TY - JOUR
T1 - Neonatal mortality in two districts in Indonesia
T2 - Findings from Neonatal Verbal and Social Autopsy (VASA)
AU - Deviany, Poppy E.
AU - Setel, Philip W.
AU - Kalter, Henry D.
AU - Anggondowati, Trisari
AU - Martini, Martini
AU - Nandiaty, Fitri
AU - Latief, Kamaluddin
AU - Weaver, Emily H.
AU - Rianty, Tika
AU - Achadi, Anhari
AU - Wahyuni, Sri
AU - Setyaningtyas, Stefania W.
AU - Haryana, Nila R.
AU - Mehrain, Luna M.
AU - Achadi, Endang L.
N1 - Funding Information:
This study is made possible by the support of the American people through the United States Agency for International Development (USAID) under the terms of the Contract Number: AID-497-C-17-00001. Information about the funder can be accessed at https://www.usaid.gov. The contents of this article are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. The funder provided support in the form of salaries for authors (PED, PWS, HDK, TA, MM, FN, KL, EHW, TR, AA, SW, LMM, and EA), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of each author are articulated in the 'author contributions' section.
Publisher Copyright:
© 2022 Deviany et al.
PY - 2022/3
Y1 - 2022/3
N2 - Background: The Government of Indonesia is determined to follow global commitments to reduce the neonatal mortality rate. Yet, there is a paucity of information on contributing factors and causes of neonatal deaths, particularly at the sub-national level. This study describes careseeking during neonates' fatal illnesses and their causes of death. Methods: We conducted a cross-sectional community-based study to identify all neonatal deaths in Serang and Jember Districts, Indonesia. Follow-up interviews were conducted with the families of deceased neonates using an adapted verbal and social autopsy instrument. Cause of death was determined using the InSilicoVA algorithm. Results: The main causes of death of 259 neonates were prematurity (44%) and intrapartum-related events (IPRE)-mainly birth asphyxia (39%). About 83% and 74% of the 259 neonates were born and died at a health facility, respectively; 79% died within the first week after birth. Of 70 neonates whose fatal illness began at home, 59 (84%) sought care during the fatal illness. Forty-eight of those 59 neonates went to a formal care provider; 36 of those 48 neonates (75%) were moderately or severely ill when the family decided to seek care. One hundred fifteen of 189 neonates (61%) whose fatal illnesses began at health facilities were born at a hospital. Among those 115, only 24 (21%) left the hospital alive-of whom 16 (67%) were referred by the hospital. Conclusions: The high proportion of deaths due to prematurity and IPRE suggests the need for improved management of small and asphyxiated newborns. The moderate to severe condition of neonates at the time when care was sought from home highlights the importance of early illness recognition and appropriate management for sick neonates. Among deceased neonates whose fatal illness began at their delivery hospital, the high proportion of referrals may indicate issues with hospital capability, capacity, and/or cost.
AB - Background: The Government of Indonesia is determined to follow global commitments to reduce the neonatal mortality rate. Yet, there is a paucity of information on contributing factors and causes of neonatal deaths, particularly at the sub-national level. This study describes careseeking during neonates' fatal illnesses and their causes of death. Methods: We conducted a cross-sectional community-based study to identify all neonatal deaths in Serang and Jember Districts, Indonesia. Follow-up interviews were conducted with the families of deceased neonates using an adapted verbal and social autopsy instrument. Cause of death was determined using the InSilicoVA algorithm. Results: The main causes of death of 259 neonates were prematurity (44%) and intrapartum-related events (IPRE)-mainly birth asphyxia (39%). About 83% and 74% of the 259 neonates were born and died at a health facility, respectively; 79% died within the first week after birth. Of 70 neonates whose fatal illness began at home, 59 (84%) sought care during the fatal illness. Forty-eight of those 59 neonates went to a formal care provider; 36 of those 48 neonates (75%) were moderately or severely ill when the family decided to seek care. One hundred fifteen of 189 neonates (61%) whose fatal illnesses began at health facilities were born at a hospital. Among those 115, only 24 (21%) left the hospital alive-of whom 16 (67%) were referred by the hospital. Conclusions: The high proportion of deaths due to prematurity and IPRE suggests the need for improved management of small and asphyxiated newborns. The moderate to severe condition of neonates at the time when care was sought from home highlights the importance of early illness recognition and appropriate management for sick neonates. Among deceased neonates whose fatal illness began at their delivery hospital, the high proportion of referrals may indicate issues with hospital capability, capacity, and/or cost.
UR - http://www.scopus.com/inward/record.url?scp=85126573861&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0265032
DO - 10.1371/journal.pone.0265032
M3 - Article
C2 - 35286361
AN - SCOPUS:85126573861
SN - 1932-6203
VL - 17
JO - PloS one
JF - PloS one
IS - 3 March
M1 - e0265032
ER -
