Early days of life are crucial for child survival in Gamo Gofa Zone, Southern Ethiopia: A community based study

Background: Though, Ethiopia has shown progress in the reduction of under-five mortality in the last few years, the problem of neonatal and under-five mortality are still among the highest in the world and that warrants continuous investigation of the situation for sustained interventions to maintain the reduction beyond the millennium development goals. Therefore, this study was conducted with the objective of determining the magnitude of childhood mortalities in the designated community. Method: A census of 11 kebeles (lowest administrative units in Ethiopia) of Arba Minch Town and 11 kebeles of Arba Minch Zuria District, which were not part of Arba Minch Demographic Surveillance System (DSS), had been done in order to identify all children (alive and dead) born between September 01, 2007 and September 30, 2014. Besides, all children born after July 01, 2009 were tracked from the data base of the Arba Minch DSS. Descriptive analyses with frequency and cross tabulation with the corresponding confidence interval and p-value were made using SPSS 16 and STATA 11. Extended Mantel-Haenszel chi-square for linear trend was also performed to assess presence of linear trend through the study period using open-Epi version 2.3. Result: A total of 20,161 children were included for this analysis. The overall weighted under five, infant and neonatal mortalities with their corresponding 95 % confidence intervals were: 42.76 (39.56-45.97), 33.89 (31.03-36.76) and 18.68 (16.53-20.83) per 1000 live births, respectively. Majority of neonatal deaths occurred within the first 7 days of life. Under-five mortality was found to be significantly higher among non-DSS rural kebeles, overall rural kebeles and females. Conclusion: Significant number of children died during their early days of life. Strengthening of maternal and child health interventions during pregnancy, during and immediately after birth are recommended in order to avert majorities of neonatal deaths.