NEONATAL MORTALITY IN THE EMPOWERED ACTION GROUP STATES OF INDIA: TRENDS AND DETERMINANTS

2008 ◽  
Vol 40 (2) ◽  
pp. 183-201 ◽  
Author(s):  
PERIANAYAGAM AROKIASAMY ◽  
ABHISHEK GAUTAM
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Universal Coverage ◽  
Mortality Rates ◽  
Mortality Data ◽  
Registration System ◽  
Action Group ◽  
Eag States ◽  
The Impact

SummaryIn 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 (NFHS-2, 1998–99) 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.

HOME VISITS DURING THE FIRST MONTH OF DELIVERY FOR RECENTLY DELIVERED WOMEN IN UTTAR PRADESH, INDIA

2020 ◽  
Vol 6 (5) ◽  
pp. 1183-1189
Author(s):  
Dr. Tridibesh Tripathy ◽  
Dr. Umakant Prusty ◽  
Dr. Chintamani Nayak ◽  
Dr. Rakesh Dwivedi ◽  
Dr. Mohini Gautam
Keyword(s):  
Large Scale ◽  
National Level ◽  
Uttar Pradesh ◽  
Life Time ◽  
Structured Interview ◽  
The Other ◽  
Registration System ◽  
Action Group ◽  
Current Article ◽  
The Impact

The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual responses of Recently Delivered Women (RDW) on their visits during the first month of their recent delivery. From the catchment area of each of the 250 ASHAs, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The response profiles of the RDWs on the post- delivery first month visits are dwelled upon to evolve a picture representing the entire state of UP. The relevance of the study assumes significance as detailed data on the modalities of postnatal visits are available but not exclusively for the first month period of their recent delivery. The details of the post-delivery first month period related visits are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these visits with a five-point approach i.e. type of personnel doing the visit, frequency of the visits, visits done in a particular week from among those four weeks separately for the three visits separately. The current study is basically regarding the summary of this Penta approach for the post- delivery one-month period.     The first month period after each delivery deals with 70% of the time of the postnatal period & the entire neonatal period. Therefore, it does impact the Maternal Mortality Rate & Ratio (MMR) & the Neonatal Mortality Rates (NMR) in India and especially in UP through the unsafe Maternal & Neonatal practices in the first month period after delivery. The current MM Rate of UP is 20.1 & MM Ratio is 216 whereas the MM ratio is 122 in India (SRS, 2019). The Sample Registration System (SRS) report also mentions that the Life Time Risk (LTR) of a woman in pregnancy is 0.7% which is the highest in the nation (SRS, 2019). This means it is very risky to give birth in UP in comparison to other regions in the country (SRS, 2019). This risk is at the peak in the first month period after each delivery. Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME,2018). As NMR data is not available separately for states, the national level data also hold good for the states and that’s how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely visits to RDWs especially in the first month period after delivery. This would help in making their post-natal & neonatal stage safe. This is the area of post-delivery first month visit profile detailing that the current article helps in popping out in relation to the recent delivery of the respondents.   A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions.  The current article deals with five close ended questions with options, two for the type of personnel & frequency while the other three are for each of the three visits in the first month after the recent delivery of respondents. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study.   Among the districts related to this article, the results showed that ASHA was the type of personnel who did the majority of visits in all the four districts. On the other hand, 25-40% of RDWs in all the 4 districts replied that they did not receive any visit within the first month of their recent delivery. Regarding frequency, most of the RDWs in all the 4 districts received 1-2 times visits by ASHAs.   Regarding the first visit, it was found that the ASHAs of Barabanki and Gonda visited less percentage of RDWs in the first week after delivery. Similarly, the second visit revealed that about 1.2% RDWs in Banda district could not recall about the visit. Further on the second visit, the RDWs responded that most of them in 3 districts except Gonda district did receive the second postnatal visit in 7-15 days after their recent delivery. Less than half of RDWs in Barabanki district & just more than half of RDWs in Gonda district received the third visit in 15-21 days period after delivery. For the same period, the majority of RDWs in the rest two districts responded that they had been entertained through a home visit.

scholarly journals Determinants of neonatal, postneonatal and maternal mortality on models of primary health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Public Policies ◽  
Family Health ◽  
Mortality Rates ◽  
Sao Paulo ◽  
The State ◽  
Care Organization ◽  
São Paulo

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

scholarly journals Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century

2010 ◽  
Vol 28 (15) ◽  
pp. 2625-2634 ◽  
Author(s):  
Malcolm A. Smith ◽  
Nita L. Seibel ◽  
Sean F. Altekruse ◽  
Lynn A.G. Ries ◽  
Danielle L. Melbert ◽  
...  
Keyword(s):  
United States ◽  
Childhood Cancer ◽  
Cancer Mortality ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Childhood Cancers ◽  
Essential Information ◽  
The Impact

Purpose This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Methods Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. Results Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. Conclusion When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

Ethics and Efficiency in the Provision of Health Care

1988 ◽  
Vol 23 ◽  
pp. 111-126 ◽  
Author(s):  
Alan Williams
Keyword(s):  
Health Care ◽  
Driving Force ◽  
Mortality Rates ◽  
Equal Access ◽  
Demographic Structure ◽  
Major Purpose ◽  
Relative Mortality ◽  
Distribution Rule ◽  
The Uk ◽  
The Impact

1.1. A major purpose in nationalizing the provision of health care in the UK was to affect its distribution between people, and, in particular, to minimize the impact of willingness and ability to pay upon that distribution. It has never been clear, however, what alternative distribution rule is to apply. There is no shortage of rhetoric about ‘equality’ and ‘need’, but most of it is vacuous, by which I mean it does not lead to any clear operational guidelines about who should get priority and at whose expense. The closest we have got so far to such explicit guidelines has been the formulae which determine the geographical distribution of NHS funds, the driving force behind which is a notion of need based on relative mortality rates and on the demographic structure. The avowed objective is to bring about equal access for equal need irrespective of where in the UK you happen to be.

scholarly journals Intervention Time Series Modeling of Infant Mortality: Impact of Free Maternal Health Care

2020 ◽  
pp. 38-47
Author(s):  
J. Kisabuli ◽  
J. Ong'ala ◽  
E. Odero
Keyword(s):  
Health Care ◽  
Time Series ◽  
Maternal Health ◽  
Infant Mortality ◽  
Moving Average ◽  
Maternal Health Care ◽  
The Sustainable Development ◽  
Infant Deaths ◽  
Moving Average Model ◽  
The Impact

Infant mortality is an important marker of the overall society health. The 3rd goal of the Sustainable Development Goals aims at reducing infant deaths that occur due to preventable causes by 2030. Due to increased infant mortality the Kenyan government introduced Free Maternal Health Care as an intervention towards reducing infant mortality through elimination of the cost burden of accessing medical care by the mother and the infant. The study examines the impact of Free Maternal Health Care on infant mortality using Intervention time series analysis particularly the intervention Box Jenkins ARIMA (Autoregressive Integrated Moving Average) model. There was significant support that Free Maternal Health Care had a significant impact on infant mortality which was estimated to be a decrease of 10.15% in infant deaths per month.

scholarly journals Births to Teens Older and Younger Than 17 Years in San Bernardino County and California

2004 ◽  
Vol 2 (2) ◽  
pp. 20-27
Author(s):  
Kofi Adade Boafo ◽  
Bruce Smith ◽  
Naomi N Modeste ◽  
Thomas J Prendergast, Jr
Keyword(s):  
Infant Mortality ◽  
Very Low Birth Weight ◽  
Age Groups ◽  
Mortality Rates ◽  
Teen Mothers ◽  
Mortality Data ◽  
San Bernardino County ◽  
Low Birth Weight Infants ◽  
Data Set ◽  
San Bernardino

Objective: The purpose of this cohort, descriptive study was to attempt to understand the variables associated with discordant infant mortality among teenagers 17-19 years old whose infants demonstrated higher mortality than infants of teenagers who were younger than 17 years old in San Bernardino County, California. The intent was to elicit further research and/or define appropriate interventions for teen mothers within the age range 17-19 years. Methods: Data was abstracted from an electronic infant mortality data set, the State of California Birth Cohort File in which birth records from San Bernardino County for the period 1989 through 1993 were matched with mortality records. Results: The data showed that infants of white teens within the 17-19 age groups were more likely to have higher infant mortality rates when compared to their younger peers. Infant mortality rates among offspring of Hispanic and black teenage mothers showed no discrepancy between the two groups nor between county and state rates. Conclusions: Further study is needed to answer why infants of white teen mothers in the 17-19 age groups have higher mortality rates. There is also a need to review the services rendered to pregnant and parenting adolescents in San Bernardino County. In addition, very low birth weight infants were much more likely to die when born to older teens than when born to younger teens.

scholarly journals Effects of Randomized Corruption Audits on Early-Life Mortality in Brazil

2020 ◽  
Author(s):  
Antonio Pedro Ramos ◽  
Robert Weiss ◽  
Simeon Nietcher ◽  
Leiwen Gao
Keyword(s):  
Health Disparities ◽  
Infant Mortality ◽  
Health Outcomes ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Early Life ◽  
Causal Effect ◽  
Preterm Births ◽  
The Impact ◽  
Improve Health

Background: Various studies suggest that corruption affects public health systems across the world. However, the extant literature lacks causal evidence about whether anti-corruption interventions can improve health outcomes. We examine the impact of randomized anti-corruption audits on early-life mortality in Brazil. Methods: The Brazilian government conducted audits in 1,949 randomly selected municipalities between 2003 and 2015. To identify the causal effect of anti-corruption audits on early-life mortality, we analyse data on health outcomes from individual- level vital statistics (DATASUS) collected by Brazil government before and after the random audits. Data on the audit intervention are from the Controladoria-Geral da Uniao, the government agency responsible for the anti-corruption audits. Outcomes are neonatal mortality, infant mortality, child mortality, preterm births, and prenatal visits. Analyses examine aggregate effects for each outcome, as well as effects by race, cause of death, and years since the intervention. Results: Anti-corruption audits significantly decreased early-life mortality in Brazil. Expressed in relative terms, audits reduced neonatal mortality by 6.7% (95% CI -8.3%, -5.0%), reduced infant mortality by 7.3% (-8.6%, -5.9%), and reduced child mortality by 7.3% (-8.5%, -6.0%). This reduction in early mortality was higher for nonwhite Brazilians, who face significant health disparities. Effects are greater when we look at deaths from preventable causes, and show temporal persistence with large effects even a decade after audits. In addition, analyses show that the intervention led to a 12.1% (-13.4%, -10.6%) reduction in women receiving no prenatal care, as well as a 7.4% (-9.4%, -5.5%) reduction in preterm births; these effects are likewise higher for nonwhites and are persistent over time. All effects are robust to various alternative specifications. Interpretation: Governments have the potential to improve health outcomes through anti-corruption interventions. Such interventions can reduce early-life mortality and mitigate health disparities. The impact of anti-corruption audits should be investigated in other countries, and further research should further explore the mechanisms by which combating corruption affects the health sector.

IMPROVED INFANT MORTALITY RATES IN A POPULATION SERVED BY A COMPREHENSIVE NEIGHBORHOOD HEALTH PROGRAM

PEDIATRICS ◽  
1971 ◽  
Vol 47 (6) ◽  
pp. 989-994 ◽  
Author(s):  
André Chabot
Keyword(s):  
Infant Mortality ◽  
Low Income ◽  
Health Program ◽  
Mortality Rates ◽  
Federal Grants ◽  
Census Tracts ◽  
Live Births ◽  
Department Of Health ◽  
Community Health Program ◽  
The Impact

The Denver Department of Health and Hospitals developed from multiple federal grants (M and I, C and Y, OEO, PHS, and Family Planning) a comprehensive community health program for the low income population of Denver. To measure the impact of this program, infant mortality rates were reviewed in the low income and nonwhite populations. Infant mortality in 25 selected low income census tracts in Denver was 34.2 per thousand live births in 1964. This decreased to 24.5 by 1968. Infant mortality of nonwhites in Denver was 41.9 in 1964 and decreased to 25.2 by 1968. This decrease in infant mortality rates in both of these populations compares very favorably with such data from other cities.

scholarly journals Mortality data reliability in an internal model

2020 ◽  
Vol 14 (2) ◽  
pp. 420-444
Author(s):  
Fabrice Balland ◽  
Alexandre Boumezoued ◽  
Laurent Devineau ◽  
Marine Habart ◽  
Tom Popa
Keyword(s):  
Data Quality ◽  
Internal Model ◽  
Mortality Rates ◽  
Solvency Ii ◽  
West Germany ◽  
Mortality Data ◽  
Longevity Risk ◽  
Capital Requirement ◽  
Stochastic Mortality ◽  
The Impact

AbstractIn this paper, we discuss the impact of some mortality data anomalies on an internal model capturing longevity risk in the Solvency 2 framework. In particular, we are concerned with abnormal cohort effects such as those for generations 1919 and 1920, for which the period tables provided by the Human Mortality Database show particularly low and high mortality rates, respectively. To provide corrected tables for the three countries of interest here (France, Italy and West Germany), we use the approach developed by Boumezoued for countries for which the method applies (France and Italy) and provide an extension of the method for West Germany as monthly fertility histories are not sufficient to cover the generations of interest. These mortality tables are crucial inputs to stochastic mortality models forecasting future scenarios, from which the extreme 0.5% longevity improvement can be extracted, allowing for the calculation of the solvency capital requirement. More precisely, to assess the impact of such anomalies in the Solvency II framework, we use a simplified internal model based on three usual stochastic models to project mortality rates in the future combined with a closure table methodology for older ages. Correcting this bias obviously improves the data quality of the mortality inputs, which is of paramount importance today, and slightly decreases the capital requirement. Overall, the longevity risk assessment remains stable, as well as the selection of the stochastic mortality model. As a collateral gain of this data quality improvement, the more regular estimated parameters allow for new insights and a refined assessment regarding longevity risk.

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