3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Risk factors for perinatal mortality in Nigeria: the role of place of delivery and delivery assistants(2009-03-24T12:32:13Z) Oji, Oti SamuelBackground: 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.