Type of delivery attendant, place of delivery and risk of early neonatal mortality

Analyses of the 1994-2007 Indonesia Demographic and Health Surveys

Dados Bibliográficos

ID11492005
AutoresChristiana Rialine Titaley (0000-0002-3023-003X, The University of Sydney), Michael J Dibley (0000-0002-1554-5180, The University of Sydney), C L Roberts, CL Roberts (The University of Sydney)
Ano2012
Volume27
Fascículo5
Páginas405-416
Data de publicação2012-08-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Policy and Planning (JOURNAL)
Identificadores do periódicoISSN: 0268-1080 • E-ISSN: 1460-2237
EditoraOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czr053
PMID21810892
OpenAlexW2100630733
IdiomaEN
Citações recebidas11
Referências citadas37

Access to skilled birth attendants and emergency obstetric care are thought to prevent early neonatal deaths. This study aims to examine the association between the type of delivery attendant and place of delivery and early neonatal mortality in Indonesia. Four Indonesia Demographic and Health Surveys from 1994, 1997, 2002/2003 and 2007 were used, including survival information from 52 917 singleton live-born infants of the most recent birth of a mother within a 5-year period before each survey. Cox proportional hazards regression models were used to obtain the hazard ratio for univariable and multivariable analyses. Our study found no significant reduction in the risk of early neonatal death for home deliveries assisted by the trained attendants compared with those assisted by untrained attendants. In rural areas, the risk of early neonatal death was higher for home deliveries assisted by trained attendants than home deliveries assisted by untrained attendants. In urban areas, a protective role of institutional deliveries was found if mothers had delivery complications. However, an increased risk was associated with deliveries in public hospitals in rural areas. Infants of mothers attending antenatal care services were significantly protected against early neonatal deaths, irrespective of the urban or rural setting. An increased risk of early neonatal death was also associated with male infants, infants whose size at birth was smaller than average and/or infants reported to be born early. A reduced risk was observed amongst mothers with high levels of education. Continuous improvement in the skills and the quality of the village midwives might benefit maternal and newborn survival. Efforts to strengthen the referral system and to improve the quality of delivery and newborn care services in health facilities are important, particularly in public hospitals and in rural areas.

Birth attendant · Environmental health · Health facility · Health services · Infant mortality · Live birth · Maternal health · Obstetrics · Population · Pregnancy · Rural area · Demography · Global Maternal and Child Health · Maternal and Neonatal Healthcare · Maternal and Perinatal Health Interventions · Medicine · Pediatrics