The determinant of neonatal near miss among neonates admitted in Gurage zone hospitals, Ethiopia: A case-control study.

Introduction: Neonatal near miss is defined as an infant who nearly died but survived a severe complication that occurred during pregnancy, birth, or within 7 days of extra-uterine life. It is highly economical and commendable to identify determinants of neonatal near miss that can be utilized as proxy determinants of neonatal mortality. However, neither determinants of neonatal mortality nor a determinant of a neonatal near miss are adequately investigated specifically in the study area. Therefore, this study is aimed to identify the determinants of neonatal near miss among neonates admitted to Gurage zone hospitals, Southern Ethiopia

Methods: Unmatched case-control study was conducted on the determinant of neonatal near misses among neonates admitted in Gurage zone hospitals, Southwest, Ethiopia.  A pre-tested structured interviewer-administered questionnaire was used to collect data. Besides, data related to the clinical diagnosis of neonates and managements given were extracted from patient records. A total of 105 cases and 209 controls were involved in the study. The consecutive sampling method was used to recruit cases while a simple random sampling technique was used to select controls. Data were entered using Epi Data software and exported to SPPS for analysis. Binary and multivariable logistic regression was employed to identify predictors of the outcome variable.

Results: Independent predictors of the outcome variable include a history of abortion with AOR 3.9 [95%C1 3.53-10.15], a referral from other health facilities AOR 7.53[95% CI 3.99-14.22], severe maternal morbidity during pregnancy AOR 4.57[95%CI 1.77-11.79], Cesarean section mode of delivery 4.45[95%CI 1.76-11.25], and knowledge on essential newborn care AOR 3.33[95% CI 1.54-7.19].

Conclusions: According to this study, easily modifiable/preventable maternal and health service utilization related factors are increasing the risk of a neonatal near-miss in the Gurage zone. It is the signal that shows the primary health care program needs to be further enhanced to bring more desirable health outcomes and/ or effectiveness of health policies needs to be examined to introduce more impactful strategies.

Keyword: Determinants, Neonatal near miss, severe neonatal morbidity, Ethiopia.