Gestational age: Accurate measurement of gestational age is an important aspect of monitoring pregnancy progress and making management decisions. The most common methods for determining gestational age were last menstrual (normal) or ultrasound, which has been well described in studies conducted in well-equipped settings [15], [20], [25], [26]. Clinical examination of pregnant women has also been used to determine gestational age [27]. Assessment of gestational age remains a challenge in resource-poor environments where LMP data are unreliable and access to early ultrasounds and specialized health workers is limited. Therefore, recommendations on gestational age determination methodology, applicable in different geographic and resource-rich environments, were described at diagnostic safety levels (www.brightoncollaboration.org). Our study also found that delay one plays an important role in neonatal mortality, as the delay one score is increased by one unit, the newborn has less chance of survival at the beginning of the neonatal period. A similar result has been observed in studies conducted in Rwanda [100], Zimbabwe [23] and Brazil [37]. The possible explanation is related to a lack of awareness of the danger signs of neonatal diseases and a preference for traditional remedies. This will obviously complicate mild diseases and easily treatable in more severe cases and adverse results. On the contrary, Ethiopia has introduced and implemented a health expansion programme to provide health education and basic health services at the community level [8].
Essential services provided through Integrated Community Case Management (ICMM) and Community Newborn Care (CBNC) enable Health Extension Workers (HEWs) to address the leading causes of child and newborn deaths at the local level. However, the result suggests that there is still a remarkable gap in programme implementation. Therefore, the MTE program should be revitalized and, where possible, integrated with other programs aimed at increasing community awareness through new communication technologies that reduce initial delay and improve outcomes for newborns. Although a WHO definition of neonatal mortality is well accepted worldwide, there is currently no established and detailed definition to be used in immunization trials and maternal surveillance following the widespread introduction of maternal immunizations. This is a missed opportunity, as comparability of data across studies or monitoring systems would facilitate interpretation of the data and promote scientific understanding of the event. Safety surveillance of currently approved vaccines has focused on fetal death, pregnancy outcome (live birth or stillbirth), birth defects, and infant growth and development [12]. 5An AEFI is defined as serious by international standards if it meets one or more of the following criteria: (1) it results in death, (2) is life-threatening, (3) requires hospitalization or results in an extension of an existing hospitalization, (4) results in persistent or significant disability or incapacity for work, (5) is a congenital anomaly/anomaly, (6) is a medically significant event or medically significant reaction. Here, we want to present epidemiological data describing the etiological factors that contribute to NFNS in low- and high-income countries, and describe initiatives to reduce early neonatal mortality. Neonatal mortality is one of the most important indicators of a country`s health and economic status [1]. Globally, neonatal mortality fell by 52%, from 5 million in 1900 to 2.4 million in 2019; However, the rate of decline has been slower than in the post-neonatal period [2]. In comparison, a very high burden of neonatal mortality has been observed in sub-Saharan Africa and South Asian countries [3]. Several global initiatives have been launched to reduce neonatal mortality.
Each Newborn Action Plan (NEAP) is one of the evidence-based solutions strategies to prevent newborn mortality. In addition, strategies to end preventable maternal mortality have been introduced to reduce inequalities in access to and delivery of services [4, 5]. To consolidate these efforts, the Sustainable Development Goal (SDG) set a new global target that aims to reduce neonatal mortality to just 12 deaths per 1000 live births by 2030 [6]. Hypothermia (lower-than-normal body temperature) has also been linked to premature newborn death. This is consistent with research conducted in Ethiopia and elsewhere that has found that hypothermia from newborn admission significantly increases the likelihood of death. [37, 38]. Hypothermia during NICU admission increased the risk of premature death of newborns, according to another study [39, 40]. This could be related to procedures such as giving birth to babies at <25°C (delivery room temperature), respiratory support with cold air during transport to the ICU and not wearing a cap in newborns, as well as unnecessary delays in skin contact, premature birth, and significant bacterial infections [40-42]. In addition, the majority (442 or 87.7%) of hypothermic infants admitted to the study hospital did not receive Kangroo Maternal Care (CMC), which protects the newborn from infection, effectively treats hypothermia, improves gastrointestinal function and cardiorespiratory stability, and promotes breastfeeding[43], thereby reducing early neonatal mortality [44, 45].
Estimating the variance of random-effect endpoints in the null model suggests that there is large variation in days of early neonatal death between clusters.