Neonatal hypothermia and associated factors within six hours of delivery in eastern part of Ethiopia: a cross-sectional study

Background: Neonatal hypothermia plays a significant role in increasing neonatal death by 80% for every 1 degree Celsius decrease of body temperature, especially in sub Saharan countries. A global burden of neonatal hypothermia indicated that 53% of Ethiopian newborns developed hypothermia due to different socio-demographic, behavioral, physiological and birth context related factors. However, the significance of these factors along the spectrum of public health institutions in the study area hasn't been yet studied.

Objective: To assess the prevalence and associated factors of neonatal hypothermia within six hours of delivery at public health institutions of Harar city, Eastern Ethiopia, 2018.

Methods: An institution based cross sectional study was conducted at Harar city after stratified followed by random selection of 3 public health institutions. Every other eligible newborn was included by systematic sampling to yield a sample of 403 newborns and their axillary temperature was measured by a calibrated digital thermometer within six hours of delivery from January 25 to February 19, 2018. A pre-tested anonymous questionnaire and checklist were used. The collected data were cleaned, coded and entered into Epi -data version 4.2 and exported to STATA version 12. Binary logistic regression model was considered and those variables with P < 0.25 in the bivariable analysis were included in to final model after which statistical significance was declared at P < 0.05. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests. Multi co-linearity was diagnosed using standard error and correlation matrix.

Results: The prevalence of neonatal hypothermia in the study area was 66.3% (95% CI: 61.1, 70.5%). No skin to skin contact (AOR = 2.87, 95% CI:1.48, 5.57), no wearing cap (AOR = 2.10, 95% CI:1.17, 3.76), no warm intra-facility transportation (AOR = 3.18, 95% CI: 1.84, 5.48), born to mothers having obstetric complication (AOR = 2.42, 95% CI:1.28, 4.57), prematurity (AOR = 3.37, 95% CI:1.53, 7.44) and neonatal health problem (AOR = 4.24, 95% CI:1.92, 9.34) were significantly associated with hypothermia.

Conclusion: The prevalence of neonatal hypothermia was relatively high. Therefore, adherence should be made to the thermal care mainly the cost effective ones like wearing cap, skin to skin contact and warm transportation.