Premium
Aetiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries
Author(s) -
Edmond Karen M.,
Quigley Maria A.,
Zandoh Charles,
Danso Samuel,
Hurt Chris,
Agyei Seth Owusu,
Kirkwood Betty R.
Publication year - 2008
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/j.1365-3016.2008.00961.x
Subject(s) - medicine , verbal autopsy , asphyxia , psychological intervention , health facility , infant mortality , cause of death , developing country , etiology , neonatal death , pregnancy , pediatrics , obstetrics , environmental health , population , health services , nursing , fetus , disease , pathology , psychiatry , economic growth , biology , economics , genetics
Summary In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community‐level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20 317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community‐level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community‐level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant.