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Need to Focus Beyond the Medical Causes: a Systematic Review of the Social Factors Affecting Neonatal Deaths
Author(s) -
Upadhyay Ravi Prakash,
Krishnan Anand,
Rai Sanjay K.,
Chinnakali Palanivel,
Odukoya Oluwakemi
Publication year - 2014
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/ppe.12098
Subject(s) - medicine , medline , cochrane library , neonatal death , pediatrics , neonatal mortality , meta analysis , systematic review , infant mortality , family medicine , environmental health , pregnancy , population , fetus , biology , political science , law , genetics
Background Reducing the global total of 3.3 million neonatal deaths is crucial to meeting the fourth M illennium D evelopment G oal. Until recently, attention has been on the medical causes of the neonatal deaths, while the social factors contextualising these deaths have largely remained unaddressed. The current review aimed to quantify the role of these factors in neonatal deaths. Methods A systematic search was performed through P ubMed, G oogle scholar, C ochrane library, M edline, I ndMed, E mbase, W orld H ealth O rganization and B iomed central databases. Studies published from 1995 to 2011 were included. Random effects meta‐analysis was performed to derive at an estimate of the burden of delays, as defined by the ‘three delays model’ by T hadeus and M aine . Results A total of 17 studies were reviewed. The majority of them ( n = 10) were from the African continent. Level 3 delay, i.e. delay in receiving appropriate treatment upon reaching a health facility (38.7%, 95% CI , 21.7%–57.3%) and delay in deciding to seek care for the illness (Level 1 delay) (28%, 95% CI , 16%–43%) were the major contributors to neonatal deaths. Level 2 delay, i.e. delay in reaching a health facility (18.3%, 95% CI , 2.6–43.8%) contributed least to the neonatal deaths. Conclusion Creating awareness among caregivers regarding early recognition and treatment seeking for neonatal illness along with improving the quality of neonatal care provided at the health facilities is essential to reduce neonatal mortality.