An analysis of factors associated with neonatal, post‐neonatal and child mortality in Haiti, including breastfeeding as a time‐dependent variable

• Published in: Journal of paediatrics and child health Vol. 58; no. 11; pp. 2023 - 2033
• Main Authors: Forde, Ian, Tripathi, Vrijesh
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons Australia, Ltd 01-11-2022; Blackwell Publishing Ltd
• Subjects: Age groups; Breast Feeding; Breastfeeding & lactation; Child; Child Mortality; Childrens health; Dependent variables; Female; Haiti - epidemiology; Health risks; Humans; Infant; Infant Mortality; Infant, Newborn; Male; neonatal mortality; Newborn babies; Nutrition; Pediatrics; post‐neonatal mortality; Proportional Hazards Models; time‐dependent variables; under‐five mortality; Haiti; post-neonatal mortality; child mortality; under-five mortality; time-dependent variables; neonatal mortality
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.16142

Aim
The main objective of the study was to identify factors associated with neonatal, post‐neonatal and child mortality. The study also investigated breastfeeding status as a time‐dependent variable.
Methods
The 2016–2017 Haitian Demographic and Health Survey was analysed. The analysis was done on 6530 live births. Time‐constant and time‐dependent multivariable Royston–Parmar spline models were used to identify associated factors for all three age groups. Restricted mean survival times were calculated for the different levels of the breastfeeding variable for each age group.
Results
Neonates and post‐neonates who were not breastfed were associated with increased mortality, hazard ratio (HR) 22.13 (95% confidence interval (CI), 16.40–29.87) and HR 4.99 (95% CI, 3.29–7.56), respectively. Males in the child age group were associated with increased mortality, HR 2.04 (95% CI, 1.29–3.23) and HR 2.03 (95% CI, 1.28–3.21) under the time‐constant and time‐dependent models, respectively.
Conclusions
Early initiation of breastfeeding and breastfeeding throughout the post‐neonatal period is recommended. Outreach programmes that provide support and education for vulnerable families are also recommended.