title: The neonatal mortality and its determinants in rural communities of Eastern Uganda.
abstract: BACKGROUND
  In Uganda, neonatal mortality rate (NMR) remains high at 27 deaths per 1000 live births. There is paucity of data on factors associated with NMR in rural communities in Uganda. The objective of this study was to determine NMR as well as factors associated with neonatal mortality in the rural communities of three districts from eastern Uganda.
  
  
  METHODS
  Data from a baseline survey of a maternal and newborn intervention in the districts of Pallisa, Kibuku and Kamuli, Eastern Uganda was analyzed. A total of 2237 women who had delivered in the last 12 months irrespective of birth outcome were interviewed in the survey. The primary outcome for this paper was neonatal mortality. The risk ratio (RR) was used to determine the factors associated with neonatal mortality using log-binomial model.
  
  
  RESULTS
  The neonatal mortality was found to be 34 per 1000 live births (95% CI = 27.1-42.8); Kamuli 31.9, Pallisa 36.5 and Kibuku 30.8. Factors associated with increased neonatal deaths were parity of 5+ (adj. RR =2.53, 95% CI =1.14-5.65) relative to parity of 4 and below, newborn low birth weight (adj. RR = 3.10, 95% CI = 1.47-6.56) and presence of newborn danger signs (adj. RR = 2.42, 95% CI = 1.04-5.62). Factors associated with lower risk of neonatal death were, home visits by community health workers' (CHW) (adj. RR =0.13, 95% CI = 0.02-0.91), and attendance of at least 4 antenatal visits (adj. RR = 0.65, 95% CI = 0.43-0.98).
  
  
  CONCLUSIONS
  Neonatal mortality in rural communities is higher than the national average. The use of CHW's to mobilize and sensitize households on appropriate maternal and newborn care practices could play a key role in reducing neonatal mortality.
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda. mk.rornald@musph.ac.ug.
authors.forename: Rornald M
authors.initials: RM
authors.lastname: Kananura
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Moses
authors.initials: M
authors.lastname: Tetui
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Aloysius
authors.initials: A
authors.lastname: Mutebi
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: John N
authors.initials: JN
authors.lastname: Bua
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Peter
authors.initials: P
authors.lastname: Waiswa
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Suzanne N
authors.initials: SN
authors.lastname: Kiwanuka
authors.affiliation: Department of Health Policy Planning and Management, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ekirapa-Kiracho
authors.affiliation: Department of Epidemiology and Biostatistics, Makerere University School of public Health, Kampala, Uganda.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Makumbi
mesh_terms: D000328:Adult; D001724:Birth Weight; D003150:Community Health Workers; D003430:Cross-Sectional Studies; D065246:Culturally Competent Care / Q000208:ethnology; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D019538:Health Care Surveys; D006792:House Calls; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D050498:Live Birth; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D054238:Perinatal Mortality; D011295:Prenatal Care; D012307:Risk Factors; D012423:Rural Health / Q000208:ethnology; D014454:Uganda / Q000453:epidemiology