Factors associated with neonatal mortality in the general population: evidence from the 2007 Zambia Demographic and Health Survey (ZDHS); a cross sectional study

Introduction: neonatal mortality accounts for almost 40 percent of under-five child mortality globally and this could be associated with a complex chain of factors including but not limited to socio-economic, biological and healthcare-related factors. We examined factors that may be associated with neonatal mortality in Zambia. Methods: using across-sectional design, data were extracted from the 2007 Zambia Demographic and Health Survey for women using a Women's Questionnaire for respondents aged 15-49 years in the selected households. Records of women who reported having given birth to live infants within the five years preceding the survey defined the study population. However only records on those infants who could have lived through the first month (28 days) were assessed (de facto population). Results: overall (n=6 435), there were 3204(49.8%) males and 3231(50.2%) females. There were 219 (3.4%) neonatal deaths recorded. Low birth weight and overweight were reported as the prominent factors. The odds of dying were significantly higher for infants with low birth weight compared to infants born with normal weight, (aOR=2.58, 95% CI 1.02-6.49). The pattern was the same in both rural though insignificant. Over weight born babies showed increased odds of dying (aOR 3.21, 95% CI 1.36-7.59). Compared to infants born from Mothers with no education, infants born from mothers with higher education were associated with increased odds of dying (aOR 3.55, CI 95%, 1.26-9.94). Conclusion: neonatal survival is still a challenge in this population and determinants show varying socio-demographic contrasts. This may suggest limitations in past efforts to improve neonatal health. Future strategies need to continue but should account for varying setting specific epidemiological contrasts.