Villar","year":"2007","journal-title":"Bmj"},{"key":"pone.0304065.ref034","first-page":"1013","article-title":"Risk factors for early neonatal mortality","author":"D. Schoeps","year":"2007","journal-title":"Revista de saude publica"},{"key":"pone.0304065.ref035","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-015-0362-3","article-title":"Still births, neonatal deaths and neonatal near miss cases attributable to severe obstetric complications: a prospective cohort study in two referral hospitals in Uganda","volume":"15","author":"A. Nakimuli","year":"2015","journal-title":"BMC pediatrics"},{"issue":"1","key":"pone.0304065.ref036","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.08.010404","article-title":"Early neonatal mortality in twin pregnancy: findings from 60 low-and middle-income countries","volume":"8","author":"S. Bellizzi","year":"2018","journal-title":"Journal of global health"},{"issue":"8","key":"pone.0304065.ref037","doi-asserted-by":"crossref","first-page":"e70549","DOI":"10.1371\/journal.pone.0070549","article-title":"Maternal and perinatal outcomes of twin pregnancy in 23 low-and middle-income countries","volume":"8","author":"J.P. Vogel","year":"2013","journal-title":"PloS one"},{"issue":"4","key":"pone.0304065.ref038","doi-asserted-by":"crossref","DOI":"10.4103\/1119-3077.116895","article-title":"Pregnancy outcome and factors affecting vaginal delivery of twins at University of Nigeria Teaching Hospital, Enugu","volume":"16","author":"T. Nwankwo","year":"2013","journal-title":"Nigerian journal of clinical practice"},{"issue":"5","key":"pone.0304065.ref039","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1111\/j.1751-486X.2007.00214.x","article-title":"Poverty and neonatal outcomes: how nurses around the world can make a difference","volume":"11","author":"C. Kenner","year":"2007","journal-title":"Nursing for Women\u2019s Health"},{"key":"pone.0304065.ref040","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-019-2190-1","article-title":"Poverty, urban-rural classification and term infant mortality: a population-based multilevel analysis","volume":"19","author":"Y.A. Mohamoud","year":"2019","journal-title":"BMC pregnancy and childbirth"},{"issue":"3","key":"pone.0304065.ref041","doi-asserted-by":"crossref","first-page":"e042753","DOI":"10.1136\/bmjopen-2020-042753","article-title":"Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis","volume":"11","author":"K. Thomson","year":"2021","journal-title":"BMJ open"},{"key":"pone.0304065.ref042","volume-title":"The State of the World\u2019s Children 2016: A Fair Chance for Every Child","author":"K. Watkins","year":"2016"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0304065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T18:09:25Z","timestamp":1717783765000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0304065"}},"subtitle":[],"editor":[{"given":"Abera","family":"Mersha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":42,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0304065","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,7]]}}}