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IJHSR. 2016; 6(8): 324-333


Differential and Determinants of Neonatal and Postnatal Mortality in India.

Payal Singh, Akash Mishra, RN Mishra.

Abstract
Introduction: Fourth MGD goal was framed to focus on reduction of Child Mortality. India achieved much reduction but could not achieve the fixed target of 27. High IMR is due to high neonatal deaths; about two third of total infant deaths. For quick reduction in IMR, determinants of neonatal and postnatal deaths need to be focussed separately.
Objectives: To assess the differential pattern of neonatal and postnatal mortality and to identify and compare the determinants of these mortalities
Data & Methodology: Data of NFHS-3 was used. Of 51555 born births history and mortality was recorded; 2876 deaths were under five and 2508 were infant deaths. Ratio of neonatal and postnatal mortality was 2.2:1. Variation of neonatal and postnatal mortality was analysed by bivariate and logistic regression.
Observations & Results: Place of residence and religion did not contribute either neonatal or postnatal mortalities. The risks of neonatal mortality was 1.89, 1.41 and 1.32 times higher in Central, East and North regions compared to south; while postnatal mortality was higher by 1.46 times in Central region only. The risks of neonatal mortality among mothers age below 20 and 20-40 years were 1.47 and 1.18 times higher; while postnatal mortality 1.50 times higher among below 20 years only. Compared to motherís education higher secondary or above, the risks of neonatal mortality was 2.53 times in mothers either with no education or primary and 1.90 times higher in secondary level while risks of postnatal mortality were 2.57 and 2.20 times higher in no education and primary mothers respectively. The risk of neonatal mortality was highest among born to poorest families compared to richest families. The risks of neonatal mortality to born of 2nd or 3rd order and 4th to 5th were lesser by 30% and 22% compared to born of 6th order; while 1st order born had almost same risk while risk of postnatal mortality was lesser by 29% only in born of 2nd or 3rd order. Neonatal mortality of male children was 1.17 times higher than female, but postnatal mortality was almost similar. The size of child at birth had influence to both neonatal as well as postnatal mortalities. The risk of neonatal mortality was almost similar in children delivered at home or institution, but postnatal mortality was 1.37 times higher among children delivered at home.
Conclusion: The findings suggest that rising marriage age, limited births through promoting family planning devices and MCH care can bring a quick reduction to both neonatal and post natal mortality and thereby in IMR and the target fixed can be achieved well in time.

Key words: Mortality, Neonatal, Postnatal, Parity.



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