1.   Peer Reviewed Title: Neonatal mortality in the empowered action group states of India: Trends and determinants. Author: Arokiasamy P; Gautam A Source: Journal of Biosocial Science. 2008 Mar;40(2):183-201. Abstract: In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India's Sample Registration System (SRS) and National Family and Health Survey are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers' younger age at childbirth, low birth weight of children and higher order births with short birth intervals. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | SURVEYS | INFANT MORTALITY | INFANT MORTALITY CHANGES | MORTALITY DETERMINANTS | ANTENATAL CARE | MATERNAL HEALTH | MATERNAL-CHILD HEALTH SERVICES | QUALITY OF HEALTH CARE | EDUCATIONAL STATUS | UTILIZATION OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Sampling Studies | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 323784 |
| 2. Peer Reviewed Title: Persistent neonatal mortality despite improved under-five survival: A retrospective cohort study in northern Vietnam. Author: Hoa DP; Nga NT; Malqvist M; Persson LA Source: Acta Paediatrica. 2008 Feb;97(2):166-170. Abstract: The aim was to examine trends in neonatal, infant and under-five mortality rates in a northern Vietnamese district during 1970-2000, and to analyze socioeconomic differences in child survival over time. Retrospective interviews with all women aged 15-54 years in Bavi district in Northern Vietnam (n = 14 329) were conducted. Of these women, 13 943 had been pregnant, giving birth to 26 796 children during 1970-2000. There was a dramatic reduction in infant and under-five mortality rate (47%) over time. However, the neonatal mortality rate (NMR) showed a very small reduction, thus causing its proportion of the total child mortality to increase. Mortality trends followed the political and socioeconomic development of Vietnam over war, peace and periods of reforms. There were no differences in under-five and neonatal mortalities associated with family economy, while differentials related to mothers' education and ethnicity were increasing. Interventions to reduce child mortality should be focused on improving neonatal care. In settings with a rapid economic growth and consequent social change, like in Vietnam, it is important that such interventions are targeted at vulnerable groups, in this case, families with low level of education and belonging to ethnic minorities. (author's) Language: English Keywords: VIETNAM | RESEARCH REPORT | RETROSPECTIVE STUDIES | COHORT ANALYSIS | INFANT MORTALITY | INFANT MORTALITY CHANGES | CHILD SURVIVAL | SOCIOECONOMIC STATUS | EDUCATIONAL STATUS | MINORITY GROUPS | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Survivorship | Length of Life | Socioeconomic Factors | Economic Factors | Population Characteristics Document Number: 324190 |
| 3. Peer Reviewed Title: Stages of the demographic transition from a child's perspective: Family size, cohort size, and children's resources. Author: Lam D; Marteleto L Source: Population and Development Review. 2008 Jun;34(2):225-252. Abstract: The demographic transition has played itself out with great regularity in developing countries over the last 50 years. Looking at a broad set of countries, a stylized version of the demographic transition is consistent with the empirical experience of most of the developing world. The transition begins with large and sustained declines in death rates, especially infant and child mortality. The immediate effect of this mortality decline is an increase in the number of surviving children at the family level and an increase in the total number of children at the population level. Mortality decline is eventually followed by the second key element of the transition, a decline in fertility, which in turn has effects on both family size and cohort size. These changes in family size and cohort size over the course of the demographic transition are the focus of this article. We develop a new characterization of stages of the transition, viewing the demographic changes from a child's perspective. As we show, dramatic changes in the numbers of siblings and the size of cohorts can occur during the demographic transition, changes with important implications for children's resources at the family level and the population level. These changes do not always move in the same direction, however, owing to the complex interaction of population momentum with falling fertility and mortality. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | THEORETICAL MODELS | DEMOGRAPHIC TRANSITION | MORTALITY DECLINE | FERTILITY DECLINE | FAMILY SIZE | CHILD MORTALITY | INFANT MORTALITY | INFANT MORTALITY CHANGES | Research Methodology | Population Dynamics | Demographic Factors | Population | Mortality | Fertility Changes | Fertility | Family Characteristics | Family and Household | Sociocultural Factors Document Number: 327507 |
| 4. Peer Reviewed Title: Widening ethnic disparities in infant mortality in southern Brazil: Comparison of 3 birth cohorts. Author: Matijasevich A; Victora CG; Barros AJ; Santos IS; Marco PL Source: American Journal of Public Health. 2008 Apr;98(4):692-668. Abstract: We analyzed trends in mortality among infants born to White and to Black or mixed-race women in 3 population-based cohorts representing all births in 1982, 1993, and 2004 in Pelotas, southern Brazil. Births were assessed during daily visits to all maternity hospitals. Maternal skin color was classified by the interviewers as White or Black or multiracial. We used logistic regression to adjust for socioeconomic, demographic, and health services variables. The mortality rate among infants born to White mothers declined from 30.4 per 1000 live births in 1982 to 13.9 per 1000 in 2004, compared with 53.8 per 1000 to 30.4 per 1000 among those born to Black and mixed-race mothers. Differences for neonatal mortality were even more marked, with reductions of 47% and 11% for infants born to White and Black or mixed-race women, respectively. Adjusted analyses showed that ethnic group differences in neonatal and infant mortality were partly explained by differences in poverty and prenatal care. Over a 22-yearperiod, improvements in health indicators were greater for infants born to White women than for other infants. The widening racial gap requires special attention from policymakers. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | COHORT ANALYSIS | INFANT MORTALITY | INFANT MORTALITY CHANGES | ETHNIC GROUPS | INEQUALITIES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Cultural Background | Population Characteristics | Socioeconomic Factors | Economic Factors Document Number: 325401 |
| 5. Title: Trends in stillbirths, early and late neonatal mortality in rural Bangladesh: The role of public health interventions. Author: Ronsmans C; Chowdhury ME; Alam N; Koblinsky M; El Arifeen S Source: Paediatric and Perinatal Epidemiology. 2008 May;22(3):269-279. Abstract: Trends were examined in a cohort study of stillbirths and early and late neonatal deaths in Matlab, a rural area of Bangladesh between 1975 and 2002, using routinely collected demographic surveillance data. Main outcome measures were stillbirths per 1000 births, early neonatal deaths per 1000 livebirths, and late neonatal deaths per 1000 children surviving after 1 week. We performed a logistic regression examining trends over time and between two areas in the three outcome measures, controlling for the effects of parental education, religion, time, geography, parity, maternal age and birth spacing. There was a marked decline in stillbirths, early and late neonatal mortality over time in both areas, though the pace of decline was somewhat faster in the ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh) service area. Stillbirths declined by 24% overall in the ICDDR,B service area (crude OR comparing 1996-2002 with 1975-81: 0.76 [95% CI 0.68, 0.84]), compared with 15% in the Government service area (crude OR comparing 1996-2002 with 1975-81: 0.85 [0.76, 0.94]). The overall reduction in early and late neonatal mortality comparing the same periods was 39% and 73%, respectively, in the ICDDR,B area, compared with 30% and 63%, respectively, in the Government service area. Adjusting for socio-economic or demographic factors did not substantially alter the time or area differentials. The dramatic decline in neonatal mortality was, in large part, due to a fall in deaths from neonatal tetanus. The pace of decline was faster in the area receiving intense maternal and child health and family planning interventions, but stillbirths, early and late neonatal deaths also declined in the area not receiving such intense attention, suggesting that factors outside the formal health sector play an important role. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | COHORT ANALYSIS | FETAL DEATH | INFANT MORTALITY CHANGES | INTERVENTIONS | TETANUS | IMMUNIZATION | PROGRAM EFFECTIVENESS | TIME FACTORS | Developing Countries | Asia, Southern | Asia | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality | Programs | Organization and Administration | Infections | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation Document Number: 326088 |
| 6. Peer Reviewed Title: Epidemiologic transition interrupted: A reassessment of mortality trends in Thailand, 1980 -- 2000. Author: Hill K; Vapattanawong P; Prasartkul P; Porapakkham Y; Lim SS Source: International Journal of Epidemiology. 2007 Apr;36(2):374-384. Abstract: In the late 1980s and early 1990s a generalized HIV epidemic affected Thailand which was relatively well controlled by an intensive national campaign by the mid 1990s. The extent to which the epidemic has slowed or possibly reversed the epidemiological transition in Thailand is relatively unknown. Under-five mortality rates (U5MR) were determined from various sources and weighted least squares regression conducted to determine U5MR over the years 1980-2000. Direct and indirect estimates of the completeness of death registration were used to estimate mortality levels in those aged more than 5 years for the 1980-90 and 1990-2000 periods. Life tables were constructed using the various estimates to determine changes in life-expectancy between the two time periods. U5MR in Thailand is estimated to have been 58/1000 live births in 1980, declining to 30 in 1990 and to 23 in 2000. The vital registration system clearly underestimates U5MR. Successive surveys of Population Change (SPC) imply coverage of death registration improving from 75-77% in 1985-86 to 95% in 1995-96, partly due to a reliance on self-reported registration in the latter survey. In contrast, the General Growth Balance-Synthetic Extinction Generations (GGB-SEG) method suggests coverage worsening from 78-85% in 1980-90 to 64-72% in 1990-2000. Life tables based on SPC adjustments show continued declines in female, and to a lesser extent, male adult mortality with corresponding increases in life-expectancy at birth of around 6 years for both sexes from 1980-90 to 1990-2000. In contrast, the indirect adjustments suggest a substantial increase in male adult mortality with female adult mortality unchanged; life expectancy decreased by 4 years for males and was only marginally higher in females. Given the conflicting evidence a definitive assessment of mortality change in Thailand between 1980 and 2000 is difficult to make. Indirect adjustments, based on demographic methods point to a major reversal in mortality decline among males, and a slowing infemales. If adult mortality registration has declined, and given the continued under-registration of infant and child deaths, remedial measures are urgently required if the mortality system is to better inform and monitor health development in Thailand. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | EPIDEMIOLOGY | VITAL STATISTICS | MORTALITY CHANGES | INFANT MORTALITY CHANGES | DEATH RATE | CAUSES OF DEATH | Asia, Southeastern | Asia | Developing Countries | Public Health | Health | Population Statistics | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality Document Number: 313608 |
| 7. Peer Reviewed Title: Mortality in the Islamic Republic of Iran, 1964-2004. Author: Khosravi A; Taylor R; Naghavi M; Lopez AD Source: Bulletin of the World Health Organization. 2007 Aug;85(8):607-614. Abstract: Reliable information on the pattern, level and trend of mortality is essential for evidence-based policy to improve health. Various sources of mortality data in the Islamic Republic of Iran have not been critically assessed. This paper aims to document and evaluate the completeness of the different data sources on mortality and to estimate the level and trends of mortality over the past 40 years according to various mortality indices such as child mortality, adult mortality and life expectancy. We undertook a systematic review of all available studies on infant mortality from 1964 to 2004 and estimated the most probable trend in child mortality. Death registration data from between 1992 and 2004 were assessed for completeness to estimate the level of adult mortality. Life tables for 2004 were constructed for the Islamic Republic of Iran based on these data, corrected for under-registration of death. Infant mortality decreased from an estimated 154 deaths per 1000 live births in 1964 to 26 in 2004.The risk of adult mortality in 2004 was estimated to be 0.124 and 0.175 for females and males respectively. According to adjusted death registration data, life expectancy at birth in 2004 was 71.2 for females and 68.7 for males. The average completeness of death registration for ages 5 years and older across all systems was 76% for the period 2001-2004. There has been a general decline in child mortality in the Islamic Republic of Iran over the past three decades. Adult mortality levels also have declined, but less substantially. Mortality information systems have improved, yet serious concerns remain regarding the completeness and quality of data. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | LIFE TABLE METHOD | MORTALITY | MORTALITY CHANGES | MORTALITY DECLINE | CHILD MORTALITY | INFANT MORTALITY | INFANT MORTALITY CHANGES | LIFE EXPECTANCY | DEATH RECORDS | Developing Countries | Middle East | Studies | Research Methodology | Demographic Analysis | Population Dynamics | Demographic Factors | Population | Length of Life | Vital Statistics | Population Statistics Document Number: 313747 |
| 8. Peer Reviewed Title: Infant mortality in the Federal District, Brazil: time trend and socioeconomic inequalities. Mortalidade infantil no Distrito Federal, Brasil: tendência temporal e desigualdades sócio-econômicas. Author: Monteiro RA; Schmitz Bde A Source: Cadernos de Saude Publica. 2007 Apr;23(4):767-774. Abstract: This study examined the trend in the infant mortality rate in the Federal District of Brazil (or Greater Metropolitan Brasilia, the national capital) from 1990 to 2000, analyzing the rate according to 5 administrative areas stratified by mean family income, from 1996 to 2000. An ecological time-series study was conducted using the Information Systems on Live Births and Mortality, produced by the Brazilian Ministry of Health. The infant mortality rate (IMR) decreased by 45.2% from 1990 to 2000, from 26.3 per 1000 live births to 14.4, or a mean annual reduction of 5.34% (R/2 = 0.9397; p < 0.0001). During this period there was a higher proportion of neonatal deaths. However, a higher percentage change occurred in the post-neonatal period (-59.0%, R/2 = 0.8452, p < 0.0001). Investigation of the IMR in the various areas of the Federal District showed a reduction in differences among the regions with respect to the component rates; however, substantial disparities persisted in relation to the income variable. The results suggest the need for effective interventions in the determinants of neonatal and post-neonatal mortality in order to improve maternal and infant health in all socioeconomic groups in the Federal District. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | MOTHERS | INFANT MORTALITY CHANGES | MORTALITY DECLINE | SOCIOECONOMIC FACTORS | INEQUALITIES | GEOGRAPHIC FACTORS | MATERNAL HEALTH | CHILD HEALTH | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Mortality | Mortality | Population Dynamics | Economic Factors | Health Document Number: 315610 |
| 9. Title: Infant mortality rate in India: Still a long way to go. Author: Singh B Source: Indian Journal of Pediatrics. 2007 May;74(5):454. Abstract: Infant Mortality Rate (IMR) is regarded as an important and sensitive indicator of the health status of a community. It also reflects the general standard of living of the people and effectiveness of interventions for improving maternal and child health in a country. Compared to other indicators like crude birth rate, maternal mortality rate and under-five mortality rate etc, this indicator has always been accorded greater importance by the public health specialists because infant mortality is the single, largest category of mortality. Moreover, deaths during infancy are due to a particular mix of diseases and conditions to which the adult population is less exposed and less vulnerable. Changes in specific health interventions affect IMR more rapidly and directly and hence it may change more dramatically than the crude death rate in a population. This is clearly demonstrated in a developing country like India. In the 1960s, IMR in India used to hover around the 100 mark in the country. (excerpt) Language: English Keywords: INDIA | CRITIQUE | INFANT | INFANT MORTALITY CHANGES | MATERNAL-CHILD HEALTH SERVICES | PRIMARY HEALTH CARE | DELIVERY OF HEALTH CARE | Asia, Southern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Health Services | Health Document Number: 317974 |
| 10. Title: Neonatal and infant mortality in the ten years (1993 to 2003) of the Gadchiroli field trial: effect of home-based neonatal care. Author: Bang AT; Reddy HM; Deshmukh MD; Baitule SB; Bang RA Source: Journal of Perinatology. 2005 Mar;25 Suppl 1:S92-S107. Abstract: The objectives were to evaluate the effect on neonatal and infant mortality during 10 years (1993 to 2003) in the field trial of home-based neonatal care (HBNC) in Gadchiroli; and to estimate the contribution of the individual components in the intervention package on the observed effect. The field trial of HBNC in Gadchiroli, India, has completed the baseline phase (1993 to 1995), observational phase (1995 to 1996) and the 7 years of intervention (1996 to 2003). We measured the stillbirth rate (SBR), neonatal mortality rate (NMR), perinatal mortality rate (PMR), postneonatal mortality rate (PNMR) and the infant mortality rate (IMR) in the intervention area and the control area. The effect of HBNC on all these rates was estimated by comparing the change from baseline (1993 to 1995) to the last 2 years of intervention (2001 to 2003) in the intervention area vs in the control area. For other estimates, we made a before-after comparison of the rates in the intervention arm in the observation year (1995 to 1996) vs intervention years (1996 to 2003). We evaluated the effect on the cause-specific NMRs. By using the changes in the incidence and case fatality (CF) of the four main morbidities, we estimated the contribution of primary prevention and of the management of sick neonates. The proportion of deaths averted by different components of HBNC was estimated. The baseline population in 39 intervention villages was 39,312 and in 47 control villages it was 42,617, and the population characteristics and vital rates were similar. The total number of live births in 10 years (1993 to 2003) were 8811 and 9990, respectively. The NMR in the control area showed an increase from 58 in 1993 to 1995 to 64 in 2001 to 2003. The NMR in the intervention area declined from 62 to 25; the reduction in comparison to the control area was by 44 points (70%, 95% CI 59 to 81%). Early NMR decreased by 24 points (64%) and late NMR by 20 points (80%). The SBR decreased by 16 points (49%) and the PMR by 38 points (56%). The PNMR did not change, and the IMR decreased by 43 points (57%, 95% CI 46 to 68%). All reductions were highly significant (p < 0.001) except for SBR it was < 0.05. The cause-specific NMR (1995 to 1996 vs 2001 to 2003) for sepsis decreased by 90%, for asphyxia by 53% and for prematurity by 38%. The total reduction in neonatal mortality during intervention (1996 to 2003) was ascribed to sepsis management, 36%; supportive care of low birth weight (LBW) neonates, 34%; asphyxia management, 19%; primary prevention, 7% and management of other illnesses or unexplained, 4%. The HBNC package in the Gadchiroli field trial reduced the neonatal and perinatal mortality by large margins, and the gains were sustained at the end of the 7 years of intervention and were carried forward as improved survival through the first year of life. Most of the reduction in mortality was ascribed to sickness management, that is, management of sepsis, supportive care of LBW neonates and management of asphyxia, in that order, and a small portion to primary prevention. (author's) Language: English Keywords: INDIA | RURAL AREAS | RESEARCH REPORT | EVALUATION | PERINATAL MORTALITY | HOME CARE | INFANT MORTALITY | INTERVENTIONS | MORBIDITY | TREATMENT | CASE FATALITY RATE | INFANT MORTALITY CHANGES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Mortality | Population Dynamics | Demographic Factors | Care and Support | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration | Diseases | Medical Procedures | Medicine | Death Rate Document Number: 310624 |
| 11. Title: Inter-state inequality in infant mortality in India, 1981-2000. Author: Chaurasia AR Source: Journal of Health and Population in Developing Countries. 2005 Mar 15;:[32] p.. Abstract: Based on the estimates of infant mortality rate available through the sample registration system, this paper measures levels and analyses trends in inter-state inequality in the probability of death during infancy in India by rural and urban residence for the period 1981 through 2000. The analysis reveals that with the declining levels of infant mortality, the absolute inter-state inequality in the probability of death during infancy has also decreased for the country and for its rural and urban populations. In terms of relative inter-state inequality, however, the declining trend in inequality could be observed in rural areas only; in urban India, the relative inter-state inequality in infant mortality has tended to increase during the 20 years under reference. There is a need of a community based public health services delivery network in the urban areas to address the increase or stagnation in relative inter-state inequality in urban infant mortality rate in India. (author's) Language: English Keywords: INDIA | RURAL AREAS | URBAN AREAS | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | INFANT MORTALITY CHANGES | INEQUALITIES | MORTALITY DETERMINANTS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Infant Mortality | Mortality | Population Dynamics | Socioeconomic Factors | Economic Factors Document Number: 288063 |
| 12. Title: Guest editorial for Journal of Perinatology supplement on the Gadchiroli field trial [editorial] Author: Parker RL Source: Journal of Perinatology. 2005 Mar;25 Suppl 1:S1-S2. Abstract: Neonatal health in developing countries has only recently emerged as a public health priority. In the 1980s and 1990s, the ''Child Survival Revolution'' focused on interventions that showed the greatest potential to reduce mortality and morbidity among children under 5 years of age. The implementation of several child survival programs -- including childhood immunizations, antibiotics to treat pneumonia, oral rehydration fluids to control diarrheal disease, and nutrition monitoring and intervention -- led to steady decreases in child mortality in many countries. Since parallel improvements in neonatal survival were small, many in the public health community then believed that neonatal interventions could only be effective in countries with better and easily accessible health care facilities. Thus, as under-five mortality decreased overall, neonatal deaths made up an increasing share of under-five mortality. (excerpt) Language: English Keywords: INDIA | RURAL AREAS | CRITIQUE | INFANT | HEALTH PERSONNEL | NEONATAL MORTALITY | HOME CARE | MORBIDITY | INTERVENTIONS | INFANT MORTALITY CHANGES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Delivery of Health Care | Health | Infant Mortality | Mortality | Population Dynamics | Care and Support | Health Services | Diseases | Programs | Organization and Administration Document Number: 310625 |
| 13. Peer Reviewed Title: Public health reforms in Estonia: impact on the health of the population. Author: Põlluste K; Männik G; Axelsson R Source: BMJ. British Medical Journal. 2005 Jul 23;331(7510):210-213. Abstract: The health of the population has worsened in most countries in central and eastern Europe during the transition period, but little has been written about the reforms in the field of public health during this time, and little evidence has been presented on the links between these reforms and the health of the population. We describe public health reforms in Estonia, focusing on the institutional structure, the reform rationale, the specific proposals and reform processes, the achievements and limitations, and the wider impact of the reforms. To describe trends in the health of the population, we use life expectancy, infant mortality, rate of abortions per 100 live births, morbidity rates (tuberculosis, HIV, sexually transmitted diseases), and the level of individual risk factors (smoking, diet, alcohol consumption). The study is based mainly on an analysis of previously published reports and official statistics. (excerpt) Language: English Keywords: ESTONIA | CRITIQUE | PUBLIC HEALTH | PROMOTION | NATIONAL HEALTH SERVICES | PREVENTION AND CONTROL | LIFE EXPECTANCY | INFANT MORTALITY CHANGES | ALCOHOL USE AND ABUSE | TOBACCO USE | TUBERCULOSIS | DIET | Europe, Eastern | Europe | Developing Countries | Health | Marketing | Economic Factors | Health Services | Delivery of Health Care | Diseases | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality | Behavior | Infections | Nutrition Document Number: 290975 |
| 14. Title: Development and effects of a neonatal care unit in rural India [letter] Author: Sen A; Mahalanabis D; Singh AK; Som TK; Bandyopadhyay S Source: Lancet. 2005 Jul 2;366(9479):27-28. Abstract: The Purulia district of the state of West Bengal, India, has an area of 6259 km/2, a population of 2.54 million, a birth rate of 24.8, and a neonatal mortality rate (NMR) of 55 per 1000 livebirths. The government health infrastructure in this district consists of a district hospital, a subdistrict hospital, five rural hospitals, 15 community health centres, and 53 primary health centres. Caesarean section and blood transfusion services are only available in the district hospital. Although an essential newborn care programme has been operational in the district for several years, no specialised sick newborn care unit (SNCU), government or private, is available in the district. We aimed to set one up in the district hospital and to estimate its effects on NMR. With the limited space, manpower, and funding available, we developed a 12-bed state-of-the-art SNCU (based on level-II criteria from the National Neonatology Forum, India). We did extensive hands-on training of in-service doctors and nurses, and mobilised resources from the local self-government (panchayat). (excerpt) Language: English Keywords: INDIA | RURAL AREAS | SUMMARY REPORT | NEONATAL MORTALITY | INTERVENTIONS | HEALTH FACILITIES | EQUIPMENT AND SUPPLIES | PROGRAM EFFECTIVENESS | INFANT MORTALITY CHANGES | RURAL HEALTH SERVICES | OBSTACLES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Programs | Organization and Administration | Delivery of Health Care | Health | Program Evaluation | Health Services Document Number: 291116 |
| 15. Title: The Egypt National Perinatal / Neonatal Mortality Study 2000. Author: Campbell O; Gipson R; El Mohandes A; Issa AH; Matta N Source: Journal of Perinatology. 2004 Mar;24(5):284-289. Abstract: The objectives were to estimate stillbirth, perinatal (PMR) and neonatal mortality rates (NMR) in Egypt and to assign main causes of death. Data were collected from a representative sample of women who gave birth from 17,521 households which were included in the Egypt Demographic and Health Survey (EDHS) 2000. Comparisons were made between three systems for classifying causes of death. The NMR was 25 per 1000 live births (17 early and eight late). Half the deaths occurred in the first two days of life. Neonatal causes of death were pre-maturity (39%), asphyxia (18%), infections (7%), congenital malformation (6%) and unclassified (29%). The PMR was 34 per 1000 births, mainly attributed to: asphyxia (44%) and prematurity (21%). The revised Wigglesworth classification agreed well with the physicians except the panel attributed more deaths to infections (20%). The WHO verbal autopsy algorithm left 48% of deaths unclassified. Infant mortality in Egypt is showing an epidemiological transition with a significant decrease in mortality, resulting in a disproportionate percentage of deaths in the first week of life. Infant mortality in Egypt declined 64% from 124 per 1000 between 1974 and 1978 to 44 per 1000 between 1995 and 1999, the decline being greatest among older infants; 55% of all infant deaths occurred during the neonatal period. The neonatal mortality rate in this study was estimated to be 25 per 1000 live births. (author's) Language: English Keywords: EGYPT | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | FETUS | INFANT | NEONATAL MORTALITY | PERINATAL MORTALITY | INFANT MORTALITY CHANGES | MORTALITY DETERMINANTS | Africa, North | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Youth | Age Factors | Population Characteristics | Infant Mortality | Mortality Document Number: 310612 |
| 16. Title: Trends in the modes of delivery and their impact on perinatal mortality rates. Tendência das formas de resolução da gravidez e sua influência sobre as taxas de mortalidade perinatal. Author: Duarte G; Coltro PS; Bedone RV; Nogueira AA; Gelonezzi GM Source: Revista de Saude Publica / Journal of Public Health. 2004;38(3):379-384. Abstract: The objective was to determine changes in the incidence of vaginal deliveries, cesarean sections, and forceps deliveries and their potential association with fetal, early neonatal, and perinatal mortality rates over time. A retrospective study was carried out and the occurrence of deliveries supervised by university services between January 1991 and December 2000 was determined. Data regarding fetal, early neonatal, and perinatal deaths were assessed using obstetric and pediatric records and autopsy reports. Of a total of 33,360 deliveries, the incidence of vaginal deliveries, cesarean sections, and forceps deliveries was relatively steady (around 60, 30, and 10%, respectively) while, at the same time, there was a marked reduction in fetal mortality (from 33.3 to 13.0‰), early neonatal mortality (from 30.6 to 9.0‰), and perinatal mortality (from 56.4 to 19.3‰). The marked reduction in perinatal mortality rates seen during the study period without an increase in cesarean sections indicates that the decrease in perinatal mortality was not impacted by cesarean section rates. The plausible hypothesis seems to be that the reduction in perinatal mortality of deliveries performed under the supervision of university services was more likely to be associated with better neonatal care rather than the mode of delivery. (author's) Spanish Abstract: El objetivo fue determinar los cambios en la incidencia de partos vaginales, cesáreas y partos con fórceps y su posible asociación con las tasas de mortalidad fetal, neonatal temprana y perinatal en el transcurso del tiempo. Se realizó un estudio retrospectivo y se determinó la incidencia de los partos supervisados por unidades universitarias entre enero de 1991 y diciembre de 2000. Se analizaron los datos con respecto a muertes fetales, neonatales tempranas y perinatales utilizando registros obstétricos y pediátricos e informes de autopsias. En el total de 33.360 partos, se registró una incidencia relativamente uniforme de partos vaginales, cesáreas, y partos con fórceps (aproximadamente 60, 30, y 10%, respectivamente) y, al mismo tiempo, una reducción marcada de la mortalidad fetal (de 33,3 a 13,0‰), mortalidad neonatal temprana (de 30,6 a 9,0‰), y mortalidad perinatal (de 56,4 a 19,3‰). La marcada reducción en las tasas de mortalidad perinatal observadas durante el período del estudio sin aumento en las cesáreas indica que las tasas de cesárea no afectaron dicha disminución. La hipótesis probable pareciera ser que la reducción en la mortalidad perinatal de partos realizados bajo la supervisión de unidades universitarias probablemente estuvo más relacionada con una mejor atención neonatal que con la modalidad del parto. (del autor) Language: English Keywords: BRAZIL | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | INFANT | CHILDBIRTH | NEONATAL MORTALITY | FETAL DEATH | CESAREAN SECTION | INFANT MORTALITY CHANGES | OBSTETRICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Infant Mortality | Mortality | Population Dynamics | Obstetrical Surgery | Surgery | Treatment | Medicine | Health Services | Delivery of Health Care | Health Document Number: 283452 |
| 17. Title: The SEARCH Experience: quality reproductive health services in rural India -- India. Author: Garg A Source: Health for the Millions. 2004 Aug-Nov;:87-88. Abstract: Alarmed by high levels of unmet needs for maternal and child health (MCH), discovered during a research on common health problems of women in rural India, Dr. Rani Bang, a gynaecologist and her husband Dr. Abhay Bang a physician, both doctors by profession, with Master of Public Health from John Hopkins University, USA, decided to form the Society for Education, Action and Research in Community Health (SEARCH) organisation to provide community healthcare to the tribes in one of the most backward districts of Maharashtra, Gadchiroli, to address the issue. As the name implies, the aim of SEARCH in words of Rani Bang is to study the health problems of the people in rural areas arid develop appropriate ways to cope with them. Its work on women's health includes four components: 1. Participatory research on women's reproductive health; 2. Participatory mass education on sexual, reproductive, and social issues; 3. Village-based women's health care services; 4. Referral services. (excerpt) Language: English Keywords: INDIA | RURAL AREAS | SUMMARY REPORT | NONGOVERNMENTAL ORGANIZATIONS | COMMUNITY WORKERS | REPRODUCTIVE HEALTH | RURAL HEALTH SERVICES | TRAINING PROGRAMS | HEALTH EDUCATION | INFANT MORTALITY CHANGES | NEONATAL MORTALITY | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Organizations | Political Factors | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Health Services | Education | Infant Mortality | Mortality | Population Dynamics | Demographic Factors Document Number: 280725 |
| 18. Title: Child survival in India: an application of Cox regression model. Author: Nair PM; Suma AV Source: [Unpublished] 2004. Presented at the 26th Annual Conference of the Indian Association for the Study of Population [IASP], Annamalai University, Tamil Nadu, February 9-11, 2004. 15 p. Abstract: Children are the valuable assets of a nation. Their health and prosperity strengthens its social and economic development in future. The children have to be protected and looked after well if the country is to thrive and prosper in all spheres of human activity. WHO (1978) has defined health status as 'a state of complete, physical mental and social well being'. Health status of children depends on many factors including care taken during prenatal and postnatal periods. India is a developing country and has the second largest child population in the World. There is a direct link between population control and child survival, which underlines the need to understand the causes of child mortality and it would help Government to reduce the population size to a certain extent. In India we know that quite seeable sections of its populations suffer from the problem of poverty, inadequate sanitation, malnutrition and lack of education. Thus the development of these children will basically depend on overall development of society (Chandrasekharan, 1972). Mortality is one of the main components of human existence. There are several types of mortality among which infant and child mortality rates reflects a country's level of socio- economic development and quality of life. Mortality levels especially during childhood in developing countries including India substantially remain high despite the development of increasingly sophisticated medical technology to combat disease(Azuh E. Dominic, 1994). U.N. report(1992) reveals the mortality rates for women and children under five years of age accounted for almost one third of the total deaths. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | LIFE TABLE METHOD | STATISTICAL REGRESSION | CHILD SURVIVAL | CHILD MORTALITY | INFANT MORTALITY CHANGES | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | MARRIAGE AGE | BIRTH ORDER | Developing Countries | Asia, Southern | Asia | Health | Demographic Analysis | Research Methodology | Data Analysis | Survivorship | Length of Life | Mortality | Population Dynamics | Population | Infant Mortality | Economic Factors | Marriage Patterns | Marriage | Nuptiality | Family Relationships | Family Characteristics | Family and Household Document Number: 284291 |
| 19. Title: Changes in infant mortality in reunion in the last fifty years. Author: Barbieri M; Catteau C Source: Population-E. 2003;58(2):207-228. Abstract: Excess female child mortality in India varies considerably from one region to another, reaching its highest levels in the north. On the basis of extensive data from the 1992-1993 National Family Health Survey, which includes the birth histories of mothers and information on child health care provision, Perianayagam AROKIASAMY makes a comparative analysis of child mortality in the different regions of the sub-continent. Moving beyond a mere description of the problem, he uses the survey data to explore the dynamics of gender bias in child mortality, focusing on the effects of birth order and lower immunization coverage rates as factors of excess female mortality. (author's) Language: English Keywords: REUNION | FRANCE | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | PREGNANT WOMEN | INFANT MORTALITY CHANGES | MATERNAL-CHILD HEALTH SERVICES | PROGRAM ACCESSIBILITY | SOCIOECONOMIC FACTORS | CAUSES OF DEATH | REPRODUCTIVE BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Economic Factors | Fertility Document Number: 312358 |
| 20. Peer Reviewed Title: Infant mortality in Zambia: socioeconomic and demographic correlates. Author: Madise NJ; Banda EM; Benaya KW Source: Social Biology. 2003 Spring-Summer;50(1-2):148-166. Abstract: Trends in infant mortality in Zambia suggest a reversal of the decline experienced between the 1960s and the late 1970s. From a high of about 140, infant mortality rate declined to about 90 in the late 1970s only to rise again to 100 by 1996. Data on 5,600 births born between 1987 and 1992, and 6,630 births between 1991 and 1996 from the Zambian DHS are analyzed to identify socioeconomic and demographic correlates of infant mortality. Demographic factors such as small size at birth and short birth intervals are associated with higher neonatal mortality. In the post-neonatal period, urban children from poorer households had the highest mortality between 1991-1996. Also, differences in infant mortality rates between provinces narrowed. Children born in the most developed province of Lusaka had as high of risk of dying as those from Luapula, a province with a history of extremely high mortality rates in Zambia. (author's) Language: English Keywords: ZAMBIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | INFANT | INFANT MORTALITY CHANGES | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | LOW BIRTH WEIGHT | BIRTH INTERVALS | SEX FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Population | Youth | Age Factors | Population Characteristics | Infant Mortality | Mortality | Economic Factors | Birth Weight | Body Weight | Physiology | Biology | Fertility Measurements | Fertility Document Number: 283299 |
| 21. Peer Reviewed Title: Ethiopia 2000: results from the Demographic and Health Survey. Author: Population Council; ORC Macro. MEASURE DHS+ Source: Studies in Family Planning. 2002 Dec;33(4):352-356. Abstract: This article presents summary statistics from the 2000 Ethiopia Demographic and Health Survey conducted by the Central Statistical Authority under the aegis of the Ministry of Health, Addis Ababa, Ethiopia, within the framework of the DHS program of ORC Macro. Language: English Keywords: ETHIOPIA | TABLES AND CHARTS | DEMOGRAPHIC AND HEALTH SURVEYS | ADULTS | POPULATION CHARACTERISTICS | FERTILITY DETERMINANTS | FERTILITY PREFERENCES | INFANT MORTALITY CHANGES | CONTRACEPTIVE USAGE DETERMINANTS | MARITAL STATUS | WOMEN'S STATUS | POSTPARTUM WOMEN | HEALTH | NUTRITION INDEXES | STATISTICS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Age Factors | Fertility | Infant Mortality | Mortality | Contraceptive Usage | Contraception | Family Planning | Nuptiality | Socioeconomic Factors | Economic Factors | Puerperium | Reproduction | Nutrition | Research Methodology Document Number: 174587 |
| 22. Title: Development, health and the environment: factors influencing infant and child survival in South Africa. Author: Romani JH; Anderson BA Source: Cape Town, South Africa, Human Sciences Research Council, HSRC Publishers, 2002. 29 p. (Integrated Rural and Regional Development Research Programme, Occasional Paper No. 5) Abstract: A central thesis of this paper is that improvements in infant and child survival are the product of the interplay among programmes developed to reduce infant mortality and morbidity. Moreover, these programmes will also be affected by the particular historical and cultural settings in which such efforts have been undertaken. An additional premise is that changes in infant and child survival are impacted not only by policies focused directly on infant and child health, but also by actions for which the central purpose may only be peripherally related to this end. This thesis is explored through an analysis of the factors influencing infant and child survival among the African and coloured populations in South Africa, and the changes that have taken place in these factors since the end of apartheid. Data for the analysis is from the October Household Surveys conducted by Statistics South Africa for the period 1994–1999. (excerpt) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DATA ANALYSIS | INFANT | CHILD | CHILD SURVIVAL | ENVIRONMENT | DEVELOPMENT POLICY | HEALTH | INFANT MORTALITY CHANGES | SOCIOECONOMIC FACTORS | INEQUALITIES | CHANGES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Policy | Infant Mortality | Economic Factors | Social Change Document Number: 273538 |
| 23. Title: Zinc deficiency, immune function, and morbidity and mortality from infectious disease among children in developing countries. Author: Black RE Source: Food and Nutrition Bulletin. 2001 Jun;22(2):155-162. Abstract: Zinc deficiency is prevalent in developing countries and has adverse effects on child health. Decreased or abnormal immune function in children can occur as a consequence of zinc deficiency, either during gestation or after delivery, and may impair host defenses against infectious diseases. Controlled trials of therapy of acute and persistent diarrhea have consistently demonstrated that zinc-supplemented children have diarrheal episodes of shorter duration and reduced severity. Controlled trials of zinc supplementation in the prevention of infectious diseases have demonstrated reductions in the incidences of diarrhea, pneumonia, and malaria, the most common causes of death in children in developing countries. Preliminary evidence from one controlled trial in full-term small-for-gestational-age infants in India found a two-thirds reduction in mortality with zinc supplementation. In conclusion, zinc deficiency reduces immune function and increases the risk of morbidity and mortality from infectious disease in children in developing countries. (author's) Language: English Keywords: DEVELOPING COUNTRIES | INDIA | BANGLADESH | INDONESIA | PERU | PAKISTAN | VIETNAM | MEXICO | GUATEMALA | PAPUA NEW GUINEA | JAMAICA | LITERATURE REVIEW | INFANT | CHILD | ZINC | FOOD SUPPLEMENTATION | DEFICIENCY DISEASES | MORBIDITY | INFANT MORTALITY CHANGES | DIARRHEA | DIARRHEA, INFANTILE | PNEUMONIA | MALARIA PREVENTION | CHILD MORTALITY | COMMUNICABLE DISEASES | PREVENTION AND CONTROL | CHANGES | ADMINISTRATION AND DOSAGE | Asia, Southern | North America | Asia | Asia, Southeastern | South America, Western | South America | Latin America | Americas | Central America | Oceania | Caribbean | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Nutrition Disorders | Diseases | Infant Mortality | Mortality | Population Dynamics | Pulmonary Effects | Malaria | Parasitic Diseases | Infections | Social Change | Drugs | Treatment Document Number: 180166 |
| 24. Peer Reviewed Title: Factors associated with trends in infant and child mortality in developing countries during the 1990s. Author: Rutstein SO Source: Bulletin of the World Health Organization. 2000;78(10):1256-70. Abstract: The 1990s have seen a remarkable decrease in mortality among infants and children in most developing countries. In some countries, particularly in sub-Saharan Africa, these declines in mortality among children have slowed and now increasing again. Internationally comparable data derived from survey programs, such as the Demographic and Health Survey (DHS) program, are available both to document the changes that have occurred in mortality and to provide insight into some of the factors that may explain these trends in mortality. The factors found in repeated DHS programs that explain these trends fall into five categories: fertility behavior, nutritional status, breast-feeding, and infant feeding; the use of health services by mothers and for children; environmental health conditions; and socioeconomic status. Both simple analyses and multivariate analyses of changes in these factors between surveys indicate that all factors affected the mortality trends. However, to explain trends in mortality, the variables themselves had to have changed over time. During the 1990s fertility behavior, breast-feeding, and infant feeding have changed less than other factors and so would seem to have played a smaller role in mortality trends. This study confirms that trends in mortality during the 1990s were related to more than just a handful of variables. It would, therefore, be a mistake to concentrate policy actions on one or a few of these while forsaking others. Countries with the largest decreases in mortality have had substantial improvements in most of the factors that might be used to explain these changes. In some countries mortality has risen. In part, these increases can be explained by the factors included in this study, such as deterioration in seeking medical care for children with fever. Other factors that were not measured, such as the increasing resistance of malaria to drug treatment and the increased prevalence of parental HIV/AIDS, may be contributing to the increases noted. (author's) Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | INFANT MORTALITY CHANGES | CHILD MORTALITY | RISK FACTORS | SOCIOECONOMIC FACTORS | CHANGES | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Population | Biology | Economic Factors | Social Change Document Number: 153029 |
| 25. Peer Reviewed Title: Reducing deaths from diarrhoea through oral rehydration therapy. Author: Victora CG; Bryce J; Fontaine O; Monasch R Source: Bulletin of the World Health Organization. 2000;78(10):1246-55. Abstract: In 1980, diarrhea was the leading cause of child mortality, accounting for 4.6 million deaths annually. Efforts to control diarrhea over the past decade have been based on multiple, potentially powerful interventions implemented more or less simultaneously. Oral rehydration therapy (ORT) was introduced in 1979 and rapidly became the cornerstone of programs for the control of diarrheal diseases. The authors report on the strategy for controlling diarrhea through case management, with special reference to ORT, and on the relationship between its implementation and reduced mortality. Population-based data on the coverage and quality of facility-based use of ORT are scarce, despite its potential importance in reducing mortality, especially for severe cases. ORT use rates during the 1980s are available for only a few countries. An improvement in the availability of data occurred in the mid-1990s. The study of time trends is hampered by the use of several different definitions of ORT. Nevertheless, the data show positive trends in diarrhea management in most parts of the world. ORT is now given to the majority of children with diarrhea. The annual number of deaths attributable to diarrhea among children aged under 5 years fell from the estimated 4.6 million in 1980 to about 1.5 million today. Case studies in Brazil, Egypt, Mexico, and the Philippines confirm increases in the use of ORT which are concomitant with marked falls in mortality. In some countries, possible alternative explanations for the observed decline in mortality have been fairly confidently ruled out. Experience with ORT can provide useful guidance for child survival programs. With adequate political will and financial support, cost-effective interventions other than that of immunization can be successfully delivered by national programs. Furthermore, there are important lessons for evaluators. The population-based data needed to establish trends in health service delivery, outcomes and impact are not available in respect of diarrhea, as is true for malaria, pneumonia and other major childhood conditions. Standard indicators and measurement methods should be established. Efforts to change existing global indicators should be firmly resisted. Support should be given for the continuing evaluation and documentation activities needed to guide future public health policies and programs. (author's) Language: English Keywords: BRAZIL | MEXICO | EGYPT | PHILIPPINES | CASE STUDIES | MORTALITY DECLINE | INFANT MORTALITY CHANGES | DIARRHEA, INFANTILE | ORAL REHYDRATION | TREATMENT | PREVENTION AND CONTROL | ADMINISTRATION AND DOSAGE | Developing Countries | South America, Eastern | South America | Latin America | Americas | North America | Africa, Northern | Africa | Asia, Southeastern | Asia | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality | Diarrhea | Diseases | Drugs Document Number: 153028 |
| 26. Title: Report on perinatal / neonatal / infant mortality, Muscat, Sultanate of Oman, December 5-19, 1998. Author: Ohlsson A Source: Muscat, Oman, Ministry of Health, 1999. 56 p. Abstract: Objective of the Situation Analysis To develop a strategic plan to reduce perinatal/neonatal mortality/morbidity in the Sultanate of Oman. Methods 1. Review of background documents provided by UNICEF prior to the site visit. In addition references were identified through a literature search using electronic databases (Medline, Embase, Cochrane Library). Additional reference material was obtained on site in the Sultanate of Oman. These documents are referred to in the list of references. 2. A number of experts were consulted for additional information (Contacts - Appendix II) 3. Health facilities in 3 regions were visited (Institutions visited - Appendix III) 4. A number of interactive presentations/focus groups were conducted (Presentations/Focus groups - Appendix IV; Agenda for Focus Group Meeting Dec. 16, 1999 - Appendix V). 5. Perinatal data from Finland were used as a "gold standard" for comparative analyses. 6. Data from Canada were used for information on trends in perinatal vital statistics. 7. Data on 47 stillbirths that occurred in Oman between September to November 1998 were analyzed and summarized. 8. Preliminary findings and recommendations were outlined and presented to the Minister of Health, Senior Ministry Officials and UNICEF Officials on December 19, 1999. 9. This document represents the final report based on review of data, field visits, group discussions and observations. (excerpt) Language: English Keywords: OMAN | LITERATURE REVIEW | RECOMMENDATIONS | RESEARCH REPORT | DATA QUALITY | COMPARATIVE STUDIES | INFANT | MORTALITY DETERMINANTS | INFANT MORTALITY CHANGES | INFANT MORTALITY | NEONATAL MORTALITY | PERINATAL MORTALITY | FETAL DEATH | PREVENTION AND CONTROL | STATISTICS | CHANGES | Developing Countries | Middle East | Data Analysis | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Social Change Document Number: 176322 |
| 27. Title: Fertility and infant mortality trends in Nicaragua 1964-1993. The role of women's education. Author: Pena R; Liljestrand J; Zelaya E; Persson LA Source: JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH. 1999 Mar;53(3):132-7. Abstract: This study assessed trends in infant mortality and fertility in Leon, Nicaragua, and examined the impact of women's education on these trends during 1964-93. Data were obtained from a community-based survey in 1993 among a representative cluster sample of 176,281 women aged 15-44 years from urban and rural areas of Leon. The number of live births amounted to 26,103 infants with 22,899 person-years for infant mortality analysis. Age-adjusted infant mortality incidence ratios were calculated according to Mantel-Haenszel techniques. The total fertility rate (TFR) is calculated as pregnancies/1000 person-years. TFR declined in all age groups, especially in the first half of the 1980s. Adolescent fertility began to decline gradually after 1980. The highest fertility was among women aged 20-29 years, whose fertility steadily declined from the early 1970s. TFR was 3.14 during 1989-93 and 3.51 during 1984-88. TFR of adolescent women adjusted for educational level remained unchanged over the 30-year period. Infant mortality rate (IMR), unadjusted and adjusted, declined from 120/1000 to 50/1000. TFR was 4.15 among women without a formal education (illiterate or without completion of primary school), 2.71 among women who completed primary school, and 2.16 among women who completed secondary school. The IMR declined from 120/1000 to 40/1000 during 1979-85 among the youngest mothers. IMR declined from 80 to 40 among mothers aged 20-29 years. IMR peaked during 1970-71, 1976-77, and 1988-89. TFR declines are mainly attributed to expanded education and IMR declines are due mainly to expanded health and social services. Language: English Keywords: NICARAGUA | RESEARCH REPORT | SURVEYS | URBAN POPULATION | EDUCATIONAL STATUS | FERTILITY DECLINE | INFANT MORTALITY CHANGES | MORTALITY DECLINE | WOMEN | Developing Countries | Central America | Latin America | Americas | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Changes | Fertility | Population Dynamics | Infant Mortality | Mortality Document Number: 140289 |
| 28. Title: Mortality peaks in Italy in the late 19th and early 20th centuries: trends by age and sex. Author: Pinnelli A; Mancini P Source: European Journal of Population. 1999;14(4):333-65. Abstract: This study aims to provide a closer look at mortality peaks following the earthquake in Calabria/Sicily in 1908 and in Marsica in 1915, as well as World War I and the 1918 Spanish flu epidemic. Infant and youth mortality in Italy began to slow down and in some cases grounded to a halt during the first two decades of the century. The Messina and Marsica earthquakes as well as World War I and the Spanish flu epidemic caused unexpected peaks in the mortality rate in the early part of the century. The impact of these events on the mortality rate are analyzed by sex, age, and cause of death. Neither of the earthquakes made any distinction by age and deaths were proportionately divided among the population affected. Mortality in the 5-9 and 10-14 year age ranges had been low, and the deaths provoked by earthquake brought about a steep rise, while in the 0-4 year age range mortality had been high previously. Neither earthquake made any distinction by sex; therefore, the difference in degree of mortality between males and females weakened at every age group. On the other hand, World War I triggered a rise in mortality that was differentiated among age groups. Childhood mortality rose during this time because children suffered from various deprivations, including food shortages, poor hygiene and living conditions, and lack of care. The war definitely altered the difference in degree of mortality between the sexes in that there was a disproportionate rise in mortality among males in the first year. The fourth crisis considered is the Spanish flu epidemic, which caused a rise in mortality that was undifferentiated by age but highly differentiated by sex in that females were more strongly affected by it. Language: English Keywords: ITALY | RESEARCH REPORT | HISTORICAL REVIEW | HISTORICAL DEMOGRAPHY | MORTALITY CHANGES | INFANT MORTALITY CHANGES | DEATH RATE | INFANT | YOUTH | SEX FACTORS | AGE FACTORS | CHANGES | Europe, Southern | Europe | Developed Countries | Demography | Social Sciences | Mortality | Population Dynamics | Demographic Factors | Population | Infant Mortality | Population Characteristics | Social Change Document Number: 143095 |
| 29. Title: [Infant mortality differences in Bolivia] Diferencias de mortalidad infantil dentro de Bolivia. Author: Darras C Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 1998 Dec;4(6):393-7. Abstract: "There was an overall decrease in infant mortality in Bolivia between the national censuses of 1976 and of 1992. That general pattern, however, in fact conceals differences in trends from one department to another, as well as between urban and rural areas. In order to elucidate this situation, in 1996 the reducible differences in mortality were analyzed.... The results show that in four departments of Bolivia...the differences in mortality rates increased.... Similarly, the decline in infant mortality rates in the rural areas has lagged behind the decreases seen in urban areas." (EXCERPT) (SUMMARY IN ENG) Language: Spanish Keywords: BOLIVIA | INFANT MORTALITY CHANGES | MORTALITY DECLINE | COMPARATIVE STUDIES | GEOGRAPHIC FACTORS | DIFFERENTIAL MORTALITY | Developing Countries | South America, Central | South America | Latin America | Americas | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology Document Number: 161651 |
| 30. Title: [Social inequalities and health. Socioeconomic level and infant mortality in Chile in 1985-1995] Desigualdades sociales y salud. Nivel socioeconomico y mortalidad infantil en Chile, 1985-1995. Author: Hollstein RD; Vega J; Carvajal Y Source: REVISTA MEDICA DE CHILE.. 1998 Mar;126(3):333-40. Abstract: Birth and death statistics from Chile s National Institute of Statistics were used to determine the influence of socioeconomic status as measured through maternal educational level on infant mortality from 1990-95 and to assess trends since 1985. The rates of infant, neonatal, and postneonatal mortality were calculated for 6 educational groups for the mother and father: 0, 1-3, 4-6,7-9, 10-12, and 13 or more years. The deaths were classified by cause according to the International Classification of Diseases and to Taucher s classification into avoidable, difficult to avoid, poorly defined, and other causes. A clear association was observed in levels of infant mortality according to maternal education. Infant mortality rates ranged from 38.2/1000 live births for children of illiterate mothers to 7.8/1000 for children of mothers with higher education. A child of an illiterate mother had a risk of death in the first year 4.9 times higher than the child of a mother with higher education. The same trend was observed for neonatal mortality and for paternal education. The mortality gradient by maternal education was maintained for all causes of death and both classifications studied. Diseases of the respiratory system had a relative risk (RR) of 14.3 and a population attributable risk (PAR) of 73%, trauma had an RR of 11.3 and PAR of 69%, and infectious diseases had an RR of 10.8 and PAR of 62%. Infant mortality rates declined between 1985-95 in all maternal educational groups, but the inequalities remained. Spanish Abstract: Se emplearon datos estadísticos de nacimiento y defunción del Instituto Nacional de Estadística de Chile para determinar la influencia que tiene la condición socioeconómica medida por el nivel educacional materno en la mortalidad infantil en 1990-95 y evaluar las tendencias registradas desde 1985. Se calcularon las tasas de mortalidad infantil neonatal y postneonatal respecto a 6 grupos educacionales de la madre y el padre: 0, 1-3, 4-6, 7-9, 10-12 y 13 años o más. Las muertes se clasificaron por causas según la Clasificación Internacional de Enfermedades y la clasificación de Taucher en las siguientes categorías: evitables, difíciles de evitar, mal definidas y otras causas. Se observó una relación evidente entre los niveles de mortalidad infantil y la educación materna. Las tasas de mortalidad infantil oscilaron entre 38,2/1000 nacimientos vivos por respecto a los niños nacidos de madres analfabetas y 7,8/1000 respecto a los niños nacidos de madres con educación superior. El hijo de una mujer analfabeta tenía un riesgo de muerte durante el primer año de vida 4,9 veces superior al riesgo del hijo de una mujer que había recibido educación superior. La misma tendencia se observó respecto a la mortalidad neonatal y la educación paterna. El gradiente de mortalidad por educación materna se mantuvo respecto a todas las causas de muerte y en las dos clasificaciones estudiadas. Las enfermedades del aparato respiratorio tenían un riesgo relativo (RR) de 14,3 y un riesgo atribuible a la población (RAP) de 73%, las lesiones tenían un RR de 11,3 y un RAP de 69% y las infecciones un RR de 10,8 y un RAP de 62%. Las tasas de mortalidad infantil bajaron en 1985-95 en todos los grupos de educación materna, pero las desigualdades no cambiaron. Language: Spanish Keywords: CHILE | RESEARCH REPORT | INFANT MORTALITY CHANGES | DIFFERENTIAL MORTALITY | CAUSES OF DEATH | EDUCATIONAL STATUS | MOTHERS | FATHERS | SOCIOECONOMIC STATUS | South America, Southern | South America | Latin America | Americas | Developing Countries | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Parents | Family Relationships | Family Characteristics | Family and Household Document Number: 141162 |
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