%0 Journal Article
%T Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death
%A Mwifadhi Mrisho
%A David Schellenberg
%A Fatuma Manzi
%A Marcel Tanner
%A Hassan Mshinda
%A Kizito Shirima
%A Beverly Msambichaka
%A Salim Abdulla
%A Joanna Armstrong Schellenberg
%J ISRN Pediatrics
%D 2012
%R 10.5402/2012/953401
%X Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health. 1. Background The Millennium Development Goal 4 aims at reducing child mortality by two-thirds by the year 2015. There are an estimated 3.6 million neonatal deaths around the world each year [1, 2]. Although simple, low-cost tools and strategies could prevent many of these deaths, the neonatal period now accounts for 41% of under-five deaths [1, 3]. Besides looking at overall child mortality and infant mortality in the first year of life, neonatal deaths are of great importance and causes of neonatal deaths and care-seeking for the neonates have been neglected in the past. The distribution of causes of neonatal deaths varies substantially between and within countries [1, 3]. About two-thirds of neonatal deaths occur in the African and southeast-asian regions. Although south-asian countries have the largest absolute number of deaths, Sub-Saharan Africa generally has higher rates of neonatal mortality. Less than 3% of neonatal deaths take place in countries with reliable vital registration data for cause of death analysis [3]. Although most studies estimate only the cause of death among neonates, for health programming, it is equally important to understand the care-seeking processes and treatment actions that occurred before each death [4, 5]. A functioning continuum of care between home and hospital is required to minimize potential delays and effectively link women and
%U http://www.hindawi.com/journals/isrn.pediatrics/2012/953401/