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Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis

Background: Sub-Saharan African (SSA) newborns are ten times more likely to die in the first month than a neonate born in a high-income country. The objective of this study was to examine the relationship between educational attainment and neonatal mortality (NM) among women with cesarean section (C...

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Autores principales: Olukade, Tawa O., Uthman, Olalekan A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406966/
https://www.ncbi.nlm.nih.gov/pubmed/36010150
http://dx.doi.org/10.3390/children9081260
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author Olukade, Tawa O.
Uthman, Olalekan A.
author_facet Olukade, Tawa O.
Uthman, Olalekan A.
author_sort Olukade, Tawa O.
collection PubMed
description Background: Sub-Saharan African (SSA) newborns are ten times more likely to die in the first month than a neonate born in a high-income country. The objective of this study was to examine the relationship between educational attainment and neonatal mortality (NM) among women with cesarean section (CS) deliveries in SSA countries. Methods: Using data from recent demographic and health surveys from 33 countries in SSA, we applied propensity score matching to estimate the effect of education attainment on post-CS neonatal mortality using a propensity-matched cohort where being educated was defined as completing at least primary school education Results: The number of reported CS births ranged from 186 in Niger to 1695 in Kenya. The odds of neonatal mortality between uneducated and educated women ranged from as low as 2.31 in Senegal to 35.5 in Zimbabwe, with a pooled overall risk for NM from all of the countries of OR 2.54 (95% CI: 1.72–3.74) and aOR 1.7 (95% CI: 1.12–2.57). From the 17,220 respondents, we successfully matched 11,162 educated respondents with 2146 uneducated respondents. Uneducated women had a 6% risk compared to a 2.9% risk among educated women for neonatal mortality, with an overall risk of 3.4%; babies from uneducated women were twice as likely to die compared to babies from educated women, RR 2.1 (95% CI, 1.69–2.52). Conclusion: Neonates from uneducated women were twice as likely to die following CS delivery than neonates from educated women. This evidence suggests that a means of achieving Sustainable Development Goal target 3.2 to lower newborn and child mortality is ensuring that everyone has access to high-quality care with efforts made at ensuring education for all and improving socio-economic conditions.
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spelling pubmed-94069662022-08-26 Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis Olukade, Tawa O. Uthman, Olalekan A. Children (Basel) Article Background: Sub-Saharan African (SSA) newborns are ten times more likely to die in the first month than a neonate born in a high-income country. The objective of this study was to examine the relationship between educational attainment and neonatal mortality (NM) among women with cesarean section (CS) deliveries in SSA countries. Methods: Using data from recent demographic and health surveys from 33 countries in SSA, we applied propensity score matching to estimate the effect of education attainment on post-CS neonatal mortality using a propensity-matched cohort where being educated was defined as completing at least primary school education Results: The number of reported CS births ranged from 186 in Niger to 1695 in Kenya. The odds of neonatal mortality between uneducated and educated women ranged from as low as 2.31 in Senegal to 35.5 in Zimbabwe, with a pooled overall risk for NM from all of the countries of OR 2.54 (95% CI: 1.72–3.74) and aOR 1.7 (95% CI: 1.12–2.57). From the 17,220 respondents, we successfully matched 11,162 educated respondents with 2146 uneducated respondents. Uneducated women had a 6% risk compared to a 2.9% risk among educated women for neonatal mortality, with an overall risk of 3.4%; babies from uneducated women were twice as likely to die compared to babies from educated women, RR 2.1 (95% CI, 1.69–2.52). Conclusion: Neonates from uneducated women were twice as likely to die following CS delivery than neonates from educated women. This evidence suggests that a means of achieving Sustainable Development Goal target 3.2 to lower newborn and child mortality is ensuring that everyone has access to high-quality care with efforts made at ensuring education for all and improving socio-economic conditions. MDPI 2022-08-20 /pmc/articles/PMC9406966/ /pubmed/36010150 http://dx.doi.org/10.3390/children9081260 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Olukade, Tawa O.
Uthman, Olalekan A.
Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title_full Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title_fullStr Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title_full_unstemmed Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title_short Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
title_sort neonatal mortality and education related inequality in cesarean births in sub-saharan africa: multi-country propensity score matching and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406966/
https://www.ncbi.nlm.nih.gov/pubmed/36010150
http://dx.doi.org/10.3390/children9081260
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