scholarly journals Potential contributions of an on-site nurse mentoring program on neonatal mortality reductions in rural Karnataka state, South India: evidence from repeat community cross-sectional surveys

2019 ◽  
Author(s):  
B.M. Ramesh ◽  
Arin Kar ◽  
Krishnamurthy Jayanna ◽  
Jyoti S. Hallad ◽  
Cunningham Troy ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
South India ◽  
Post Partum ◽  
Substantial Reduction ◽  
Mortality Rates ◽  
Mentoring Program ◽  
Health Providers ◽  
Neonatal Mortality Rate

Abstract Background: We assessed the effects of a nurse mentoring program on neonatal mortality in eight districts in India. Methods: From 2012 to 2015, nurse mentors supported improvements in critical MNCH-related practices among health providers at primary health centres (PHCs) in northern Karnataka, South India. Baseline (n=5,240) and endline (n=5,154) surveys of randomly selected ever-married women were conducted. Neonatal mortality rates (NMR) among the last live-born children in the three years prior to each survey delivered in NM and non-NM-supported facilities were calculated and compared using survival analysis and cumulative hazard function. Mortality rates on days 1, 2-7 and 8-28 post-partum were compared. Cox survival regression analysis measured the adjusted effect on neonatal mortality of delivering in a nurse mentor supported facility. Results: Overall, neonatal mortality rate in the three years preceding the baseline and endline surveys was 30.5 (95% CI 24.3-38.4) and 21.6 (95% CI 16.3-28.7) respectively. There was a substantial decline in neonatal mortality between the survey rounds among children delivered in PHCs supported by NM: 29.4 (95% CI 18.1-47.5) vs. 9.3 (95% CI 3.9-22.3) (p=0.09). No significant declines in neonatal mortality rate were observed among children delivered in other facilities or at home. In regression analysis, among children born in nurse mentor supported facilities, the estimated hazard ratio at endline was significantly lower compared with baseline (HR: 0.23, 95% CI: 0.06-0.82, p=0.02). Conclusion: The nurse mentoring program was associated with a substantial reduction in neonatal mortality. Further research is warranted to delineate whether this may be an effective strategy for reducing NMR in resource-poor settings. [b]Key words:[/b] Nurse mentoring, Quality of care, Neonatal mortality This work was supported by the Bill & Melinda Gates Foundation, Grant Number OPPGH5310

scholarly journals Potential contributions of an on-site nurse mentoring program on neonatal mortality reductions in rural Karnataka state, South India: evidence from repeat community cross-sectional surveys

2020 ◽  
Author(s):  
B.M. Ramesh ◽  
Arin Kar ◽  
Krishnamurthy Jayanna ◽  
Jyoti S. Hallad ◽  
Cunningham Troy ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
South India ◽  
Post Partum ◽  
Substantial Reduction ◽  
Mortality Rates ◽  
Mentoring Program ◽  
Health Providers ◽  
Neonatal Mortality Rate

Abstract Background: We assessed the effects of a nurse mentoring program on neonatal mortality in eight districts in India.Methods: From 2012 to 2015, nurse mentors supported improvements in critical MNCH-related practices among health providers at primary health centres (PHCs) in northern Karnataka, South India. Baseline (n=5,240) and endline (n=5,154) surveys of randomly selected ever-married women were conducted. Neonatal mortality rates (NMR) among the last live-born children in the three years prior to each survey delivered in NM and non-NM-supported facilities were calculated and compared using survival analysis and cumulative hazard function. Mortality rates on days 1, 2-7 and 8-28 post-partum were compared. Cox survival regression analysis measured the adjusted effect on neonatal mortality of delivering in a nurse mentor supported facility. Results: Overall, neonatal mortality rate in the three years preceding the baseline and endline surveys was 30.5 (95% CI 24.3-38.4) and 21.6 (95% CI 16.3-28.7) respectively. There was a substantial decline in neonatal mortality between the survey rounds among children delivered in PHCs supported by NM: 29.4 (95% CI 18.1-47.5) vs. 9.3 (95% CI 3.9-22.3) (p=0.09). No significant declines in neonatal mortality rate were observed among children delivered in other facilities or at home. In regression analysis, among children born in nurse mentor supported facilities, the estimated hazard ratio at endline was significantly lower compared with baseline (HR: 0.23, 95% CI: 0.06-0.82, p=0.02).Conclusion: The nurse mentoring program was associated with a substantial reduction in neonatal mortality. Further research is warranted to delineate whether this may be an effective strategy for reducing NMR in resource-poor settings.

scholarly journals Potential contributions of an on-site nurse mentoring program on neonatal mortality reductions in rural Karnataka state, South India: evidence from repeat community cross-sectional surveys

2020 ◽  
Author(s):  
B.M. Ramesh ◽  
Arin Kar ◽  
Krishnamurthy Jayanna ◽  
Jyoti S. Hallad ◽  
Cunningham Troy ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Neonatal Mortality ◽  
South India ◽  
Post Partum ◽  
Substantial Reduction ◽  
Mortality Rates ◽  
Mentoring Program ◽  
Health Providers ◽  
Neonatal Mortality Rate

Abstract [b]Background: [/b]We assessed the effects of a nurse mentoring program on neonatal mortality in eight districts in India. [b]Methods: [/b]From 2012 to 2015, nurse mentors supported improvements in critical MNCH-related practices among health providers at primary health centres (PHCs) in northern Karnataka, South India. Baseline (n=5,240) and endline (n=5,154) surveys of randomly selected ever-married women were conducted. Neonatal mortality rates (NMR) among the last live-born children in the three years prior to each survey delivered in NM and non-NM-supported facilities were calculated and compared using survival analysis and cumulative hazard function. Mortality rates on days 1, 2-7 and 8-28 post-partum were compared. Cox survival regression analysis measured the adjusted effect on neonatal mortality of delivering in a nurse mentor supported facility. [b]Results:[/b] Overall, neonatal mortality rate in the three years preceding the baseline and endline surveys was 30.5 (95% CI 24.3-38.4) and 21.6 (95% CI 16.3-28.7) respectively. There was a substantial decline in neonatal mortality between the survey rounds among children delivered in PHCs supported by NM: 29.4 (95% CI 18.1-47.5) vs. 9.3 (95% CI 3.9-22.3) (p=0.09). No significant declines in neonatal mortality rate were observed among children delivered in other facilities or at home. In regression analysis, among children born in nurse mentor supported facilities, the estimated hazard ratio at endline was significantly lower compared with baseline (HR: 0.23, 95% CI: 0.06-0.82, p=0.02). [b]Conclusion: [/b]The nurse mentoring program was associated with a substantial reduction in neonatal mortality. Further research is warranted to delineate whether this may be an effective strategy for reducing NMR in resource-poor settings. [b]Key words:[/b] Nurse mentoring, Quality of care, Neonatal mortality This work was supported by the Bill & Melinda Gates Foundation, Grant Number OPPGH5310

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.

Time Trends in Characteristics and Outcome of Twin Pregnancies

1991 ◽  
Vol 40 (2) ◽  
pp. 181-192 ◽  
Author(s):  
L. Moreault ◽  
S. Marcoux ◽  
J. Fabia ◽  
S. Tennina
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Preterm Births ◽  
Mortality Rates ◽  
Fetal Mortality ◽  
Neonatal Mortality Rate ◽  
Risk Of Death ◽  
Twin Pregnancies ◽  
Over Time

AbstractThis study describes the evolution in fetal and neonatal mortality rates among twin pairs born in 22 hospitals located in the eastern regions of the province of Quebec in 1976-1978 (n = 776 pairs) and 1982-1985 (n = 712 pairs). It also assesses the contribution of maternal factors, obstetrical care and characteristics of twins in the variation of the risk of death over time. The fetal mortality rate did not improve from 1976-1978 (22.6 per 1000) to 1982-1985 (28.1 per 1000). However, the neonatal mortality rate declined from 44.7 to 34.7 per 1000 liveborn first twins and from 56.8 to 36.1 per 1000 liveborn second twins. For first twins as for second twins, birthweight-specific neonatal mortality rates decreased within birth weight categories under 2500 g. In the second period, 96.9% of twin pregnancies were detected before confinement compared to 59.6% in the earlier period. The proportion of twins delivered by obstetricians, the percentage of twin births occurring in ultraspecialized perinatal units and the frequency of caesarean sections increased markedly. The proportion of preterm births increased over time (34.5% vs 43.1%) whereas the percentage of low birthweight twins decreased but not significantly (54.3% 51.6%). In this study, changes in maternal age, parity, educational level, sex of pairs, qualification of the physician, and level of care available at the hospital of birth, did not account for the decrease in neonatal mortality rates among twins. The increase in the frequency of caesarean sections seemed to explain only a small proportion of the decrease in the neonatal mortality rate among second twins. In the second as well as in the first period, the neonatal mortality rate for twins was six times higher than that for singletons.

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.

State Reporting of Live Births of Newborns Weighing Less Than 500 Grams: Impact on Neonatal Mortality Rates

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 850-854
Author(s):  
Ann L. Wilson ◽  
Lawrence J. Fenton ◽  
David P. Munson
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Live Birth ◽  
Mortality Rates ◽  
World Health ◽  
Neonatal Mortality Rate ◽  
Live Births ◽  
The World ◽  
Definition Of ◽  
Health Organization

The National Center for Health Statistics reports that in 1983 65% of all infant deaths in the United States occurred in the neonatal period. Of these reported neonatal deaths, 17% were of infants weighing less than 500 g at birth. There was, however, variation in state-reported incidence of live births of newborns in this weight cohort (0.2 to 2.2 per 1,000 live births). Thé states with the lowest neonatal mortality rate have the lowest incidence of birth weights less than 500 g (ρ = .77). If it is assumed that mortality for this weight category is nearly 100%, there is marked variation (5% to 32%) in the contribution of this weight cohort to a state's total neonatal mortality rate. Contributing to this variation may be definitions of live birth used by states. The World Health Organization defines a live birth as the product of conception showing signs of life "irrespective of the duration of pregnancy" and this definition is used by 33 states. Only one state (Ohio) includes the gestational criteria of "at least 20 weeks" in its definition of live birth. There is evidence to suggest that definitions are not uniformly used within individual states. For example, in 1983, 20 states did not report any live births with weights less than 500 g among their "other" populations of nonwhite, nonblack residents. Half of these states, however, use the World Health Organization definition of live birth. Despite the exclusionary wording in Ohio's definition of live birth, 16% of newborns who died in that state had birth weights less than 500 g. Inconsistency in state definitions and possible variations in reporting live births less than 500 g affect state comparisons of infant and neonatal mortality rates.

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.

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