Determinants of neonatal mortality in Ethiopia: an analysis of the 2016 Ethiopia Demographic and Health Survey

Background: The first 28 days of life, the neonatal period, are the most vulnerable time for a child's survival. Neonatal mortality accounts for about 38% of under-five deaths in low and middle income countries. This study aimed to identify the determinants of neonatal mortality in Ethiopia. Methods: The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). Once the data were extracted; editing, coding and cleaning were done by using SAS 9.4.Sampling weights was applied to ensure the representativeness of the sample in this study. Both bivariate and multivariable logistic regression statistical analysis was used to identify determinants of neonatal mortality in Ethiopia. Results: A total of 11,023 weighted live-born neonates born within five years preceding the 2016 EDHS were included this in this study. Multiple logistic regression analysis showed that multiple birth neonates (Adjusted Odds Ratio (AOR)=6.38;95%-Confidence Interval (CI):4.42-9.21), large birth size (AOR=1.35; 95% CI: 0.28-1.62), neonates born to mothers who did not utilize ANC (AOR=1.41; 95% CI: 1.11-1.81), neonates from rural area (AOR=1.88; 95% CI: 1.15-3.05) and neonates born in Harari region (AOR=1.45; 95% CI: 0.61-3.45)had higher odds of neonatal mortality. On the other hand, female neonates (AOR=0.60; 95% CI: 0.47-0.75), neonates born within the interval of more than 36 months of the preceding birth (AOR=0.56; 95% CI: 0.43-0.75), neonates born to fathers with secondary and higher education level (AOR=0.51; 95%CI: 0.22-0.88) had lower odds of neonatal mortality in Ethiopia. Conclusion: To reduce neonatal mortality in Ethiopia, there is a need to implement sex specific public health intervention mainly focusing on male neonate during pregnancy, child birth and postnatal period. A relatively simple and cost-effective public health intervention should be implemented to make sure that all pregnant women are screened for multiple pregnancy and if positive, extra care should be given during pregnancy, child birth and postnatal.