Zaw, Ko Ko, Myo Myo Mon, and Kerry L. D. MacQuarrie. 2019. Use of Maternal and Neonatal Health Services Associated with Neonatal Death in Myanmar. Further Analysis of the Myanmar Demographic and Health Survey 2015-16. DHS Further Analysis Reports No. 125. Rockville, Maryland, USA: ICF.
Neonatal death is a main contributor to the death of children under age 5. Research has identified factors that influence neonatal death such as the use of health services and other behavioral and biological factors. Of these factors, access to and use of maternal and neonatal health services is one of the most manageable with health interventions. This study aims to assess the association between the use of maternal and neonatal health services and neonatal death, and to provide information that will help direct priority public health interventions to reduce neonatal deaths.
We conducted secondary analysis of the 2015-16 Myanmar Demographic and Health Survey data. We analyzed data from 3,583 last children born to women age 15 to 49 and calculated the probability of neonatal death. With bivariate analysis and multiple logistic regression, we analyzed the association of neonatal death with the use of maternal and neonatal services and other important factors (household, maternal, and neonatal characteristics).
Compared to neonates who received postnatal care from skilled providers, the risk of neonatal death among neonates who received postnatal care from unskilled providers was more than 4 times higher and neonates without any postnatal care had a 9-fold increase in risk of neonatal death. More than 60% of neonates in the study did not receive any postnatal care. When compared with neonates with average birth size, neonates with small birth size had a 4-fold increase in risk of neonatal death, while neonates with a very small birth size had a 9-fold increase in the risk of neonatal death. The odds of receiving postnatal care from a skilled provider were nearly double among mothers who had four or more antenatal visits compared to those who received fewer than four visits or no antenatal care.
The results of this study suggest that a major focus of public health interventions should be improving the use of postnatal care. This should also be linked with the promotion of proper antenatal care and institutional delivery because these services are closely linked and integrated.