A systematic review of risk factors for neonatal mortality in Adolescent Mother’s in Sub Saharan Africa

  • BMC Research Notes, Volume 7, No. 1, Year 2014

listen audio

Study Justification:
– The study focuses on the risk factors for neonatal mortality in adolescent mothers in Sub Saharan Africa (SSA).
– This is an important area of research because teenage births in SSA are particularly high, and adolescent mothers have a significantly higher risk of neonatal mortality compared to adults.
– Understanding the risk factors associated with neonatal mortality in adolescent mothers can help inform interventions and policies to improve maternal and child health outcomes in SSA.
Study Highlights:
– The study systematically searched six databases to determine risk factors for neonatal mortality and pregnancy outcomes between adolescent and adult mothers in SSA.
– The study found that being single and coming from a single-parent household was more prevalent among adolescent mothers.
– Other risk factors such as sexually transmitted infections and not going to school were also more prevalent in younger mothers.
– The study highlights the importance of inter-generational support for single mothers in SSA communities to prevent early pregnancies and ensure healthy outcomes.
Study Recommendations:
– Future studies should test related hypotheses and further explore the relationships between being single and other risk indicators for neonatal mortality in young mothers.
– Current policy initiatives should take into account the context of single African women’s lives, including low opportunity, status, and limited access to supportive relationships or practical help.
Key Role Players:
– Researchers and academics specializing in maternal and child health in SSA.
– Healthcare professionals and organizations working in SSA.
– Government officials and policymakers responsible for maternal and child health policies in SSA.
– Non-governmental organizations (NGOs) and community-based organizations (CBOs) focused on maternal and child health in SSA.
Cost Items for Planning Recommendations:
– Research funding for future studies to test hypotheses and explore relationships between risk factors and neonatal mortality in young mothers.
– Funding for interventions and programs aimed at providing inter-generational support for single mothers in SSA communities.
– Budget allocation for training healthcare professionals and improving access to healthcare services for adolescent mothers in SSA.
– Funding for awareness campaigns and educational programs targeting adolescents to prevent early pregnancies and improve reproductive health outcomes.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The review systematically searched multiple databases and assessed the quality of the articles. However, the abstract does not provide specific quantitative data on neonatal mortality rates between adolescents and adults in Sub Saharan Africa. To improve the evidence, the abstract could include the specific findings on neonatal mortality rates, such as the perinatal/neonatal mortality ratio (PNMR) for adolescents and adults, and the prevalence rates of risk factors for neonatal mortality in both groups. Additionally, including the p-values or confidence intervals for the significant risk factors would further strengthen the evidence.

Background: Worldwide, approximately 14 million mothers aged 15 – 19 years give birth annually. The number of teenage births in Sub Saharan Africa (SSA) is particularly high with an estimated 50% of mothers under the age of 20. Adolescent mothers have a significantly higher risk of neonatal mortality in comparison to adults. The objective of this review was to compare perinatal/neonatal mortality in Sub Saharan Africa and it’s associated risk factors between adolescents and adults. Results: We systematically searched six databases to determine risk factors for perinatal/neonatal mortality, and pregnancy outcomes, between adolescent and adults in SSA. Article’s quality was assessed and synthesized as a narrative. Being single and having a single parent household is more prevalent amongst adolescents than adults. Nearly all the adolescent mothers (97%) were raised in single parent households. These single life factors could be interconnected and catalyze other risky behaviors. Accordingly, having co-morbidities such as Sexually Transmitted Infections, or not going to school was more prevalent in younger mothers. Conclusions: Inter-generational support for single mothers in SSA communities appears essential in preventing both early pregnancies and ensuring healthy outcomes when they occur during adolescence. Future studies should test related hypothesis and seek to unpack the processes that underpin the relationships between being single and other risk indicators for neonatal mortality in young mothers. Current policy initiatives should account for the context of single African women’s lives, low opportunity, status and little access to supportive relationships, or practical help.

Focusing on quantitative data measuring neonatal mortality between adolescents <20 years and mothers older than 20 years in SSA, we reviewed literature to determine risk of neonatal mortality stratified by maternal age. There was no existing prior review protocol.Studies were systematically screened from PubMed, Cochrane database, Adolec, Popline, Google Scholar and Global Health Archive on adolescent and adult pregnancy in SSA until February 2013 (Figure 1). Flow chart for literature screening & selection. The studies were selected based on the main inclusion criteria: Any quantitative study measuring the association between risk factors for perinatal/neonatal mortality (PNM) and pregnancy outcome between adolescent and adults in SSA either comparing directly or as stratified groups. Due to the changing African developing context, we excluded publications prior to 1994. Also excluded were analyses that focused on older mothers, because neonatal mortality risk increases in mothers over 35 years of age, suggesting a potentially different set of risk indicators in this age category (Additional file 1: Appendix 3) [9–12]. Articles were graded using the Quality Assessment Tool for Quantitative Studies [13]. Randomized control trials and cohort studies were viewed as providing more robust findings, although cross-sectional studies were also examined. Risk factors for neonatal mortality were significant if p ≤ 0.05 and 95% Confidence Interval (95% CI) ≠ 0 were met. Articles were graded on the following scale: strong +++, moderate ++ and weak + by AR. In order to calculate perinatal/neonatal mortality ratio (PNMR), data was extracted for adolescents and adults from individual studies and calculated using the formula: PNM cases/total number of adolescent or adult population*1000. A proportion of the rates was reported in the results. Prevalence rate of risk factors was calculated through the extraction of data from individual studies, using the formula: total cases/total population of adolescent or adult population. If there were multiple studies reporting the same risk factor, the cases and population was totaled stratified by adolescent and adults. A proportion was determined for adolescents and adults in addition to the 95% CI and then a z score was calculated to determine the p-value. Some studies reported odds ratios (OR) and hazard ratios (HR); these were reported to provide additional statistics. We report a narrative review comparing perinatal/neonatal mortality in SSA and it’s associated risk factors between mothers 15–19 years and 20–35 years of age.

Based on the information provided, here are some potential innovations that could be used to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop and implement mobile applications that provide information and support to adolescent mothers in Sub Saharan Africa. These apps could provide access to educational resources, prenatal care reminders, and connect mothers with healthcare professionals for virtual consultations.

2. Community Health Workers: Train and deploy community health workers who can provide personalized support and education to adolescent mothers in their local communities. These workers can help bridge the gap between healthcare facilities and young mothers, ensuring they receive the necessary care and support.

3. Telemedicine: Implement telemedicine services that allow adolescent mothers to consult with healthcare professionals remotely. This can help overcome barriers such as distance and transportation, making it easier for young mothers to access prenatal and postnatal care.

4. Peer Support Programs: Establish peer support programs where adolescent mothers can connect with and learn from other young mothers who have gone through similar experiences. These programs can provide emotional support, share knowledge, and empower young mothers to make informed decisions about their health.

5. Comprehensive Sex Education: Implement comprehensive sex education programs in schools and communities to educate adolescents about reproductive health, contraception, and the importance of delaying pregnancy. By providing accurate information and empowering young people to make informed choices, the rate of teenage pregnancies may decrease.

6. Strengthening Health Systems: Invest in strengthening healthcare systems in Sub Saharan Africa, including improving infrastructure, increasing the availability of skilled healthcare professionals, and ensuring the availability of essential maternal health services and supplies.

These innovations aim to address the specific challenges faced by adolescent mothers in Sub Saharan Africa and improve their access to maternal health services and support.
AI Innovations Description
Based on the information provided, the recommendation to improve access to maternal health in Sub Saharan Africa is to focus on inter-generational support for single mothers in the community. This support should aim to prevent early pregnancies and ensure healthy outcomes when pregnancies occur during adolescence.

Additionally, future studies should be conducted to test related hypotheses and understand the underlying processes that contribute to the relationship between being single and other risk indicators for neonatal mortality in young mothers. Current policy initiatives should also take into account the context of single African women’s lives, including low opportunity, status, and limited access to supportive relationships or practical help.

To develop this recommendation into an innovation, it could involve implementing community-based programs that provide comprehensive support to adolescent mothers, including education on reproductive health, access to contraceptives, prenatal and postnatal care, and counseling services. These programs could also involve engaging and educating the wider community to reduce stigma and discrimination against young mothers.

Furthermore, innovative approaches could include leveraging technology to improve access to maternal health services, such as mobile health applications that provide information, reminders, and virtual consultations for adolescent mothers. This could help overcome barriers to accessing healthcare facilities, particularly in remote or underserved areas.

Overall, the innovation should focus on addressing the specific needs and challenges faced by adolescent mothers in Sub Saharan Africa, while also promoting community involvement and support to ensure sustainable and effective improvements in maternal health access and outcomes.
AI Innovations Methodology
Based on the provided information, here are some potential recommendations for improving access to maternal health:

1. Increase access to comprehensive sexual and reproductive health education: Implementing comprehensive sexual and reproductive health education programs can help adolescents make informed decisions about their reproductive health, including delaying pregnancy and understanding the risks associated with early motherhood.

2. Strengthen healthcare infrastructure: Invest in improving healthcare infrastructure, particularly in rural areas, by increasing the number of skilled healthcare providers, improving access to essential maternal health services, and ensuring the availability of necessary medical equipment and supplies.

3. Promote community-based interventions: Implement community-based interventions that focus on raising awareness about maternal health issues, providing support to adolescent mothers, and engaging community members in promoting positive health behaviors.

4. Enhance access to family planning services: Ensure that family planning services are readily available and accessible to adolescents, including access to a range of contraceptive methods and counseling services.

5. Address social determinants of health: Addressing social determinants of health, such as poverty, gender inequality, and lack of education, is crucial for improving access to maternal health. This can be done through targeted interventions that aim to empower women and girls, reduce poverty, and promote gender equality.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define the indicators: Identify specific indicators that can measure the impact of the recommendations, such as the percentage of adolescent mothers receiving comprehensive sexual and reproductive health education, the availability of skilled healthcare providers in rural areas, the uptake of family planning services among adolescents, etc.

2. Collect baseline data: Gather data on the current status of the indicators before implementing the recommendations. This can be done through surveys, interviews, or existing data sources.

3. Implement the recommendations: Roll out the recommended interventions and initiatives to improve access to maternal health.

4. Monitor and evaluate: Continuously monitor and evaluate the progress and impact of the recommendations. Collect data on the indicators at regular intervals to assess any changes or improvements.

5. Analyze the data: Analyze the collected data to determine the impact of the recommendations on improving access to maternal health. Compare the baseline data with the data collected after implementing the recommendations to identify any significant changes.

6. Draw conclusions and make adjustments: Based on the analysis, draw conclusions about the effectiveness of the recommendations. Identify any gaps or areas that need improvement and make necessary adjustments to the interventions.

7. Repeat the process: Continuously repeat the process to monitor and evaluate the impact of the recommendations over time and make further improvements as needed.

Statistics:
Citations: 18
Authors: 5
Identifiers:
DOI: 10.1186/1756-0500-7-750
Research Areas:
Environmental, Health System and Policy, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health
Study Design:
Cohort Study, Cross Sectional Study, Narrative Study
Study Approach:
Mixed-methods, Qualitative, Quantitative, Systematic Review
Participants Gender:
Female
Share this:
Facebook
Twitter
LinkedIn
WhatsApp
Email