scholarly journals Neonatal mortality and child health in a remote rural area in Nepal: a mixed methods study

2019 ◽  
Vol 3 (1) ◽  
pp. e000519
Author(s):  
Bindu Kumari Karki ◽  
Guenter Kittel
Keyword(s):  
Mixed Methods ◽  
Mortality Rate ◽  
Health Services ◽  
Neonatal Mortality ◽  
Rural Area ◽  
Acute Lower Respiratory Infection ◽  
Cultural Perceptions ◽  
Live Births ◽  
Under Five ◽  
Remote Rural Area

ObjectiveTo assess neonatal and under-five mortality and the health situation for children in Dolpa, a remote rural area of Nepal.Study designMixed methods: quantitative (retrospective cross sectional) and qualitative (semistructured interviews).RationaleProgress in reducing child and newborn mortality in Nepal has reached the remote areas to a limited extent. Furthermore, there may be substantial under-reporting and data may be unreliable.Setting and participantsThe population of Dolpa district is approximately 35 000. We visited 10 randomly selected villages (plus one settlement) with approximately 12 000 inhabitants.MethodologyRecords of the number of deliveries, neonatal and under-five deaths were collected. 100 children (10 different villages) were evaluated for common diseases present during the month prior to the investigation. 20 interviews were conducted about the cultural perceptions of neonatal death and morbidity; in each village at least one interview was undertaken.ResultsThe population of the 10 villages (plus one settlement) under investigation was 12 287. 300 deliveries have taken place during the last 12 months before the study. There were 30 children reported to have died; out of those 20 were in the neonatal period. This reflects an estimated neonatal mortality rate in Dolpa district of 67/1000 live births (95% CI 41-101/1000) and an estimated under-five mortality rate of 100/1000 (95% CI 70-140/1000). In the previous month, out of 100 children surveyed there had been 11 cases of acute lower respiratory infection (ALRI), 7 cases of diarrhoea, 3 cases of isolated malnutrition and 5 cases of malnutrition combined with ALRI or diarrhoea.Based on qualitative interviews traditional beliefs still play a major role, and are partly a hindrance to progress in health. There is also mistrust in the health services and misconceptions about ‘modern’ medicine and treatment facilities.ConclusionDespite progress in child morbidity and mortality in Nepal, some areas remain underserved by health services and neonatal mortality is far above the Nepalese average, which is 29/1000 live births. There is a substantial need to increase and train health staff. Health promotion should be encouraged but cultural perceptions have to be understood if positive behavioural change is to be achieved.

scholarly journals The Trend of Children Mortality Rates in Indonesia

2020 ◽  
Vol 11 (01) ◽  
pp. 52-62
Author(s):  
Sani Rachman Soleman
Keyword(s):  
Mortality Rate ◽  
Health Services ◽  
Neonatal Mortality ◽  
Premature Birth ◽  
Mortality Rates ◽  
World Health ◽  
Neonatal Mortality Rate ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children

Children mortality rates describe the health services’ quality as indicators of each countries’ welfare, particularly in Indonesia. Several factors were determined as the main contributors of mortality, such as neonatal factors, maternal, environment and health services. The important of this research is to give recommendation to the government of Indonesia to propose some policies in handling of the increasing children mortality and modifying underlying disease as contributor mortality among children in Indonesia. The design of this study is cross sectional. The data was taken from World Health Organization Maternal Child Epidemiology Estimation from 2000 to 2017. There were three main categories : neonatal mortality rate (NND), post neonatal mortality rate (PND) and under five mortality rate (UFIVE). The leading causes of mortality were searched according to those categories and followed by descriptive analysis by line graphs. According to the data that had been found, there was declining on  NND (102.700 to 60.986), PND (138.553 to 63.471), UFIVE (241.253 to 124.457). The children mortality tend to decline at the range of 17 years, meanwhile the highest mortality among the three of groups are : premature birth in neonates, ARI in post neonates and premature birth in under five children.  In conclusion, the trend of three parameters of children mortality declined within 17 years. On several cases, there were outbreak of injury on 2004 and fluctuation of measles incident among infant and under five children. Premature birth and ARI have the highest prevalence among children in Indonesia.

scholarly journals Infant mortality: comparison between two birth cohorts from Southeast and Northeast, Brazil

2004 ◽  
Vol 38 (6) ◽  
pp. 773-779 ◽  
Author(s):  
Valdinar S Ribeiro ◽  
Antônio A M Silva ◽  
Marco A Barbieri ◽  
Heloisa Bettiol ◽  
Vânia M F Aragão ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Protective Factor ◽  
Infant Mortality Rate ◽  
Northeast Brazil ◽  
Birth Cohorts ◽  
Neonatal Mortality Rate ◽  
Live Births

OBJECTIVE: To obtain population estimates and profile risk factors for infant mortality in two birth cohorts and compare them among cities of different regions in Brazil. METHODS: In Ribeirão Preto, southeast Brazil, infant mortality was determined in a third of hospital live births (2,846 singleton deliveries) in 1994. In São Luís, northeast Brazil, data were obtained using systematic sampling of births stratified by maternity unit (2,443 singleton deliveries) in 1997-1998. Mothers answered standardized questionnaires shortly after delivery and information on infant deaths was retrieved from hospitals, registries and the States Health Secretarys' Office. The relative risk (RR) was estimated by Poisson regression. RESULTS: In São Luís, the infant mortality rate was 26.6/1,000 live births, the neonatal mortality rate was 18.4/1,000 and the post-neonatal mortality rate was 8.2/1,000, all higher than those observed in Ribeirão Preto (16.9, 10.9 and 6.0 per 1,000, respectively). Adjusted analysis revealed that previous stillbirths (RR=3.67 vs 4.13) and maternal age <18 years (RR=2.62 vs 2.59) were risk factors for infant mortality in the two cities. Inadequate prenatal care (RR=2.00) and male sex (RR=1.79) were risk factors in São Luís only, and a dwelling with 5 or more residents was a protective factor (RR=0.53). In Ribeirão Preto, maternal smoking was associated with infant mortality (RR=2.64). CONCLUSIONS: In addition to socioeconomic inequalities, differences in access to and quality of medical care between cities had an impact on infant mortality rates.

Retrospective analysis of neonatal deaths secondary to infections in England and Wales, 2013–2015

2020 ◽  
pp. fetalneonatal-2020-319093
Author(s):  
Godwin Oligbu ◽  
Leila Ahmed ◽  
Laura Ferraras-Antolin ◽  
Shamez Ladhani
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Neonatal Mortality ◽  
Mortality Rates ◽  
Neonatal Mortality Rate ◽  
England And Wales ◽  
Neonatal Deaths ◽  
Live Births ◽  
Extremely Preterm ◽  
Related Mortality

ObjectiveTo estimate the overall and infection-related neonatal mortality rate and the pathogens responsible using electronic death registrations.DesignRetrospective analysis of national electronic death registrations data.SettingEngland and Wales.PatientsNeonates aged <28 days.Main outcome measuresOverall and infection-related mortality rate per 1000 live births in term, preterm (28–36 weeks) and extremely preterm (<28 weeks) neonates; the contribution of infections and specific pathogens; comparison with mortality rates in 2003–2005.ResultsThe neonatal mortality rate during 2013–2015 (2.4/1000 live births; 5095 deaths) was 31% lower than in 2003–2005 (3.5/1000; 6700 deaths). Infection-related neonatal mortality rate in 2013–2015 (0.32/1000; n=669) was 20% lower compared with 2003–2015 (0.40/1000; n=768), respectively. Infections were responsible for 13.1% (669/5095) of neonatal deaths during 2013–2015 and 11.5% (768/6700) during 2003–2005. Of the infection-related deaths, 44.2% (296/669) were in term, 19.9% (133/669) preterm and 35.9% (240/669) extremely preterm neonates. Compared with term infants (0.15/1000 live births), infection-related mortality rate was 5.9-fold (95% CI 4.7 to 7.2) higher in preterm (0.90/1000) and 188-fold (95% CI 157 to 223) higher in extremely preterm infants (28.7/1000) during 2013–2015. A pathogen was recorded in 448 (67%) registrations: 400 (89.3%) were bacterial, 37 (8.3%) viral and 11 (2.4%) fungal. Group B streptococcus (GBS) was reported in 30.4% (49/161) of records that specified a bacterial infection and 7.3% (49/669) of infection-related deaths.ConclusionsOverall and infection-related neonatal mortality rates have declined, but the contribution of infection and of specific pathogens has not changed. Further preventive measures, including antenatal GBS vaccine may be required to prevent the single most common cause of infection-related deaths in neonates.

scholarly journals Neonatal mortality and leading causes of deaths: a descriptive study in China, 2014–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042654
Author(s):  
Yuxi Liu ◽  
Leni Kang ◽  
Chunhua He ◽  
Lei Miao ◽  
Xiaoqiong Qiu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Middle Income ◽  
Government Interventions ◽  
Neonatal Deaths ◽  
Live Births ◽  
Urban And Rural Areas

ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.

scholarly journals Akses Remaja dengan Komplikasi Kehamilan terhadap Pelayanan Persalinan dan Kelangsungan Hidup Anak di Indonesia

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Tin Afifah ◽  
Novianti Novianti ◽  
Suparmi Suparmi ◽  
Kemal Nazaruddin Siregar ◽  
Nurillah Amaliah ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Adolescent Pregnancy ◽  
Neonatal Mortality ◽  
Pregnancy Complications ◽  
Death Rate ◽  
Health Facilities ◽  
Childhood Mortality ◽  
Pregnant Adolescents ◽  
Live Births ◽  
Under Five

Abstract Age-Specific Death Rate (ASDR) cases of maternal death are highest in the adolescent group (<20 years). Adolescent pregnancy is a risky pregnancy, so it is necessary to deliver at health facilities.   A complication of pregnancy in adolescents is also at risk of childhood mortality. The study aims to assess the access of pregnant adolescents with complications to delivery facilities and the relation with the survival of the child. This study is a secondary data analysis of the 2017 Indonesia Demographic and Health Survey (IDHS). The unit of analysis of live births five years preceding survey, and mother's age birth before 35 years (14,634 live births). There are 2 dependent variables: access to delivery services (skill birth attendant and health facilities); and survival of the child (neonatal, infant and under-five mortality). Interest variables is multiple high-risk category, a combination of morbidity status (complications during pregnancy) and age adolescents (<20 years) compared adults (20-34 years). Covariate variables are parity and characteristics (mother’s education, residence and wealth index). Statistical test with logistic regression, 95%CI. All pregnancies with complications were significant association with neonatal and infant mortality. Specifically adolescent pregnancy with complications is also significantly associated with under-five mortality. In adolescents with pregnancy complications had OR neonatal mortality=7.4, OR infant mortality=4.56 and OR infant mortality=3.73, compared with adults pregnant without complication. Pregnancies ages 20-34 with complications having neonatal OR=1.95 and OR infant mortality=1.64. Pregnant adolescents are significantly associated with facilities of delivery (OR<1). The conclusions are: the access of adolescents with pregnancy complications to childbirth at the health facility is still low; adolescent pregnancy with complications is significantly related to childhood mortality and the highest risk of neonatal mortality. ABSTRAK  Age Spesific Death Rate (ASDR) kasus kematian maternal tertinggi pada kelompok remaja (<20 tahun). Kehamilan pada usia remaja merupakan kehamilan berrisiko, sehingga mereka perlu akses ke fasilitas persalinan yang aman. Kehamilan dengan komplikasi pada remaja juga berisiko terhadap kematian anaknya. Tujuan studi untuk menilai akses remaja yang hamil dengan komplikasi terhadap pelayanan persalinan dan mengetahui status kelangsungan hidup anaknya. Studi ini merupakan analisis data sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) 2017. Unit analisis adalah kelahiran hidup periode lima tahun sebelum survey dan saat dilahirkan usia ibu belum mencapai 35 tahun (14.634 kelahiran hidup). Variabel dependen yang diteliti ada 2: akses ke pelayanan persalinan (tenaga kesehatan dan fasilitas pelayanan kesehatan); dan kelangsungan hidup anak (kematian: neonatal, bayi, dan balita). Variabel interes adalah status ganda yaitu kombinasi status komplikasi kehamilan dan umur risiko remaja dibandingkan umur tidak berisiko (20-34 tahun). Variabel kovariat: paritas dan karakteristik (pendidikan, tempat tinggal dan indeks kekayaan). Uji statistik dengan regresi logistik, 95%CI. Semua kehamilan dengan komplikasi berhubungan signifikan dengan kematian neonatal dan bayi bila dibandingkan dengan kehamilan usia 20-34 tanpa komplikasi. Khusus kehamilan remaja dengan komplikasi juga berhubungan signifikan dengan kematian balita. Pada remaja dengan komplikasi kehamilan mempunyai OR kematian neonatal=7,4, OR kematian bayi=4,56 dan OR kematian balita=3,73. Kehamilan usia 20-34 dengan komplikasi mempunyai OR neonatal=1,95 dan OR kematian bayi=1,64. Remaja hamil berhubungan signifikan dengan persalinan di fasyankes (OR<1). Kesimpulan studi ini adalah akses remaja dengan kehamilan komplikasi terhadap persalinan di fasyankes masih rendah. Kehamilan remaja dengan komplikasi berhubungan signifikan dengan kematian anak, dan risiko paling tinggi terhadap kematian neonatus.   

scholarly journals PEREMPUAN DAN KESEHATAN REPRODUKSI

EGALITA ◽  
2012 ◽  
Author(s):  
Imamah Imamah
Keyword(s):  
Mortality Rate ◽  
Health Services ◽  
Maternal Mortality ◽  
Human Development ◽  
Access To Information ◽  
Live Births ◽  
Human Development Report ◽  
Mothers And Children ◽  
Mother And Child ◽  
The Government

In terms of Indonesian women’s health services are still treated unfairly and still are the number two. It can be seen from the report reporting Indonesia Human  Development Report 2005 on maternal mortality rate (MMR) delivery, which is currently listed at number 307 out of every 100,000 live births. This shows that the government has not seriously and equitable in the provision of health services particularly for women. Maternal mortality can be used as indicators of poor health services received by mothers and children and low access to information owned by mother and child.<br /><br />Keywords: Perempuan, Human Development Report, Angka Kematian Ibu, Indikator dan Kesehatan.<br /><br />

scholarly journals A community based study of neonatal mortality in Aligarh by using verbal autopsy

2018 ◽  
Vol 5 (6) ◽  
pp. 2491
Author(s):  
Ambren Chauhan ◽  
M. Salman Shah ◽  
Najam Khalique ◽  
Uzma Eram
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Verbal Autopsy ◽  
Birth Asphyxia ◽  
Survival Strategies ◽  
Biological Factors ◽  
Neonatal Mortality Rate ◽  
Community Based ◽  
Cross Sectional ◽  
Live Births

Background:Neonatal mortality rate is regarded as an important and sensitive indicator of the health status of a community. Children face the highest risk of dying in their first month of life. The present study was aimed to 1) determine the prevalence of neonatal mortality rate 2) identify socio-biological factors in relation to neonatal mortality.3) determine the causes of neonatal mortality. Methods:A community based cross sectional study was conducted in the field practice areas of Department of Community Medicine, AMU, Aligarh. All the live births and all neonatal deaths were taken for one year from June 2016 to May 2017. A standard Verbal autopsy questionnaire (WHO 2012) was used as a study tool. Results:The prevalence of neonatal mortality rate was38.2/1000 live births. The early neonatal mortality rate was 28.3/1000 live births and late neonatal mortality rate was 9.9/1000 live births. The associated socio –biological factors were gender [OR-2.381, 95% CI-1.037-5.468], birth order [OR-4.090, 95% CI-1.119-14.946] and gestational age [OR-12.62, 95% CI-3.26-48.82]. The leading causes of deaths among newborns were preterm births (22.2%), birth asphyxia (22.2%), other causes (19%), ARI (14.3%), congenital anomalies (14.3%) and diarrhoeaandneonatal sepsis accounted for (4.8%) each. Conclusions: The neonatal mortality rate assessed by verbal autopsy is higher than nationally reported. Most of the deaths were in early neonatal period. There is a need for programs encouraging the use of antenatal care, encouraging institutional deliveries and care of LBW neonates; as well as implementation of community-based newborn survival strategies.

scholarly journals Socio-demographic determinants of under-five mortality in rural Agra

2017 ◽  
Vol 4 (9) ◽  
pp. 3108
Author(s):  
Krishan Kumar ◽  
Rajiv Srivastava ◽  
S. K. Mishra
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Nuclear Family ◽  
Well Being ◽  
Infant Mortality Rate ◽  
Age Group ◽  
Neonatal Mortality Rate ◽  
Important Indicator ◽  
Live Births

Background: One of the most important indicator or index of socio-economic development of a country or region is infant mortality rate. The present study was undertaken to assess the quantum of childhood mortality and to find out the social factors associated with these deaths by verbal autopsies. Methods: This one year cross-sectional study was undertaken in a purposively selected community Development Block Sainyan, district Agra among children aged between 0-5 years using multistage random sampling technique. Suitable statistical methods were applied. Results: Out of total 8355 families surveyed, a total of 185 deaths were reported among children. Number of deaths was higher among those belonging to nuclear family and lower socioeconomic status. The neonatal mortality rate was estimated to be 33.55/1000 live births. The post neonatal mortality rate was found to be 40.78/1000 live births and infant mortality rate was 74.33/1000 live births. Mortality rate in 1-5 year age group children was 10.6/1000 same age group children, while 0-5 yrs. mortality was estimated to be 22.39/1000 children of same age group. Out of 185 children who died, 52.7% were unimmunized and another 35.67% were partially immunized. Conclusions: Female education and socioeconomic well-being should be strengthened. 

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