Abstract:
Background: The concept of a neonatal near miss is used to explain neonates who nearly
died but survived a life-threatening complication in the first 28 days of life. We have left many
ill surviving (near-miss) neonates, due to a lack of valid and reliable assessment scale,
particularly in Ethiopia.
Aim: We aim to psychometrically validate the neonatal near-miss assessment scale (NNMAS)
for Ethiopia.
Methods: A total of 465 live birth neonates were included with the assumption of a participantto-item ratio of 15:1. A new contextually validated NNMAS was used to collect data. The Kaiseri––
Mayer––Olkin (KMO) measure of sampling adequacy with a cutoff value of ≥0.50 for each item
was applied. For reliability and validity of NNMAS, exploratory factor analysis using principal
component analysis with oblique varimax rotation was used. Internal consistency and reliability
were assessed using Cronbach’s alpha. Convergent and discriminant validity was assessed using
composite reliability (CR) and average variance extracted (AVE).
Results: The Kaiser––Mayer––Olkin (KMO = 0.74) measure of sampling adequacy and
Bartlett’s Sphericity test for the appropriateness of the identity matrix (χ2 = 2903.9,
df = 276, and P = 0.000) were suitable for exploratory factor analysis (EFA). The correlation
matrix determinant of the study was 0.002. The principal component analysis (PCA) identified
six factors and together explained 54.3% of the variation in the Neonatal Near miss. The
Cronbach-alpha coefficient was 0.80 for the entire scale. The composite reliability values of
the factors ranged from 0.87 to 0.95. The AVEs, CR, and factor loadings were above 0.5 for all
factors indicating that convergent validity was met. The square roots of the AVEs were greater
than factor correlation values. It was revealed that discriminated validity was also met.
Conclusion: The neonatal near-miss assessment scale was found to be valid and reliable in
the present context. The scale can be used to identify near-miss neonates in Ethiopia.
