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PRESENTED BY:
Group C2
BHARATI KC(09)
SAMJHANA SHRESTHA(31)
SEEMA GIRI(32)
SUNIL KOIRALA(36)
NEONATAL MORTALITY :A
CHALLENGE TOWARDS THE
ACHIEVEMENT OF MDG-4
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INTRODUCTION
The term neonate is used for the newborn infant during 28 daysperiod. Neonatal mortality refers to the probability of dying within
the first month of life.
Although being new born is not a disease, large number of childrendies soon after birth: many of them in first four weeks of life
(neonatal deaths) and most of those during the first week of life
(early neonatal deaths).
The major causes of newborn deaths in Nepal are infection, birth
asphyxia, preterm birth and hypothermia
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Neonatal mortality and Millennium Development
Goal-4
MDGs provide a framework for theentire international community to work
together towards a common end
making sure that human development
reaches everyone, everywhere.
Goal 4: Reduce child mortality
Target
Reduce by two-thirds, between 1990
and 2015, the under five mortality
rate
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Cont..
Neonatal mortality levels play an increasingly important role in
child mortality.
The proportion of child deaths that occurs in the neonatal period
greatly influence the Millennium Development Goal-4 .
Neonatal mortality is a serious concern in Nepal, accounting for 69
per cent of IMR and 54 per cent of U5MR in 2006 (DOHS 2008).
Hence MDGs of child survival cannot be met without substantial
reductions in neonatal mortality
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STATEMENT OF PROBLEM
30,000 children die each yearin Nepal during their first month of life.
2/3rd20,000 child dies in their firstweek of birth
2/3rd
16,000 child dies within
24hrs of their birth
About 3-4neonates
dies each
hour in
Nepal
(National Neonatal
Strategy 2004).
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OBJECTIVES
General Objective:
To study the situation of neonatal mortality as a challenge
towards achieving MDG-4.
Specific Objectives:
To assess the trend of neonatal mortality from the year 1996
to 2010 A.D.
To assess the required difference to meet MDG-4 2015
target.To determine the challenges influencing neonatal mortality (
Exclusive breastfeeding , safe motherhood services: ANC,
place of delivery, PNC, Birth interval, Birth size)
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METHODOLOGY
Study AreaThe study area was Nepal.
Study design
The study design was cross-sectional descriptive type done
with the help of secondary data.
Study duration
The study was conducted from the 25th November to 15th
December.
Data Collection Procedure
The data were collected through systematic review secondary
sources, including research, internet, journals and various
reports
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Cont..
Data Analysis Technique
The collected data were analyzed in MS-EXCEL (Version 7)and represented in bar diagrams and tables using number and
percentage.
Limitation of the study
The study was solely based on secondary data.
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FINDINGS
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Trend of Neonatal Mortality Rate in Nepal
50
39
33 33
0
10
20
30
40
50
60
1991-1995 1996-2000 2001-2005 2006-2010
rate/1000
liv
ebirths
Trend of NMR
Source: NDHS Report 1996 to 2011
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MDG Target for reducing Child Mortality Rate
Indicators Status at 1990 MDG Target to be
achieved by 2015
Infant Mortality Rate
(IMR)
108 per 1000 live births 34 per 1000 live births
Under-five Mortality Rate
(U5MR)
162 per 1000 live births 54 per 1000 live births
Neonatal mortality
Rate(NMR)
(accounts for 69 per cent of
IMR and54 per cent of
U5MR)
50 per thousand live births 16 per thousand live
births
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Trends of reduction in Neonatal mortality Rate
(1990-2010)
Mortality
Indicators
per
thousand
live births
Differences between the years per
1000 live births
Required
difference to meet
the MDG target
2010-2015(16)1991-1995
(50)
1996-2000
(39)
2001-2005
(33)
2006-2010
(33)
Neonatal
Mortality
Rate
11 6 6 0 17
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Factors influencingNMR
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NMR by birth size
56
27
0
10
20
30
40
50
60
Small/Very small Average/Large
per1000
live
births
Source :NDHS 2006
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NMR trend by birth interval
Source :NDHS 2006
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Factors influencing NMR: presenting challenges towards
the achievement of MDG-4
0
20
40
60
80
ANC(any) Births at health
facility
PNC Initiation of
breast feeding
within 1Hrs
72
18
23
35
percentage
Challenge
-1
Challenge-2
Source: DHS 2006
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DISCUSSION
The trend of neonatal mortality has been decreased from50/1000 live births in 1996 to 39/1000 live births in 2001
while the NMR remained constant from 2006 to 2011.
While comparing our study with analysis of demographic
and health survey from around developing world we
found that neonatal mortality is reduced for preceding
birth intervals of 3 years as compared with intervals of lessthan 2 years.
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Cont..
Similarly while comparing our study findings with the
evaluation study on Neonatal Mortality of Low Births
Infants conducted in Bangladesh, we found that small
birth size babies have higher risk of deaths influencing
NMR
Across 40 countries with DHS data between 1995 and
2003, more than 50% of neonatal deaths arose after ahome birth with no skilled care while in our study only
18% of the child birth took place at health institution.
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CONCLUSION
The trend of NMR remained almost constant without anyslight reduction during the gap of four years presenting
challenge towards the achievement of MDG-4 since
reduction of child mortality largely depends on saving
more new born lives.
The trends in reduction of neonatal mortality followed
decelerating pace but still 17% reduction in NMR isrequired to achieve the MDG target by 2015 i.e with in
four years.
C
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Cont..
Various factors such as birth size, birth interval, safemotherhood services (ANC, delivery services by health
workers, PNC, breastfeeding) influenced NMR, thereby
presenting challenges towards the achievement of MDG
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RECCOMENDATIONS
A single approach focusing on reducing child mortality is
not sufficient enough. DOHs should focus towards the
improvement of new born health through employing
integrated approach combining safe motherhood andfamily planning services.
The focus should be given towards the improving neonatalhealth since MDG-4 couldnt be achieved without
reducing NMR.
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REFRENCES
Millennium Development Goals Indicators: The Official
United Nations Site for MDG Indicators.
[http://www.mdgs.un.org/unsd/mdg/Data.aspx].
UNICEF. State of the Worlds Children 2009. New York:
UNICEF, 2009. NDHS ,2006 ,2011
ANNUAL REPORT 2066/67
http://www.mdgs.un.org/unsd/mdg/Data.aspxhttp://www.mdgs.un.org/unsd/mdg/Data.aspx7/31/2019 NEONATAL MORTALITY :A CHALLENGE TOWARDS THE ACHIEVEMENT OF MDG-4
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Knowing is not enough, we
must apply;Willing is not enough, we
must do.
Thank you