Neonatal Survival in Sub-Sahara: A Review of Kenya and South Africa

Figures & data

Figure 1 PRISMA flow diagram.

Note: Adapted from Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):65–94.⁹

Table 1 A Description of the Articles Utilised

Article	Year	Design	Setting	Results
Masaba and Mmusi-phetoe, 2019^Citation10	2019	Cross-sectional	Kenya	A multifaceted approach is needed to reduce neonatal mortalities in Kenya
Tank, Omar, and Musoke, 2019^Citation11	2019	Prospective audit	Kenya	Mortality was high among preterm neonates
Shikuku, Milimo, Ayebare, Gisore, and Nalwadda, 2018^Citation12	2018	Observational	Kenya	Effective resuscitation for birth asphyxia
Gitobu, Gichangi, and Mwanda, 2018^Citation13	2018	Survey	Kenya	Free maternal services increased hospital deliveries
Ayodo, Samba, Amimo, and Asweto, 2018^Citation14	2018	Survey design	Kenya	Preterm birth is one of the main causes of neonatal death
Wagura, Wasunna, Laving, Wamalwa, and Ng, 2018.^Citation15	2018	Cross-sectional	Kenya	At-risk mothers should receive intensified antenatal care to mitigate preterm birth
Okube and Sambu, 2017^Citation16	2017	Cross-sectional	Kenya	Prevalence rate of preterm birth was 20.2%
Ministry-of-Health-[MOH], 2015^Citation17	2015	National surveys	Kenya	1.5 million babies are born in Kenya annually
Yego et al, 2013^Citation18	2013	Retrospective	Kenya	Pre-term birth and asphyxia are the leading causes of neonatal deaths
Velaphi et al, 2019^Citation19	2019	Prospective study	South Africa	Using a combination of blood culture and a PCR-based test the common pathogens isolated in neonates with sepsis were Ureaplasma spp. and GBS
Rhoda, Velaphi, Gebhardt, Kauchali, and Barron, 2018.^Citation20	2018	South Africa Demographic Health Survey	South Africa	South Africa has a double burden of disease driving neonatal mortality; term babies are dying owing to intrapartum-related events, and preterm deaths are linked to related complications.
Brits et al, 2015.^Citation21	2015	Case control	South Africa	Co-morbidity as a risk to preterm birth
Rhoda and Velaphi, 2015^Citation22	2015	National survey	South Africa	Preterm infants are at high risk of developing hypothermia
Bruckmann and Velaphi, 2015.^Citation23	2015	Medical record analysis	South Africa	The incidence of asphyxia ranged from 8.7 to 15.2/1000 live births
Bamford, 2015.^Citation24	2015	National DHS analysis	South Africa	South Africa continues to face a high burden of disease and high maternal and child mortality rates.
Mabaso, Ndaba, and Mkhize-kwitshana, 2014.^Citation25	2014	Analysis of National Department of Health	South Africa	Re-engineering of the Primary Health Care (PHC) services to reduce neonatal mortality
Save the Children Fund [SCF], 2013.^Citation26	2013	National analysis	South Africa	84,000 preterm births occur in South Africa annually
WHO, 2019^Citation1	2019	Regional estimates	Sub-Sahara	15 million babies are born too early every year
Chawanpaiboon et al, 2019.^Citation27	2019	Multi-regional analysis	Sub-Sahara	12·0 million (81.1%) of these preterm births occurred in Asia and sub-Saharan Africa.
Amare, Mela, and Dessie, 2019.^Citation28	2019	Review	Developing countries	Neonatal sepsis was found to be high which accounted for a third of the neonates.
Ranjeva, Warf, and Schiff, 2018.^Citation29	2018	Global health agencies data analysis	Africa	Neonatal sepsis presents a $10–$469 billion financial burden that could be alleviated through successful treatment and prevention
Mongella, Songane, and Akande, 2010^Citation30	2010	Regional estimates	Africa	Each year at least 1.16 million newborns die in Sub-Saharan Africa
UNICEF, 2019.^Citation6	2019	Global survey	United Nation regions	In 2018, the NMR for Kenya was 19.6 deaths per 1000 live births
Lawn et al, 2013.^Citation5	2013	Systematic estimates	12 countries	Investing in care of every woman and every newborn will reduce both deaths and disabilities
UNICEF, 2013.^Citation31	2013	Regional estimates	Global analysis	Globally, an estimated 10 million babies have breathing difficulties at birth.
Gillam-Krakauer and Gowen, 2018.^Citation32	2018	Regional estimates	–	15–20% of babies diagnosed with birth asphyxia die during the neonatal period
Lawn, Mongi, and Cousens, 2010^Citation33	2010	Regional estimates	Africa	Birth asphyxia also accounts for 280,000 deaths a year in sub-Saharan Africa

Figure 2 Kenya and South Africa National Neonatal Mortality rate, (per 1000 live births).

Table 2 Percentage Distribution of Causes of Neonatal Deaths in 2018: South Africa and Kenya

Causes	South Africa	Kenya
Preterm birth complications	36%	28%
Intrapartum related events	20%	29%
Sepsis/tetanus	14%	16%
Congenital abnormalities	10%	13%
Diarrhoea	0%	0%
Pneumonia	5%	7%
Other conditions	15%	8%

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