Determinants of early neonatal mortality: secondary analysis of the 2012 and 2017 Indonesia Demographic and Health Survey

Christiana Rialine Titaley, Anifatun Mu'asyaroh, Bertha Jean Que, Dwi Hapsari Tjandrarini, Iwan Ariawan

Research output: Contribution to journalArticlepeer-review


Background: Most neonatal deaths occur during the first week of life (i.e., early neonatal deaths). In this analysis, we aimed to investigate the determinants of early neonatal deaths in a nationally representative sample of births in Indonesia over the five years before each survey. Methods: Data were obtained from the 2012 and 2017 Indonesia Demographic and Health Survey (IDHS), including information from 58,902 mothers of children aged <5 years of age. The outcome variable was early neonatal death (death of a newborn within the first six days of life). Explanatory variables were categorized into environmental, household, maternal, pregnancy, childbirth, and child characteristics. Multivariate regression methods were employed for analysis. Results: Increased odds of early neonatal deaths were associated with mothers who lacked formal education or had incomplete primary schooling (adjusted odd ratio [OR] = 2.43, 95% confidence interval [CI]: 1.18–5.01), worked outside the house in agricultural (aOR = 5.94, 95% CI: 3.09–11.45) or non-agricultural field (aOR = 2.98, 95% CI: 1.88–4.72), and were required to make a joint decision about health care with their partner or another household member (aOR = 1.79, 95% CI: 1.12–2.84). Increased odds were also observed in smaller-than-average infants, particularly those who received low-quality antenatal care services (aOR = 9.10, 95% CI: 5.04–16.41) and those whose mothers had delivery complications (aOR = 1.72, 95% CI: 1.10–2.68) or who were delivered by cesarean section (aOR = 1.74, 95% CI: 1.07–2.82). Furthermore, male infants showed higher odds than female infants (aOR = 1.85, 95% CI: 1.23–2.76). Conclusions: A multifaceted approach is essential for curtailing early neonatal mortality in Indonesia. Enabling workplace policies, promoting women's empowerment, strengthening the health system, and improving the uptake of high-quality antenatal care services are among the critical steps toward preventing early neonatal deaths in Indonesia.

Original languageEnglish
Article number1288260
JournalFrontiers in Pediatrics
Publication statusPublished - 2024


  • low birth weight
  • maternal education
  • maternal occupation
  • mode of delivery
  • neonatal mortality
  • preterm
  • quality of antenatal care
  • women empowerment


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