PDF(Pubmed)
Abstract：
BACKGROUND: Globally, infant mortality is one of the major public health threats, especially in low-income countries. The infant mortality rate of Somalia stands at 73 deaths per 1000 live births, which is one of the highest infant death rates in the region as well as in the world. Therefore, the aim of this study was to ascertain the risk factors of infant mortality in Somalia using national representative data.
METHODS: In this study, data from the Somali Health and Demographic Survey (SHDS), conducted for the first time in Somalia in 2018/2019 and released in 2020, were utilized. The analysis of the data involved employing the Chi-square test as a bivariate analysis. Furthermore, a multivariate Cox proportional hazard model was applied to accommodate potential confounders that act as risk factors for infant death.
RESULTS: The study found that infant mortality was highest among male babies, multiple births, and those babies who live in rural areas, respectively, as compared to their counterparts. Those mothers who delivered babies with small birth size and belonged to a poor wealth index experienced higher infant mortality than those mothers who delivered babies with average size and belonged to a middle or rich wealth index. Survival analysis indicated that mothers who did use ANC services (HR = 0.740; 95% CI = 0.618-0.832), sex of the baby (HR = 0.661; 95% CI = 0.484-0.965), duration of pregnancy (HR = 0.770; 95% CI = 0.469-0.944), multiple births (HR = 1.369; 1.142-1.910) and place of residence (HR = 1.650; 95% CI = 1.451-2.150) were found to be statistically significantly related to infant death.
CONCLUSIONS: The study investigated the risk factors associated with infant mortality by analyzing data from the first Somali Health and Demographic Survey (SHDS), which included a representative sample of the country\'s population. Place of residence, gestational duration, infant\'s gender, antenatal care visits, and multiple births were identified as determinants of infant mortality. Given that infant mortality poses a significant public health concern, particularly in crisis-affected countries like Somalia, intervention programs should prioritize the provision of antenatal care services, particularly for first-time mothers. Moreover, these programs should place greater emphasis on educating women about the importance of receiving antenatal care and family planning services, in order to enhance their awareness of these vital health services and their positive impact on infant survival rates.
METHODS: In this study, data from the Somali Health and Demographic Survey (SHDS), conducted for the first time in Somalia in 2018/2019 and released in 2020, were utilized. The analysis of the data involved employing the Chi-square test as a bivariate analysis. Furthermore, a multivariate Cox proportional hazard model was applied to accommodate potential confounders that act as risk factors for infant death.
RESULTS: The study found that infant mortality was highest among male babies, multiple births, and those babies who live in rural areas, respectively, as compared to their counterparts. Those mothers who delivered babies with small birth size and belonged to a poor wealth index experienced higher infant mortality than those mothers who delivered babies with average size and belonged to a middle or rich wealth index. Survival analysis indicated that mothers who did use ANC services (HR = 0.740; 95% CI = 0.618-0.832), sex of the baby (HR = 0.661; 95% CI = 0.484-0.965), duration of pregnancy (HR = 0.770; 95% CI = 0.469-0.944), multiple births (HR = 1.369; 1.142-1.910) and place of residence (HR = 1.650; 95% CI = 1.451-2.150) were found to be statistically significantly related to infant death.
CONCLUSIONS: The study investigated the risk factors associated with infant mortality by analyzing data from the first Somali Health and Demographic Survey (SHDS), which included a representative sample of the country\'s population. Place of residence, gestational duration, infant\'s gender, antenatal care visits, and multiple births were identified as determinants of infant mortality. Given that infant mortality poses a significant public health concern, particularly in crisis-affected countries like Somalia, intervention programs should prioritize the provision of antenatal care services, particularly for first-time mothers. Moreover, these programs should place greater emphasis on educating women about the importance of receiving antenatal care and family planning services, in order to enhance their awareness of these vital health services and their positive impact on infant survival rates.
摘要：
背景：在全球范围内，婴儿死亡率是主要的公共卫生威胁之一，特别是在低收入国家。索马里的婴儿死亡率为每1000名活产婴儿73人死亡，这是该地区乃至世界上婴儿死亡率最高的国家之一。因此,本研究的目的是利用国家代表性数据确定索马里婴儿死亡的危险因素.
方法：在本研究中，来自索马里健康和人口调查(SHDS)的数据，2018/2019年首次在索马里进行，并于2020年发布。所涉及的数据分析采用卡方检验作为双变量分析。此外，采用多变量Cox比例风险模型,以适应作为婴儿死亡危险因素的潜在混杂因素.
结果：研究发现，男婴中婴儿死亡率最高，多胎,那些生活在农村地区的婴儿，分别,与他们的同行相比。那些分娩婴儿的婴儿出生尺寸较小，属于贫穷财富指数的母亲比分娩婴儿平均尺寸且属于中等或富裕财富指数的母亲经历了更高的婴儿死亡率。生存分析表明，使用ANC服务的母亲（HR=0.740；95％CI=0.618-0.832），婴儿性别（HR=0.661；95%CI=0.484-0.965），妊娠持续时间（HR=0.770;95％CI=0.469-0.944），多胎(HR=1.369;1.142-1.910)和居住地(HR=1.650;95%CI=1.451-2.150)与婴儿死亡有统计学显著相关.
结论：该研究通过分析第一次索马里健康和人口调查（SHDS）的数据，调查了与婴儿死亡率相关的危险因素，其中包括该国人口的代表性样本。居住地,妊娠期,婴儿的性别，产前护理访问，多胎分娩被确定为婴儿死亡率的决定因素。鉴于婴儿死亡率构成重大公共卫生问题，特别是在索马里等受危机影响的国家，干预计划应优先提供产前保健服务，特别是第一次做妈妈的。此外，这些方案应更加重视教育妇女接受产前保健和计划生育服务的重要性，以提高他们对这些重要卫生服务及其对婴儿存活率的积极影响的认识。
方法：在本研究中，来自索马里健康和人口调查(SHDS)的数据，2018/2019年首次在索马里进行，并于2020年发布。所涉及的数据分析采用卡方检验作为双变量分析。此外，采用多变量Cox比例风险模型,以适应作为婴儿死亡危险因素的潜在混杂因素.
结果：研究发现，男婴中婴儿死亡率最高，多胎,那些生活在农村地区的婴儿，分别,与他们的同行相比。那些分娩婴儿的婴儿出生尺寸较小，属于贫穷财富指数的母亲比分娩婴儿平均尺寸且属于中等或富裕财富指数的母亲经历了更高的婴儿死亡率。生存分析表明，使用ANC服务的母亲（HR=0.740；95％CI=0.618-0.832），婴儿性别（HR=0.661；95%CI=0.484-0.965），妊娠持续时间（HR=0.770;95％CI=0.469-0.944），多胎(HR=1.369;1.142-1.910)和居住地(HR=1.650;95%CI=1.451-2.150)与婴儿死亡有统计学显著相关.
结论：该研究通过分析第一次索马里健康和人口调查（SHDS）的数据，调查了与婴儿死亡率相关的危险因素，其中包括该国人口的代表性样本。居住地,妊娠期,婴儿的性别，产前护理访问，多胎分娩被确定为婴儿死亡率的决定因素。鉴于婴儿死亡率构成重大公共卫生问题，特别是在索马里等受危机影响的国家，干预计划应优先提供产前保健服务，特别是第一次做妈妈的。此外，这些方案应更加重视教育妇女接受产前保健和计划生育服务的重要性，以提高他们对这些重要卫生服务及其对婴儿存活率的积极影响的认识。
