CLCD’s core mission is to conduct research to prevent unnecessary newborn deaths. We focus on the most impactful interventions that target the most vulnerable population.
Neonatal Health projects
National and Regional Change in Neonatal Mortality in Ghana, from 1993-2014
The death of a child causes significant pain to families, so everything needs to be done to prevent unnecessary child deaths. One way to assess how well a county is doing in relation to children's health is to look at their neonatal mortality rate, a health indicator that measures how many children die in a country before their first month of life for every 1,000 that are born alive.
In Ghana, neonatal mortality accounts for about 40% of child deaths in the first five years of life. Currently, for every 1,000 children that are born, 29 of them will die in the first month - that's about 2,000 preventable deaths per year. Based on data from the Demographic and Health survey from 1993-2014, we tracked the progress of each region in reducing neonatal mortality. We also ranked them based on how change has occurred in each region, by examining the average change per year.
Fast Facts About State of Neonatal Mortality Rate (NMR) in Ghana
Identifying successful community-level strategies that have led to a 67% decline in neonatal mortality in the Northern Region of Ghana
Kristin Watkoske, BS, Prince Owusu, MPhil, Catherine Ohrt, Lydia Ademuwagun, Blessed Sheriff, Leonie Akofio-Sowah, Msc., Amos Laar, PhD, MPH, MA, Mufaro Kanyangarara, PhD, and Kwame Sakyi, PhD, MSPH, (1) Oakland University, Rochester, MI, (2) Center for Learning and Childhood Development-Ghana, Accra, Ghana, (3) Brown University, Providence, RI, (4) The Institute of Economic Affairs, Christianborg Accra, Ghana, (5) University of Ghana, Accra, Ghana, (6) Johns Hopkins University
Background: Globally, 2.6 million newborns die within the first 28 days of life. Most deaths occur in sub-Saharan Africa. Addressing neonatal mortality has been challenging for many countries. The Northern Region of Ghana has however reduced their neonatal mortality rate by 67% between 1993-2014. We sought to identify community-level factors that contributed to this decline to inform future interventions across Ghana and other parts of sub-Saharan Africa.
Methods: Thirty-eight qualitative semi-structured interviews were conducted with government officials, non-profit workers, healthcare providers, traditional birth attendants (TBA), and community leaders. Data collection occurred in June 2018 and was analyzed thematically using an inductive approach. Interview topics included community-level interventions, policies, and challenges faced in the Northern Region.
Results: To reduce neonatal mortality, several multifaceted interventions were purposefully implemented to (1) increase skilled attendants at birth, (2) improve accessibility to maternity and newborn care, and (3) promote health education. TBAs and mothers were incentivized with baby products and food supplies for health facility deliveries. Local leaders implemented financial penalties to reduce intentional home births. Public health officials increased welfare clinics and newborn check-up appointments through Community-Based Health Planning and Services (CHPS) compounds. Community members created an emergency transportation system to transfer pregnant women to health facilities. Health education focused on hospital delivery, breastfeeding, and cord care and were promulgated through mother-to-mother support groups and community drama performances.
Conclusion: The successful lessons learned from the Northern Region can be adapted to further reduce neonatal mortality rates across Ghana and other parts of sub-Saharan Africa.