scholarly journals Impact of the ‘Seguro Médico Siglo XXI’ medical insurance programme on neonatal and infant mortality in Mexico, 2006–14: an ecological approach to estimation

2020 ◽  
Vol 35 (5) ◽  
pp. 609-615
Author(s):  
José Urquieta-Salomón ◽  
Héctor Lamadrid-Figueroa ◽  
Gustavo Angeles ◽  
Alejandra Montoya ◽  
Rosalba Rojas-Martínez ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Social Security ◽  
Neonatal Mortality ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Medical Insurance ◽  
Mortality Rates ◽  
Ecological Approach ◽  
Negative Binomial Regression Model ◽  
Insurance Programme

Abstract The ‘Seguro Médico Siglo XXI’ (SMSXXI), a universal coverage medical insurance programme for children under 5 years of age, started in 2006 to help avoid catastrophic health expenditures in poor families without social security in Mexico. The study used information from the National Health Information System for the 2006–14 period. An ecological approach was followed with a panel of the 2457 municipalities of Mexico as the units of analysis. The outcome variables were the municipality-level neonatal mortality and infant mortality rates in population without access to social security. The programme variable was the coverage of the SMSXXI programme at the municipality level, expressed as a proportion. Demographic and economic variables defined at the municipality level were included as covariates. Impact was estimated by fitting a fixed-effects negative binomial regression model. Results reveal that the SMSXXI significantly reduced both infant and neonatSal mortality in the target population, although in a non-linear fashion, with minimum mortality levels found around the 70% coverage range. The effect is mostly given by the transition from the first quintile to the fourth quintile of coverage (<13% vs 70.5–93.7% coverage), and it is attenuated significantly at coverage levels very close to or at 100%. The observed risk reduction amounted to an estimated total of 11 358 infant deaths being avoided due to the SMSXXI during the 2006–14 period, of which 48% were neonatal. In conclusion, we found a significant impact of the SMSXXI programme on both infant mortality and neonatal mortality. An attenuation of the effect of the insurance on mortality rates at levels close to 100% coverage may reflect the saturation of health units in detriment of the quality of care.

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.

scholarly journals Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

2019 ◽  
pp. tobaccocontrol-2019-054923 ◽  
Author(s):  
Thomas Hone ◽  
Andre Salem Szklo ◽  
Filippos T Filippidis ◽  
Anthony A Laverty ◽  
Isabela Sattamini ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Fixed Effects ◽  
Infant Health ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Quasi Experimental ◽  
Fixed Effects Regression

ObjectiveTo examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DesignMonthly longitudinal (panel) ecological study from January 2000 to December 2016.SettingAll Brazilian municipalities (n=5565).ParticipantsInfant populations.InterventionSmoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes.Statistical analysesMunicipal-level linear fixed-effects regression models.Main outcomes measuresInfant and neonatal mortality.ResultsImplementation of partial smoke-free legislation was associated with a −3.3 % (95% CI −6.2% to −0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with −5.2 % (95% CI −8.3% to −2.1%) and −3.4 % (95% CI −6.7% to −0.1%) step reductions in infant and neonatal mortality, respectively, and a −0.36 (95% CI −0.66 to−0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.ConclusionsStrengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes—particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation’s Sustainable Development Goal three.

Is the performance improvement effect of social capital contingent on life cycle stages of professional athletes? Evidence from motorboat racing in Japan

2017 ◽  
Vol 44 (12) ◽  
pp. 2466-2485
Author(s):  
Nobuya Fukugawa
Keyword(s):  
Social Capital ◽  
Life Cycle ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Professional Athletes ◽  
Physical Factors ◽  
Negative Binomial Regression Model ◽  
Content Type ◽  
Bridging Social Capital ◽  
Life Cycle Stages

Purpose The purpose of this paper is to examine whether bonding and bridging social capital of professional athletes affect their performance and whether the impacts vary according to their life cycle stages. Design/methodology/approach This study establishes an unbalanced panel of motorboat racers in Japan, and estimates a fixed-effects negative binomial regression model to analyze determining factors in the number of wins in a final, focusing on not only physical factors but also social capital. Findings Bridging social capital, measured by the number of racers in the same regional division, has no impact on performance. Bonding social capital, measured by the number of racers who graduated the training institute in the same period, has positive impacts on performance. This positive effect is more salient among racers who are less experienced, and thus need to extract benefits from social capital to augment limited internal resources. Originality/value This study adds statistical evidence to previous literature on the contingency theory that different types of social capital have different impacts on performance under different environments.

scholarly journals Trends in Infant Mortality and Stillbirth Rates in Scotland by Socio-Economic Position, 2000-2018: A Longitudinal Ecological Study

2021 ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background:As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of worsening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000-2018, inclusive.Methods:Data for live births, infant deaths, and stillbirths between 2000-2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010.Results:IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000-2018, with no change in trend identified. Stillbirth rates were relatively static between 2000-2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2015 onwards.Conclusion:Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000-2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

scholarly journals Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of widening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000 and 2018, inclusive. Methods Data for live births, infant deaths, and stillbirths between 2000 and 2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010. Results IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000 and 2018, with no change in trend identified. Stillbirth rates were relatively static between 2000 and 2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2016 onwards. Conclusion Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000 and 2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

scholarly journals Impact of federal transfers upon US infant mortality rates: a secondary analysis using a fixed effects regression approach

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021533
Author(s):  
Michael McLaughlin ◽  
Mark R Rank
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Fixed Effects ◽  
State Level ◽  
Well Being ◽  
Mortality Rates ◽  
Postneonatal Mortality ◽  
Per Capita ◽  
Fixed Effects Regression ◽  
The Impact

ObjectivesIn order to improve health outcomes, the federal government allocates hundreds of billions of annual dollars to individual states in order to further the well-being of its citizens. This study examines the impact of such federal intergovernmental transfers on reducing state-level infant mortality rates.SettingAnnual data are collected from all 50 US states between 2004 and 2013.ParticipantsEntire US population under the age of 1 year between 2004 and 2013.Primary and secondary outcome measuresState-level infant mortality rate, neonatal mortality rate and postneonatal mortality rate.ResultsUsing a fixed effects regression model to control for unmeasurable differences between states, the impact of federal transfers on state-level infant mortality rates is estimated. After controlling for differences across states, increases in per capita federal transfers are significantly associated with lower infant, neonatal and postneonatal mortality rates. Holding all other variables constant, a $200 increase in the amount of federal transfers per capita would save one child’s life for every 10 000 live births.ConclusionsConsiderable debate exists regarding the role of federal transfers in improving the well-being of children and families. These findings indicate that increases in federal transfers are strongly associated with reductions in infant mortality rates. Such benefits should be carefully considered when state officials are deciding whether to accept or reject federal funds.

Heterogeneous impact of CO2 emissions on renewable energy technology innovation between oil importers and exporters

2020 ◽  
pp. 0958305X2092893
Author(s):  
Bai Liu ◽  
Yutian Liu ◽  
Ailian Zhang
Keyword(s):  
Renewable Energy ◽  
Solar Energy ◽  
Fixed Effects ◽  
Negative Binomial ◽  
Technology Innovation ◽  
Empirical Test ◽  
Negative Binomial Regression Model ◽  
Energy Technology ◽  
Renewable Energy Technology ◽  
The Impact

With the depletion of fossil energy and the rise of global temperature, it is urgent to use renewable energy to solve environmental problems. By studying the heterogeneous relationship between CO2 emissions and renewable energy technology innovation in different countries, we can find out the gap and something helpful to energy development. In the empirical test, we use the negative binomial regression model with fixed effects to study the impact of CO2 emissions on renewable energy technology innovation from 1997 to 2016. The research shows that impact is positive in oil-importing countries, but this relationship is not established in oil-exporting countries. In both oil importers and oil exporters, CO2 emissions have a positive effect on the solar energy technological innovation, however, the influence on the technology innovation of solar energy in oil exporters is more significant than that of renewable energy. Whether for oil importers or oil exporters, it can be more reasonable and effective to develop renewable energy by clarifying the impact of CO2 emissions on domestic renewable energy technology innovation.

scholarly journals Infant mortality rates according to socioeconomic status in a Brazilian city

2001 ◽  
Vol 35 (3) ◽  
pp. 256-261 ◽  
Author(s):  
Marcelo Zubaran Goldani ◽  
Marco Antonio Barbieri ◽  
Heloisa Bettiol ◽  
Marisa Ramos Barbieri ◽  
Andrew Tomkins
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Social Inequality ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
Neonatal Mortality Rate ◽  
Chi Square ◽  
The Poor ◽  
Poor Area

OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381) and infant deaths (total of 731) that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05). These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head), in particular the post-neonatal mortality rate (chi-square for trend, p<0.05). Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

scholarly journals Effect of home-based newborn care on neonatal and infant mortality: a cluster randomised trial in India

2020 ◽  
Vol 5 (9) ◽  
pp. e000680
Author(s):  
Reeta Rasaily ◽  
NC Saxena ◽  
Sushma Pandey ◽  
Bishan S Garg ◽  
Saraswati Swain ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Neonatal Mortality ◽  
Young Infant ◽  
Randomised Trial ◽  
Newborn Care ◽  
Mortality Rates ◽  
Cluster Randomised Trial ◽  
Home Based ◽  
Home Based Care ◽  
Facility Births

BackgroundHome-based newborn care has been found to reduce neonatal mortality in rural areas. Study evaluated effectiveness of home-based care delivered by specially recruited newborn care workers- Shishu Rakshak (SR) and existing workers- anganwadi workers (AWW) in reducing neonatal and infant mortality rates.MethodsThis three-arm, community-based, cluster randomised trial was conducted in five districts in India. Intervention package consisted of pregnancy surveillance, health education, care at birth, care of normal/low birthweight neonates, identification and treatment of sick neonates and young infants using oral and injectable antibiotics and community mobilisation. The package was similar in both intervention arms—SR and AWW; difference being healthcare provider. The control arm received routine health services from the existing health system. Primary outcomes were neonatal and young infant mortality rates at ‘endline’ period (2008–2009) assessed by an independent team from January to April 2010 in the study clusters.FindingsA total of 6623, 6852 and 5898 births occurred in the SR, AWW and control arms, respectively, during the endline period; the proportion of facility births were 69.0%, 64.4% and 70.6% in the three arms. Baseline mortality rates were comparable in three arms. During the endline period, the risk of neonatal mortality was 25% lower in the SR arm (adjusted OR 0.75, 95% CI 0.57 to 0.99); the risks of early neonatal mortality, young infant mortality and infant mortality were also lower by 32%, 27%, and 33%, respectively. The risks of neonatal, early neonatal, young infant, infant mortality in the AWW arm were not different from that of the control arm.InterpretationHome-based care is effective in reducing neonatal and infant mortality rates, when delivered by a dedicated worker, even in settings with high rates of facility births.Trial registration numberThe study was registered with Clinical Trial Registry of India (CTRI/2011/12/002181).

State-Level Infant, Neonatal, and Postneonatal Mortality: The Contribution of Selected Structural Socioeconomic Variables

1998 ◽  
Vol 28 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Sheryl Thorburn Bird ◽  
Karl E. Bauman
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Neonatal Mortality ◽  
State Level ◽  
The United States ◽  
Mortality Rates ◽  
Structural Factors ◽  
Postneonatal Mortality ◽  
Structural Variables ◽  
Black Populations

Reducing infant mortality in the United States is a national priority. States' infant mortality rates vary substantially. Public health researchers, practitioners, and leaders have long argued that social and other structural factors must be addressed if health outcomes are to be improved. A knowledge of which structural variables are most strongly related to state-level infant mortality is needed to guide the development of policies and programs to reduce this mortality. The authors examine the importance of several structural (social, economic, and political) variables for state-level infant, neonatal, and postneonatal mortality. With the state as the unit of analysis, data for all 50 states were analyzed using multiple regression. Together, the structural variables accounted for two-thirds of the variance in infant and neonatal mortality rates and over half of the variance in postneonatal mortality rates. States with proportionately larger black populations had higher infant, neonatal, and postneonatal mortality rates. States with greater percentages of high school graduates had lower neonatal mortality rates but higher postneonatal mortality rates. The findings suggest that a better understanding of the relationship between states' social structure and infant health outcomes is needed if state-level infant mortality is to be reduced.

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