Evidence map›Paper›PMID 42559727›Full record

ArticleGlobal health action2026

Sex-stratified mortality trends in preterm birth complications in Sierra Leone: progress, persistence, and equity implications.

Alpha Umaru Bai-Sesay, Rosetta Doreen Jones, Alimamy Paul Simeon Baun, Daniel Karim Dauda Sesay

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Article in Global health action, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Alpha Umaru Bai-SesayMinistry of Health/National Public Health Agency, Freetown, Sierra Leone.ORCID 0009-0008-6137-4870
Rosetta Doreen JonesMinistry of Health/National Public Health Agency, Freetown, Sierra Leone.
Alimamy Paul Simeon BaunMinistry of Health/National Public Health Agency, Freetown, Sierra Leone.
Daniel Karim Dauda SesayMinistry of Health/National Public Health Agency, Freetown, Sierra Leone.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreterm birth complications remain a leading cause of neonatal mortality in Sierra Leone, despite recent health system gains. Evidence on long-term sex-specific disparities in mortality due to preterm birth complications is limited, constraining equitable neonatal care planning.

objectiveTo examine two‑decade trends in sex‑stratified mortality from preterm birth complications using standardized equity indicators.

methodsWe conducted a retrospective longitudinal analysis of sex-disaggregated mortality estimates from the World Health Organization (WHO) Global Health Estimates (GHE), accessed through the WHO Health Equity Assessment Toolkit (HEAT), Built-in Database Edition (Version 6.0). Mortality rates per 100,000 population were extracted for 2001, 2006, 2011, 2016, and 2021. Inequality was assessed using absolute difference (

resultsMortality declined substantially between 2001 and 2021 for both males (85.1-49.3 per 100,000) and females (71.2-39.9 per 100,000). Male mortality remained consistently higher across all years, with relative ratios indicating approximately 20-25% excess mortality among male neonates. Absolute inequalities narrowed modestly over time, whereas relative inequalities remained largely unchanged. PAR and PAF remained close to zero throughout the study period. Wider uncertainty intervals in earlier years reflected limited empirical data availability.

conclusionAlthough preterm mortality declined over two decades, a persistent male disadvantage remained in Sierra Leone. These findings highlight the importance of integrating sex-disaggregated equity monitoring into neonatal policies and programmes. Future research should evaluate strategies to reduce the persistent excess mortality among male neonates while sustaining overall improvements in neonatal survival and progress toward Sustainable Development Goal 3.2.

Indexed as

Health Status DisparitiesInfant MortalityPremature BirthFemaleHumansInfantInfant, NewbornLongitudinal StudiesMalePregnancyRetrospective StudiesSex FactorsSierra Leonehealth equityinequality monitoringNeonatal mortalityneonatal policypreterm birth complicationssex‑based disparitiesSierra LeoneWHO HEAT metrics

Identifiers

PMID42559727
PMCPMC13449426

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