Neonatal mortality in sri lanka: timing, causes And distribution

Abstract

BACKGROUND: Millennium Development Goals (MDG) state that all countries should commit to reduce under 5 mortality in children by two thirds between 1990 and 2015. However, the reduction of neonatal mortality rate (NMR) in Sri Lanka during past decade had been slow (12.6 to 10.6). Having a NMR far better than most of the neighbours and developing countries, had given a false reassurance to Sri Lankan policy makers, reducing their attempts on farther reduction of NMR to reach MDG. There is a paramount need for accurate epidemiological data about the causes and distribution of neonatal deaths for meaningful policy making and efficient resource distribution. OBJECTIVE: To analyse the neonatal mortality data in Sri Lanka to shed light on neonatal deaths. DESIGN, SETTING AND METHOD: This study evaluated the neonatal deaths in Sri Lanka from year 1997 to 2001. Data related to neonatal mortality was obtained from the civil registration system maintained by the Registrar-General Office of Sri Lanka and analyzed according to 25 districts of the country. RESULTS: A total of 17,946 neonatal deaths had occurred during the period 1997 to 2001 in Sri Lanka, on average 3589 per year. Of them, 90.5% had occurred during the first week of life. The main causes for neonatal deaths were preterm deliveries (33%), infections (20%, including 15 deaths from neonatal tetanus), cardiac anomalies (17.4%), birth asphyxia (6.5%), meconium aspiration (5%), non cardiac anomalies (3%) and maternal cornplications (1%). The other causes accounted for 13.6%. The NMR was higher in Kandy (19), Anuradhapura (18.9), Badulla (18.4), Colombo (13.4) and Nuwara Eliya (13). CONCLUSION: Approximately 3600 neonates die in Sri Lanka annually. The number of deaths reported was higher in some of the major cities and in the estate sector. The majority of deaths were due to complications of preterm birth, neonatal sepsis and cardiac anomalies.