Association between timing and type of postnatal care provided with neonatal mortality: A large scale study from India

• Published in: PloS one Vol. 17; no. 9; p. e0272734
• Main Authors: Singh, Lucky, Dubey, Ritam, Singh, Prashant Kumar, Nair, Saritha, Rao, M Vishnu Vardhana, Singh, Shalini
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.09.2022; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Biology and Life Sciences; Birth weight; Births; Cesarean section; Children & youth; Data analysis; Dependent variables; Fatalities; Female; Focus groups; Health aspects; Health care; Humans; India - epidemiology; Infant; Infant Mortality; Infants; Infants (Newborn); Medical care; Medicine and Health Sciences; Methods; Middle Aged; Mortality; Neonates; Newborn babies; Patient outcomes; People and Places; Perinatal Death; Postnatal Care; Postpartum period; Pregnancy; Quality management; Regression analysis; Socioeconomic Factors; Statistical analysis; Surveys; Variables; Womens health; Young Adult; India
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0272734

This study examines the association between quality Postnatal Care (PNC) considering timing and providers' type on neonatal mortality. The aim extends to account for regional disparities in service delivery and mortality including high and non-high focus states. Ever-married women aged 15-49 years (1,87,702) who had delivered at least one child in five years preceding the survey date surveyed in National Family Health Survey (2015-16) were included in the study. Neonatal deaths between day two and seven and neonatal deaths between day two and twenty-eight were considered dependent variables. Descriptive statistics and multivariate regression analysis were conducted. Chances of early neonatal mortality were 29% (OR = 0.71; 95%CI: 0.59-0.84) among newborns receiving PNC within a day compared to ones devoid of it while 40% (OR: 0.60; 95%CI: 0.51-0.71) likelihood for the same was noted if PNC was delivered within a week. Likelihood of neonatal mortality decreased by 24% (OR: 0.76; 95%CI: 0.65-0.88) when skilled PNC was delivered within 24 hours. Receiving quality PNC by skilled providers within a day in a non-high focus state decreased the chances of neonatal mortality by 26% (OR: 0.74; 95%CI: 0.59-0.92) compared to ones who did not receive any PNC. Neonatal deaths were significantly associated with socioeconomic and contextual characteristics including age, education, household wealth, social group and region. Timing of PNC delivered and by a skilled healthcare provider was found significant in reducing neonatal mortality.