Need to Focus Beyond the Medical Causes: a Systematic Review of the Social Factors Affecting Neonatal Deaths

作者：Upadhyay Ravi Prakash^*; Krishnan Anand; Rai Sanjay K; Chinnakali Palanivel; Odukoya Oluwakemi

来源：Paediatric and Perinatal Epidemiology, 2014, 28(2): 127-137.

DOI：10.1111/ppe.12098

• neonatal deaths
• social factors
• three delays model
• systematic review

BackgroundReducing the global total of 3.3 million neonatal deaths is crucial to meeting the fourth Millennium Development Goal. 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.
MethodsA systematic search was performed through PubMed, Google scholar, Cochrane library, Medline, IndMed, Embase, World Health Organization and Biomed 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 Thadeus and Maine.
ResultsA 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.
ConclusionCreating 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.

• 出版日期2014-3
• 单位河北医科大学