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Risk factors for perinatal mortality in Nigeria: the role of place of delivery and delivery assistants

Background: This study examines the association between place of delivery, delivery assistants
and perinatal mortality in Nigeria. Previous studies have found these factors to be associated
with the risk of perinatal mortality. This study therefore aims to determine the extent to which
these two factors predict perinatal mortality in the Nigerian context as this information will be
useful in informing health policy decisions and actions in so far as a desirable reduction in
childhood mortality in Nigeria is concerned. Methods: This study uses cross sectional design
through secondary analysis of the 2003 Nigerian Demographic and Health Survey (NDHS). The
variables representing place of delivery and delivery assistants have been fitted into logistic
regression models to determine their association with perinatal mortality. Several other known
risk factors for perinatal mortality such as maternal education and birth weight, to mention a
few, have also been investigated using the logistic regression analysis. Results: 5783 live
singleton births were analyzed with 194 newborns dying within the first seven days of life
giving an early neonatal mortality rate (ENMR) of 33.5 per 1000 and an estimated perinatal
mortality rate (PNMR) of 72.4 per 1000 live births. The results also show that place of delivery
[p=0.8777] and delivery assistants [p=0.3812] are not significantly associated with perinatal
mortality even after disaggregating the analysis by rural and urban areas. However being small
in size at birth [AOR= 2.13, CI=1.41 – 3.21], female [AOR=0.57, CI= 0.42 – 0.77] and having a
mother who practiced traditional religion [AOR= 4.37, CI= 2.31 – 8.26], were all significantly
associated with perinatal mortality. Conclusions: Place of delivery and delivery assistants are
not good predictors of perinatal mortality in the Nigerian context. However various limitations
of the study design used such as the issue of uncontrolled confounding may have affected the
findings. Nonetheless, the increased risk of perinatal deaths in small babies and the decreased
risk of death among female babies are consistent with other studies and have both been
attributed elsewhere to biologic mechanisms.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/6784
Date24 March 2009
CreatorsOji, Oti Samuel
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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