Prevalence and determinants of neonatal danger signs in northwest Ethiopia: a multilevel analysis

Background There is association between neonatal danger signs and neonatal deaths. Hence, understanding the factors associated with the occurrence of neonatal danger signs help reduce the stagnating neonatal mortality in countries like Ethiopia. Method A cross sectional community and facility linked study was conducted in 39 kebeles in Amhara region, North Gondar Zone of Ethiopia from March 3-18, 2016. A representative sample of 1,150 mother-newborn pairs were included in the study. Percentage was used to calculate the prevalence. Multilevel analysis was used to identify individual and kebele level characteristics associated with the occurrence of neonatal danger signs. Result The result showed that around a quarter, 286 (24.9%), of the newborns experienced one or more danger signs during the neonatal period. Significant differences were found between groups/kebeles in the occurrence of danger signs. At individual level, having low birth weight (AOR= 0.65; 95% CI: 0.48-0.88) and maternal danger signs during pregnancy and delivery (AOR= 1.93; 95% CI: 1.41-2.65) were found to be significantly associated with the occurrence of neonatal danger signs. At group/kebele level, antenatal care coverage (AOR= 0.35; 95% CI: 0.13-0.93) and year of health extension workers experience (AOR= 0.91; 95 % CI: 0.84-0.99) were significantly associated with the occurrence of neonatal danger signs. Conclusion The prevalence of neonatal danger signs is high. There are i ndividual and kebele level characteristics associated with occurrence of danger signs in newborns. Expanding maternal health services and strengthening the health extension program is critical.