Analysis of the cause of neonatal death using verbal autopsies in rural Bangladesh

Bangladesh is often considered as a champion in terms of health gains, despite presenting poorer development indicators than other South Asian countries. Neonatal mortality has decreased from 55 to 27 per 1000 livebirths from 1990 to 2010. Despite this important reduction, the newborn mortality rate in Bangladesh remains high and currently represents two thirds of the under-five mortality rate. 

The government of Bangladesh and the Centre for Injury Prevention and Research Bangladesh, our main partner in Bangladesh, implemented a population-based Maternal and Perinatal Death Review (MPDR) system in four rural districts of the country (Thakurgaon, Jamalpur, Moulvibazar and Narail). We analysed data from verbal autopsies conducted under the MPDR to identify the causes of neonatal death and the determinants of care seeking for ill neonates in these districts.

Our analysis showed that asphyxia was the commonest cause of death. Moreover, most neonates who died had access to qualified care. Improving recognition of neonatal illness by parents and quality of care both at community and health facility level is needed for Bangladesh to reduce neonatal mortality and achieve the Every Newborn Action Plan targets.