Abstract

Background: Neonatal mortality is a significant public health concern worldwide. It is estimated that four million neonatal deaths occur annually, 98% of which occur in developing countries. In Ethiopia neonatal mortality is a major problem accounting for more than 42% of under-five deaths. This study is an attempt to study the determinants of neonatal mortality in Ethiopia using data collected in Ethiopian demographic and health survey.
Methods: The survey collected information from a total of 16,515 women aged 15-49 years out of which 9209 women were considered in this study. To meet our objectives, descriptive statistics and Poisson, negative binomial, zero inflated Poisson and zero-inflated negative binomial regression models were used for data analysis considering household, maternal and socio-demographic, socio-economic and environmental variables as explanatory variables and number of neonatal deaths per-woman as the response variable.
Results: Each of the four models was compared by a variety of statistical techniques and it was found that zeroinflated negative binomial model was a better fit than the other models. Based on descriptive statistics results 23.2% of mothers have experienced at least one neonatal death in their lifetime. From result of the zero-inflated negative binomial regression model, being born to mothers whose age at first birth is at least 20 years, whose level of education is secondary and above, who reside in urban areas and who attended at least four antenatal care visits significantly decreases the risk of neonatal mortality.
Conclusion: Neonatal mortality must decline more rapidly to achieve the Millennium Development Goal (MDG) target for under-five mortality in Ethiopia. Increasing access to maternal and child health services in rural areas, improving the level of education of mothers, encouraging utilization of antenatal care services and improving access to safe/pipe drinking water are recommended as possible interventions.

Keywords: Neonatal mortality; Poisson; Negative binomial; Zeroinflated Poisson; Zero-inflated; Negative binomial