A1 Refereed original research article in a scientific journal
Cause-variations in neonatal mortality across Europe and Africa; evidence from a 20-year retrospective dataset and clinical practice guidelines
Authors: Adusei-Mensah, Frank; Boudia, Ahmed Ould; Agjei, Richard Osei; Awoniyi, Luqman; Sanusi, Ismaila Temitayo; Kauhanen, Jussi
Publisher: Elsevier BV
Publication year: 2026
Journal: Dialogues in Health
Article number: 100272
Volume: 8
ISSN: 2772-6533
DOI: https://doi.org/10.1016/j.dialog.2025.100272
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Open Access publication channel
Web address : https://doi.org/10.1016/j.dialog.2025.100272
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/508992388
Self-archived copy's licence: CC BY NC
Self-archived copy's version: Publisher`s PDF
BackgroundGlobal health disparities highlight significant inequities between regions such as Africa and Europe. This present study aims to: (i) compare the trends of the leading causes of neonatal mortalities across Europe and Africa over the past two decades; (ii) analyze the impact of clinical practice guidelines on neonatal mortality trends; and (iii) explore variations in cause-specific neonatal mortality rates between the regions.MethodsRecent mortality data (2002−2022) were extracted from the WHO database on neonatal mortality for WHO member countries. A comparative non-parametric statistical analysis was conducted on the dataset. Additionally, a scoping review of clinical practice guidelines for both continents was performed, followed by a trend analysis and interrupted time series analysis to explore the impact of these guidelines on neonatal mortality rates.ResultsWe observed marked regional differences in the causes of neonatal mortality. In Africa, rates were notably high for conditions including birth asphyxia, prematurity, and infections. Europe showed lower mortality levels with more stable trends. A steady decline in European mortality was significantly associated with a higher volume of published clinical practice guidelines compared to Africa.ConclusionNeonatal mortality trends differ significantly between Europe and Africa, with declining rates in Europe and stable or rising rates in Africa. Regional variation in leading causes is evident. The presence of context-specific clinical guidelines is linked to improved outcomes, underscoring the need for tailored, evidence-based interventions.
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Funding information in the publication:
No funding was received in carrying out this study.
