Dynamics of factors associated with neonatal death in Madagascar

A comparative analysis of the 2003, 2008, 2021 DHS

Bibliographic Data

ID19593769
AuthorsSedera Radoniaina Rakotondrasoa (0000-0001-9687-9846, University of Antananarivo), Kadari Cissé (0000-0003-0219-0197, Centre National de la Recherche Scientifique et Technologique), Tieba Millogo (0000-0003-3548-3789), Hajalalaina Rabarisoa (0009-0000-2942-3400, University of Antananarivo), Felix Alain (0009-0008-2445-3326, University of Antananarivo), Seni Kouanda (0000-0003-2426-7669, Centre National de la Recherche Scientifique et Technologique), Julio Rakotonirina (University of Antananarivo), Julio El-C Rakotonirina
EditorsHassan Haghparast Bidgoli
Year2025
Volume5
Issue4
Pagese0003732
Publication date2025-04-29
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003732
PMID40299973
OpenAlexW4409906755
LanguageEN
References cited32

Neonatal mortality remains a major public health challenge, as reductions have stagnated worldwide despite cost-effective interventions in recent years. The temporal evolution of its determinants is insufficiently studied. This study aimed to analyze the dynamics of factors associated with neonatal death in Madagascar between 2003 and 2021. A secondary analysis was conducted using data from the 2003, 2008, and 2021 Demographic and Health Surveys (DHS) of Madagascar. The study population is focused on children under the age of 5 years at the time of these surveys. The death of a newborn within 30 days after birth constitutes the outcome variable. A multilevel binomial logistic regression was performed. The number of children under 5 included in the analysis were 5,415 in 2003, 12,448 in 2008 and 12,399 in 2021. The prevalence of neonatal deaths was 3.1% in 2003, 2.4% in 2008, and 2.6% in 2021. Persistent significant associations with neonatal death were observed for low birth weight, lack of breastfeeding, medium-sized households, large households, and high birth weight. A loss of statistical significance of the association with neonatal death over time was observed for a birth interval of 2–3 years and 4 years and more, mother’s age 40–49 years, and use of mosquito net by the mother. In 2021, new significant associations with neonatal mortality were identified in the province of Toliara, absence of geographic barriers to healthcare access, 4–7 ANC visits, and supervised delivery. The factors associated with neonatal mortality, which have worsened over time in Madagascar, include birth weight abnormalities and delivery in the presence of qualified personnel. This deterioration underscores the urgency of improving the quality of perinatal care in healthcare facilities, beyond mere geographical accessibility

Birth weight · Breastfeeding · Environmental health · Infant mortality · Logistic regression · Neonatal death · Neonatal mortality · Population · Pregnancy · Psychological intervention · Public health · Child Nutrition and Water Access · Demography · Global Maternal and Child Health · Maternal and Neonatal Healthcare · Medicine · Pediatrics

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