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In the present work, we present an overview of the contents of the communications presented at the Second National Congress of Paediatrics, held in San Sebastian in 1923, on the occasion of the 100th year anniversary.The problem of infant mortality stands out as a common thread, which in those years was very high in Spain and was a concern of politicians, intellectuals and the medical profession.It is worth noting that some of the proposals and concerns of the paediatricians who attended that congress continue to be relevant today. Resumen: En el presente trabajo se presenta una aproximación a los contenidos de las ponencias del II Congreso Nacional de Pediatría, celebrado en San Sebastián en 1923, con ocasión del centenario del mismo.Se destaca como hilo conductor de las mismas el problema de la mortalidad infantil que en aquellos años era muy elevada en España y era una preocupación de políticos, intelectuales y de la clase médica.Se constata que alguna de las propuestas y preocupaciones de los pediatras que asistieron a dicho congreso siguen vigentes hoy en día.

Objective: To define the feasibility of determining inequality in infant mortality according to the mother's educational level and according to the wealth quintile of the 1991-2013 period, considering the level of precision of said rates. Methods: The type of study was quantitative and observational, with a crosssectional design based on repeated surveys. The data from the ENDES surveys corresponding to those of 1991, 1992, 1996, 2000, 2008 and 2013 were used. Infant mortality was determined using the direct method of synthetic cohort life tables. The level of precision of the estimates was determined by the relative error. Results: It´s observed that the level of precision of the estimates of these general rates has fluctuated between good and very good in the 1991-1992, 1996 and 2000 surveys; however, in 2008 and 2013 they only reach an acceptable level. Infant mortality rates tend to be lower as the mother's educational level improves, as well as the wealth quintile and elsewhere exists among successive surveys a tendency to reduce infant mortality in different categories. Conclusion: It is not feasible to determine the inequality of the measurement of Infant Mortality according to the mother's educational level and according to the wealth quintile in the period 1991-2013, because the sample size has not been increased, depending on the decreased mortality.

ABSTRACT Objective To investigate the trend of infant mortality from preventable causes in children under one year of age in Rondônia from 2008 to 2018. Method Epidemiological study of time series with data from the Mortality and Live Birth Information Systems, driven by STATA® version 11.0, trend measured by Prais-Winsten linear regression and autocorrelation with Durbin and Watson test. Results The infant mortality rate was 14.57 deaths / 1,000 live births, 9.14 / 1,000 due to preventable causes. Deaths decreased by 2.88% annually (95% CI: - 4.67; -1.06). However, causes that can be reduced by running immunization actions, to women during pregnancy and fetal and non-childbirth growth, have stable rates. Deaths from preventable causes in the late neonatal period were declining (-11.69%; 95% CI -19.56; -3.05). Conclusion Managers need to qualify maternal and child care, considering the performance of the team of professionals in assisting the pregnant-puerperal cycle as well as improving the quality of infant mortality records in the region.

The objective was to analyze childhood mortality at a regional health department in the State of Paraná before and after the implementation of the Rede Mãe Paranaense program. The descriptive and retrospective method was used with secondary data from the Information System of the State Secretary of Health, using data from children younger than one year and causes of death, between 2009 and 2014. It was observed that, in the early neonatal period, the population size increased from 15,000 to 50,000, from 31% to 36% of deaths after the implementation. Despite the implementation of the program to improve women’s health during pregnancy and birth and infant health, the avoidable deaths remained high, i.e. 63% before and 51% after the implementation. The results did not evidence a significant reduction in childhood mortality after the implementation of the program, but its implementation is still recent, demanding further time for the cities to adapt to the program and invest in the training of the professionals involved

OBJECTIVE: To analyze the characteristics of infant mortality at the extremes of maternal age.METHOD: Retrospective, cross-sectional quantitative study using data from Live Birth Certificates, Death Certificates and from Child Death Investigation records in Londrina, Paraná, in the years of 2000-2009.RESULTS: During the 10-year study period,there were 176 infant deaths among mothers up to 19 years of age, and 113 deaths among mothers aged 35 years or more. The infant mortality rate among young mothers was 14.4 deaths per thousand births, compared to 12.9 deaths in the other age group. For adolescent mothers, the following conditions prevailed: lack of a stable partner (p

The present study aims at analyzing the child mortality profile Ribeirão Preto-SP inhabitants between 2009 and 2011, based on data from the Mother-Infant Mortality Committee. In this period, there were 224 deaths, of which 58 were avoidable. There were more deaths among children under a week old, with low birth weight and gestational age under 30 weeks; pre-natal care was considered insufficient in most cases. There was an association between age of death and gestational age; increased years of schooling proved to be a protective factor regarding deaths in the first week of life. The identification of real or potential risks to the child’s life allows nursing professionals to plan individual and qualified assistance. Such planning allows interventions to be carried out, in the sense of improving health care and consequently children’s quality of life, reducing infant mortality. doi: 10.5216/ree.v16i2.20321

El objetivo del presente estudio es examinar el efecto de factores reproductivos y demográficos sobre la sobrevivencia infantil en Bolivia, uno de los países más pobres de América Latina. Modelamos los efectos conjuntos que tienen la edad de la madre, paridad, intervalos entre nacimientos, duración de la lactancia y uso de contracepción moderna en la mortalidad de la niñez. Los datos utilizados provienen de la Encuesta de Demografía y Salud (ENDES), llevada a cabo en Bolivia durante 1998. Los resultados obtenidos apoyan la evidencia encontrada en otros estudios similares: la lactancia y el intervalo entre nacimientos son los patrones reproductivos más importantes que afectan a los riesgos de mortalidad en la niñez, y sus efectos son fuertes y consistentes aún después de considerar variables socioeconómicas en los modelos: intervalos anteriores entre nacimientos cortos y duraciones de lactancia cortas aumentan los riesgos de muerte en los primeros dos años de vida.

A taxa de mortalidade infantil é considerada indicador síntese da qualidade de vida e do nível de desenvolvimento de uma população. Este artigo analisa a evolução dessas taxas no Município do Rio de Janeiro, no período de 1979 a 2004, e as causas em 2004. Trata de estudo descritivo a partir do total de óbitos infantis e nascimentos ocorridos, utilizando-se os sistemas de informação produzidos pelo Ministério da Saúde. Para avaliação, segundo causa básica de morte, usou-se a Classificação Internacional de Doenças. As taxas de mortalidade infantil por mil nascidos vivos decresceram de 37,4 em 1979 para 15,1 em 2004, sendo o componente pós-neonatal o principal responsável por este declínio. Em 2004, as principais causas de óbito neonatais foram as afecções perinatais e as malformações congênitas; entre os óbitos pós-neonatais destacaram-se as doenças infecciosas e parasitárias, as causas mal definidas e as doenças respiratórias. Embora tenha sido observada queda da taxa de mortalidade infantil, esta não teve uma redução maior, devido ao pequeno declínio do componente neonatal precoce. Observou-se que a assistência à saúde da criança, no município do Rio de Janeiro, ainda deixa a desejar no que se refere à integralidade da assistência desde o período pré-natal.La tasa de mortalidad infantil es considerada indicador síntese de la calidad de vida y del nivel de desarrollo de una población. Este artículo analiza la evolución de esas tasas en la Ciudad del Rio de Janeiro, en el periodo de 1979 hasta 2004, y las causas en 2004. Tratase de un estudio descriptivo desde el total de fallecimientos infantiles y nacimientos ocurridos, usando los sistemas de informaciones producidos por el Ministerio de la Salud. Para la evaluación, según causa básica de muerte, fue usada la Clasificación Internacional de Enfermedades. Las tasas de mortalidad infantil por mil nacimientos vivos decrecieron de 37,4 en 1979 para 15,1 en 2004, siendo el componente post neonatal el principal responsable por esta declinación. En 2004, las principales causas de fallecimientos neonatales fueran las afecciones perinatales y las malformaciones congénitas; entre los fallecimientos post neonatales destacaranse las enfermedades infecciosas y parasitarias, las causas mal definidas y las enfermedades respiratorias. Aunque se ha observado un declive de la tasa de mortalidad infantil, esta no tuvo una reducción mayor, debido al pequeño declino del componente neonatal precoz. Fue observado que la ayuda a la salud del niño, en la ciudad de Rio de Janeiro, aún deja a desear en el que se refiere a la integralidad de la ayuda desde el periodo prenatal.The child mortality rate is considered a synthesis indicator of life quality and of the development level of a population. This article analyses the evolution of these rates in the Rio de Janeiro City, in the period between 1979 and 2004, and the causes in 2004. It is a descriptive study from the total of child death and births occurred, using the information system produced by the Health Department. For the evaluation, according basic death cause, it was used the Disease International Classification. The rates of child mortality per thousand born live decreased from 37.4 in 1979 to 15.1 in 2004, being the post neonatal the main responsible for this decline. In 2004, the main causes of neonatal deaths were the perinatal affections and the congenital malformation; among deaths post neonatal was detached the infectious and parasitic diseases, the undefined causes and the respiratory diseases. Although it was observed a drop in the child mortality rate, this hasn't a mayor reduction, because a little decline of the precocious neonatal component. It was observed that the assistance to the child health, in the city of Rio de Janeiro, yet let to desire in what is about the integrality of the assistance since the prenatal period.

Although the use of computers and sophisticated software, particularly R, has become common in demography, this has not led to a revision of some traditional demographic algorithms, which were originally designed to overcome computational obstacles that nowadays no longer exist. This article argues that, rather than implementing the existing algorithms in today’s powerful software, it is time to take advantage of this software to modify the algorithms themselves. It illustrates this idea with three examples: Sprague interpolation, the Relational Gompertz method for fertility estimation, and the estimation of infant and child mortality from proportions of surviving children by mother’s age. In each case, it is shown that the analysis can be made simpler, more direct, intuitive, transparent, and precise by making use of the resources offered by software such as R. It is also shown that the greater flexibility of these algorithms creates opportunities for extending each method.

OBJETIVO: Estimar la brecha en salud para México a través de la diferencia entre la tasa de mortalidad observada para 1998, y la estimada para el mismo año en función de indicadores sociales y económicos, con relación a otros países. MATERIAL Y MÉTODOS: Se desarrolló un modelo econométrico con estimaciones de la tasa de mortalidad infantil de 1998 como variable dependiente, e indicadores macro de tipo social y económico como variables explicativas. El modelo incluyó 70 países para los que existía información completa. RESULTADOS: El modelo propuesto permite explicar más de 90% de la variación en la mortalidad infantil entre países. La tasa de mortalidad infantil esperada para México es 22% menor que la observada, lo que representó en 1998 cerca de 20 mil muertes infantiles en exceso. CONCLUSIONES: Una vez ajustando por las diferencias en productividad, distribución e inversión en capital humano, el exceso en la tasa de mortalidad infantil sugiere un problema de eficiencia del sistema de salud mexicano - por lo menos en los servicios destinados a reducir la mortalidad infantil.OBJECTIVE: To estimate the health gap in Mexico, as evidenced by the difference between the observed 1998 mortality rate and the estimated rate and the estimated rate for the same year according to social and economic indicators, with rates from other countries. MATERIAL AND METHODS: An econometric model was developed, using the 1998 child mortality rate (CMR) as the dependent variable, and macro-social and economic indicators as independent variables. The model included 70 countries for which complete data were available. RESULTS: The proposed model explained over 90% of the variability in CMR among countries. The expected CMR for Mexico was 22% lower that the observed rate, which represented nearly 20 000 excess deaths. CONCLUSIONS: After adjusting for differences in productivity, distribution of wealth, and investment in human capital, the excess child mortality rate suggested efficiency problems in the Mexican health system, at least in relation to services intended to reduce child mortality.

Estudo transversal para investigar cobertura vacinal e mortalidade de crianças menores de um ano de idade, identificar recursos, ações e dificuldades para alcançar meta vacinal. Participaram 2.206 crianças e 62 enfermeiros das Unidades Básicas de Saúde da Família. Utilizou-se formulário e entrevista semi-estruturada. Identificaram-se ações direcionadas à saúde da criança; dispersão entre o número de crianças cadastradas nas UBSF e o de nascidos vivos; oscilações dos percentuais de vacinação, ora aproximando-se da meta, ora afastando-se. A resistência dos pais a vacinação, falta de insumos e de ACS em algumas UBSF foram as principais barreiras enfrentadas para atingir a meta. O índice de mortalidade infantil ficou abaixo de 20, confirmando o impacto da cobertura vacinal.Estudio transversal para investigar cubierta vacunal y mortalidad de niños menores de un año de edad, identificar recursos, acciones y dificultades para alcanzar meta vacunal. Participaron 2.206 niños y 62 enfermeros de las Unidades Basicas de Salud de la Familia. Se utilizó formulario y entrevista semi estructurada. Se identificaron acciones orientadas a la salud del niño; dispersión entre el número de niños registrados en las unidades y los de nacidos vivos; oscilaciones de los porcentajes de vacunación, ora aproximándose de la meta, ora alejándose. La resistencia de los padres a vacunación, falta de insumos y de ACS en algunas unidades fueron las principales barreras enfrentadas para atingir la meta. El índice de mortalidad infantil se quedo abajo de 20, confirmando el impacto de la cubierta vacunal.Cohort study to investigate mortality and immunization coverage of children under one year of age, identify resources, actions and difficulties to achieve goal vaccine. 2,206 children and 62 nurses from Family Health Basic Unities participated in the study. A questionnaire and semi-structured interview were used. Children's health targed acctions, the dispersion of the registered children in this unities and the number of live births; the oscillations of the percentage of vaccination, now closer or distant of the goal. The resistance of parent's vaccination, lack of inputs and ACS in some UBSF were the main barrier faced to achieve the goal. The rate of infant mortality was below 20, confirming the impact of immunization coverage.

One of the Millennium Development Goals of the United Nations - goal #4 - is the reduction of child mortality by two thirds between 1990 and 2015. Political and economic efforts have been made to reduce infant and child mortality in the world. A recent international descriptive study including data from 2013 showed that 6.3 million children under five died, representing a reduction of 64% since 1970. Rates by country ranging from a low of 2.3 per thousand in Singapore and a maximum of 152 per thousand in (...)

Objective: To describe the different types of child deaths in Paediatric Intensive Care Units (PICU) in Spain, and to analyse the characteristics of those dying from a limitation of therapeutic efforts (LET)., Method: A multicentre retrospective study by conducted by reviewing the hospital discharge reports corresponding to deceased patients in 8 Spanish PICUs between 2011 and 2017., Results: A total of 337 deaths were recorded, of which 151 (50'7%) occurred after a decision of LET, while 114 (33'8%) were due to an indicated, but failed, cardiopulmonary resuscitation, and 52 (15.4%) were due to brain death. The most common causes of hospital admission for those children that finally died were a heart-related problem (32.6%) or a respiratory problem (22.6%). A total of 86 cases (25.5%) had a previous hospital admission, with 253 cases (75%) suffering from some type of chronical illness, and 78 (23%) had a serious disability at the time of the admission. LET cases were more frequent among these children and those suffering from cancer. The predominant LET type consisted in: not starting the CPR in the event of a cardiac arrest (45%), withdrawal of the respiratory support (31.6%), and withdrawal of vasoactive drugs (21.6%)., Conclusions: At the present time, at least half of the children dying in a PICU in Spain die after a LET decision, which is more frequent in those patients with previous hospital admissions, with a serious incapacity, and chronic or oncological disease. Health professionals should be aware of this situation, and be prepared to share decisions with the families, and to offer children at the end of their life the best possible caring quality., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

This is an update of knowledge on the role of the vitamin A status in determining child mortality, morbidity and growth. Recent information confirms the earlier conclusion of Beaton et al. that a 23% reduction in young child mortality results following improvements in the vitamin A status. Studies show that the mortality effect is primarily due to reductions in deaths due to acute gastroenteritis and measles but not acute respiratory infections (ARI) and malaria. While improvement of the vitamin A status enhances the survival of older preschool children, it remains unclear whether it benefits infants (i.e.

Objetivo. Conocer el panorama de las muertes por envenenamiento en niños de 0-14 años ocurridas en la República mexicana, entre 1979 y 1994. Material y métodos. Se utilizaron fuentes secundarias. Las variables analizadas fueron: edad, sexo, año, causa externa de traumatismos y envenenamientos, de la IX Clasificación Internacional de Enfermedades: E850-E858, E860-E869 y E905. Mediante un modelo de regresión Poisson se analizaron tendencias por causa específica y se obtuvieron riesgos relativos según edad, sexo y entidad federativa. Resultados. Hubo un total de 11 272 defunciones en menores de 15 años; las principales causas fueron el envenenamiento y las reacciones tóxicas causadas por plantas y animales venenosos (E905), el envenenamiento accidental por gas de uso doméstico y por monóxido de carbono (E868) y el envenenamiento accidental por otras drogas (E858). El grupo de edad que presentó los mayores riesgos, para las causas mencionadas, fue el de menores de un año con un riesgo relativo (RR) de 29.6, IC95% 29.2-33.4; RR 3.47, IC95% 2.86-4.22, y RR 31.86, IC95% 24.8-40.9. El riesgo fue similar en ambos sexos, salvo para la causa E905. El estado de Aguascalientes se situó sistemáticamente entre los de mayor riesgo para todas las causas analizadas, mientras que Nuevo León siempre se ubicó entre los de riesgo más bajo. Conclusiones. El envenenamiento constituye una importante causa de muerte en los niños; el riesgo se incrementa al disminuir la edad. Considerando que esas muertes son potencialmente evitables y que la mayor parte de los envenenamientos ocurren en el hogar, para prevenirlos, se recomienda a los familiares vigilar y mantener fuera de peligro al niño. Por otra parte, la multicausalidad del fenómeno requiere que su prevención se realice desde una perspectiva multidisciplinaria que genere una cultura y un ambiente de seguridad en la sociedad.Objective. To determine the standing of mortality by poisoning in children in the Mexican Republic, in the years from 1979-1994. Material and methods. Secondary sources were employed. Analyzed variables were: age, sex, year, external cause of trauma and poisoning according to the 9th International Classification of Diseases: E850-E858, E860-E869 and E905. Tendencies by specific causes were analyzed with a Poisson regression model and relative risk by age, sex and district were obtained. Results. A total of 11 272 children under 15 years of age were recorded. The main causes were poisoning and toxic reactions caused by venomous plants or animals (E905); accidental poisoning by household gas or carbon monoxide (E868); and accidental poisoning by other drugs (E858). The relative risk was highest in age group

The objective of the present study is to examine the effects of several reproductive and demographic factors on child survival in Bolivia, one of the most impoverished nations in all of Latin America. We model the joint effects of maternal age, parity, pace of childbearing, duration of breastfeeding, and use of modern contraception on child mortality. Data for this research come from “Demographic and Health Survey” (DHS) carried out during 1998. The results obtained in this paper support the evidence found in other studies: breastfeeding and the pace of childbearing are the most important reproductive patterns affecting child mortality risks, and their strong, consistent effects tend to persist even after the introduction of various socioeconomic variables as controls: short preceding birth intervals and short durations of breastfeeding increase the risk of death during the first two years of life.

El objetivo del presente estudio es examinar el efecto de factores reproductivos y demográficos sobre la sobrevivencia infantil en Bolivia, uno de los países más pobres de América Latina. Modelamos los efectos conjuntos que tienen la edad de la madre, paridad, intervalos entre nacimientos, duración de la lactancia y uso de contracepción moderna en la mortalidad de la niñez. Los datos utilizados provienen de la Encuesta de Demografía y Salud (ENDES), llevada a cabo en Bolivia durante 1998. Los resultados obtenidos apoyan la evidencia encontrada en otros estudios similares: la lactancia y el intervalo entre nacimientos son los patrones reproductivos más importantes que afectan a los riesgos de mortalidad en la niñez, y sus efectos son fuertes y consistentes aún después de considerar variables socioeconómicas en los modelos: intervalos anteriores entre nacimientos cortos y duraciones de lactancia cortas aumentan los riesgos de muerte en los primeros dos años de vida.

Introduction: The quality of water for human consumption has been correlated with the occurrence of different diseases. Studying the relationship between these parameters would allow determining the impact of water quality on human health, and to direct preventative measures and promote environmental health., Objective: To analyze the quality of water intended for human consumption and its association with morbimortality in Colombia, 2008-2012., Materials and Methods: The database for surveillance of water quality was analyzed by means of descriptive statistics of the principal indicators (total coliforms, Escherichia coli , turbidity, color, pH, free residual chlorine and water quality risk index). The results were correlated with infant mortality and morbidity due to acute diarrheal diseases, foodborne diseases and hepatitis A. A risk map was prepared to identify those municipalities with the highest risk of water contamination and infant mortality., Results: A high percentage of municipalities did not conform to existing standards for water potability values. Problems were identified that were related to presence of E. coli and total coliforms, as well as absence of free residual chlorine, a situation that was exacerbated in rural areas. Water quality showed a high correlation with infant mortality, highlighting its importance for children's health., Conclusion: Water quality was found to have an important impact on infant mortality. Improving water quality in Colombia will require policies that strengthen water supply systems in this country. Strengthening of environmental health surveillance programs is essential to guide actions aimed at improving water quality and exert a positive impact on health.

Introduction: The Pediatric Index of Mortality 2 (PIM2) is one of the most commonly used scoring systems to predict mortality in patients admitted to pediatric intensive care units (PICU) in Argentina. The objective of this study was to validate the PIM2 score in PICUs participating in the Quality of Care Program promoted by the Argentine Society of Intensive Care., Population and Methods: Multicenter, prospective, observational, cross-sectional study. All patients between 1 month and 16 years old admitted to participating PICUs between January 1st, 2009 and December 31st, 2009 were included. The discrimination and calibration of the PIM2 score were assessed in the entire population and in different subgroups (risk of mortality, age, diagnoses on admission)., Results: Two thousand, eight hundred and thirty-two patients were included. PIM2 predicted 246 deaths; however, 297 patients died (p < 0.01). The standardized mortality ratio was 1.20 (95% confidence interval [CI]: 1.01-1.43). The area under the ROC curve was 0.84 (95% CI: 0.82-0.86). Statistically significant differences were detected between the observed and the predicted mortality for the entire population and for the different risk intervals (χ2: 71.02, df: 8, p < 0.001). Statistically significant differences were also found between observed and predicted mortality in adolescent patients (37/22, p = 0.03) and in those hospitalized due to respiratory disease (105/81, p = 0.03)., Conclusions: The PIM2 score adequately discriminates survivors from non-survivors. However, it underscores the overall risk of death, especially in adolescent patients and those hospitalized due to respiratory disease. It is critical to take such differences into account when interpreting results.

This work aims to analyze the conditions that affect the probability of a Brazilian municipality reaching the Millennium Development Goal 4 (MDG4), considering the period from 2000 to 2015. For this, the spatial Probit model was used, with regional estimates. There was evidence of an advance in the municipalities that reached MDG4 in 2015, with heterogeneity across the country. With regard to what affects the probability of meeting MDG4, a negative effect was found for female illiteracy, fertility and income inequality, with a spatial effect of these variables. In addition, the PSF contributed positively to achieving MDG4.

ABSTRACT Objectives: to analyze the risks of deaths in the first 24 hours of life and their preventable causes. Methods: cross-sectional study carried out in Pernambuco, Northeast of Brazil, between 2000-2019, with mortality and live birth data. The avoidability was analyzed through the Brazilian List of Avoidable Causes of Deaths due to Interventions of the Unified Health System. For the statistical analyses, Pearson’s chi-squared test and relative and attributable risks were used. Results: 13,601 deaths were registered, of which 10,497 (77.19%) were from preventable causes. Of the total, 5,513 (40.53%) were reducible through adequate care for women during pregnancy. The lower the gestational age, birth weight and education level, the higher the relative and attributable risk of death in the first 24 hours of life. Conclusions: most of the deaths were considered avoidable and with high relative and attributable risks. These early deaths suggest care failures and the need to reinforce prevention and treatment measures.

Objective. We examined delays during the search for care and associations with mother, child, or health services characteristics, and with symptoms reported prior to death. Materials and methods. Cross-sectional study compris­ing household interviews with 252 caregivers of children under-5 who died in the state of Yucatán, Mexico, during 2015-2016. We evaluated the three main delays: 1) time to identify symptoms and start search for care, 2) transport time to health facility, and 3) wait time at health facility. Results. Children faced important delays including a mean time to start the search for care of 4.1 days. The mean transport time to the first facility was longer for children enrolled in Seguro Popular and there were longer wait times at public facilities, especially among children who also experienced longer travel time. Conclusions. Providing resources to enable caregiv­ers to access health services in a timely manner may reduce delays in seeking care.

Objective: To measure the underregistry of mortality in children under five years old, and the coverage of the Birth Certificate (BC) in municipalities with very low human development index (HDI) in Mexico., Materials and Methods: We studied all deaths of children under five years old occurred in 2007 and all births occurred in 2007 and 2008 in a sample of 20 municipalities with very low HDI in Mexico. We conducted an intentional search of births and deaths., Results: We identified 12 additional deaths not included in official registries, for an underregistration of 22.6%, and 68.1% of births did not have a BC. Lack of BC was more frequent if the mother did not speak Spanish, if she did not have Seguro Popular if the birth was attended by a traditional midwife. Conclusions. It is necessary to strengthen the registry of deaths and births in municipalities with very low HDI.

Objective: Comparing and analysing crude death (CDR), child mortality (CMR) 5-year per thousand live births (LBR) and infant mortality rates (IMR) in the Boyacá department, Colombia, during the early 20th and 21st centuries., Methods: A descriptive epidemiological comparative historical approach was adopted. Two data sources were used for deaths: parish registers 1912-1927 and the Boyacá Epidemiological Bulletin 2007 population census for 1912-1918-1927 and 2005 (Colombian Statistics Bureau - DANE); data was stored and analysed in Mysql. Crude rates, age-specific and child mortality ratios and mortality were calculated by cause., Results: 7,958 deaths were recorded from 1912-1927 compared to 5,813 in the 21st century. CDR dropped from 150 to 42 deaths per 10,000 inhabitants; the IMR became significantly reduced from 231 to 17 for every 1,000 LB. Although specific rates for children under 8 years of age could be compared to children under 5, there was variability in the range and construction of the specific MR and that defined by WHO-UNICEF., Conclusions: There was a higher reduction in mortality in the 21st century due to national and international policies for controlling preventable diseases and maternal death. The 1918-19 flu pandemic significantly affected mortality in all population groups; violent causes were prominent in infant mortality in the 21st century.

Objective: Determine the magnitude of child mortality from cancer in Colombia and evaluate the trends in its evolution from 1985 to 2008., Methods: Mortality in the Colombian population aged 0-14 years from cancer in any site (e.g., leukemia, malignant tumors of the central nervous system (CNS), non-Hodgkin's lymphoma, Hodgkin's lymphoma, bone tumors, kidney tumors) during this period was analyzed. The mean change in the variations of cancer mortality trends in this age group was calculated., Results: Deaths from cancer accounted for 3.5% of mortality in children under 15 years of age. During the periods 1985-1989 and 2005-2008 there was a decrease in mortality from cancer in both sexes, with figures dropping from 54.4 deaths per million to 44.8 deaths per million in boys and from 40.9 deaths per million to 37.9 deaths per million in girls. There was a statistically significant decrease in leukemia- and lymphoma-related mortality, whereas mortality associated with cancers of the CNS increased significantly., Conclusions: In spite of slight downward trends in mortality from leukemia and non-Hodgkin's lymphoma, childhood cancer mortality rates in Colombia remain high. Significant work on treatments for childhood cancer is required to obtain greater success.

Objectives: Demographically describing the present and future for Mexican children to correlate aspects regarding demographic and social equity during childhood and describing the challenges these variables represent for Mexican children during the next few years., Methods: The present and future scenario for Mexican childhood was evaluated using existing population projections. Mortality rates were estimated from avoidable causes during childhood per Mexican state, per state grouped by quartile depending on their marginalisation level and by municipality grouped according to their degree of marginalisation. The Gini coefficient was used for measuring inequality., Results: Even though the absolute numbers of children in Mexico will tend to decrease in the future, the number will remain high until 2025. A greatest numbers of children were living in states having the highest degree of social marginalisation. Avoidable mortality was higher in these states compared to states having lower marginalisation. The Gini coefficient was highest concerning mortality rate caused by acute respiratory infection (0.34). Excess of avoidable mortality was evident in municipalities having high and extremely high marginalisation., Conclusions: Conditions related to demographic ageing and childhood diseases coexist in Mexico. Inequity in children's health is evident; it is related to high levels of social marginalisation. In-depth structural changes are needed to change this situation which will lead to reducing some Mexican populations' unjust social disadvantages.

Objective: Determine and evaluate the relationship between the variables for water conditions, environmental sanitation, and mortality in children under 5 years of age associated with a group of waterborne diseases., Methods: An exploratory ecological study was conducted based on data obtained from the 2000 national demographic census and the Unified Health System for the 558 microregions of Brazil. The model used multiple linear regression analysis. Mortality associated with waterborne diseases in children under 5 years of age was considered to be the response variable. Water conditions, sanitation, and level of education were considered to be explanatory variables., Results: A direct relationship was observed between inadequate sanitation in the dwelling (e.g., sewage disposal via rudimentary gutters and pits, the disposal of waste in uncultivated land or public areas) and mortality in children under 5 years of age associated with waterborne diseases. An inverse relationship was found between level of education and mortality associated with waterborne diseases in these children., Conclusions: The greatest health hazards related to poor sanitation were found in the microregions with a high concentration of low-income population with limited education. The general sanitation conditions and other factors related to dwelling quality and infrastructure are major determinants of mortality. Coverage of the water services, which reach 90% of households in Brazil, was not in itself found to be an important factor in the reduction of the mortality studied.

Introduction: The infant-mortality rate in children aged less than five is an indicator of the general state of health of a population and directly reflects the quality of life and the level of socio-economic development of a country., Objective: Avoidable mortality was assessed in preschool children as a reflection of Colombia quality of life and socio-economic development., Materials and Methods: Mortality trends were analyzed in preschool children aged less than five throughout Colombia during a 20-year period from 1985-2004, and focused on mortality causes that were considered avoidable. This was a descriptive, retrospective study; the sources of information were Departamento Administrativo Nacional de Estadística records of deaths and population projections 1985-2004. Mortality rate due to avoidable causes was the statistical indicator., Results: In children aged less than one, the reducible mortality due to "early diagnosis and medical treatment" occupied the first place amongst causes for every year of the study period and accounted for more than 50% of recorded deaths. In children aged 1 to 4, the category "other important reducible causes" was associated with 40% of recorded deaths-deaths due mainly to respiratory diseases. Over the 20-year period, the avoidable mortality rate decreased by 34% in children aged less than one, in children 1-4, it decreased by 23%., Conclusions: Although the infant-mortality rate in preschool children was reduced, the decrease was small, from 80% to 77%. The situation requires more analysis with respect to strategies in public health, particularly concerning preventable diseases of the infancy.

Well into the XXI century, child mortality is still high in developing countries. The Millennium Declaration approved at the United Nations Millennium Summit held in September 2000 set down, as its fourth objective, the reduction of child mortality by two thirds; from the 93 children per 1,000 that died before the age of 5 in 1990, to 31 per 1,000 in 2015. To this end, considerable advances have been made although the proposed goal is still a long way off in some countries and regions. In this context, the recent economic crisis has, in addition, posed a serious threat to attaining this objective. In general terms, the recessionary phases of such cycles negatively impact the progress and welfare of countries with economic, political and social consequences for the population in general, and particularly for children. Therefore, the principal objective of this paper is to revisit the main impact of the recent global economic decline on the more vulnerable children of countries of the South, with a special focus on the goal proposed by the fourth Millennium Development Goal (MDG), given that it presently constitutes a great challenge for the whole population within the framework of the Sustainable Development Goals (SDGs).

Objective: To estimate the health gap in Mexico, as evidenced by the difference between the observed 1998 mortality rate and the estimated rate and the estimated rate for the same year according to social and economic indicators, with rates from other countries., Material and Methods: An econometric model was developed, using the 1998 child mortality rate (CMR) as the dependent variable, and macro-social and economic indicators as independent variables. The model included 70 countries for which complete data were available., Results: The proposed model explained over 90% of the variability in CMR among countries. The expected CMR for Mexico was 22% lower that the observed rate, which represented nearly 20,000 excess deaths., Conclusions: After adjusting for differences in productivity, distribution of wealth, and investment in human capital, the excess child mortality rate suggested efficiency problems in the Mexican health system, at least in relation to services intended to reduce child mortality. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Introduction: Breastfeeding has a protective effect against acute respiratory and diarrheal infections. There are psychological and social effects due to physical isolation in the population in the mother-child group., Objective: To assess the impact on infant mortality due to a decrease in the prevalence of breastfeeding during 2020 due to the physical isolation against the SARS CoV-2 (COVID-19) pandemic in Colombia., Materials and Methods: We used the population attributable risk approach taking into account the prevalence of breastfeeding and its potential decrease associated with the measures of physical isolation and the relative risk (RR) of the association between exclusive breastfeeding and the occurrence of acute infection consequences in the growth (weight for height) of children under the age of five through a mathematical modeling program., Results: We found an increase of 11.39% in the number of cases of growth arrest in the age group of 6 to 11 months with a 50% decrease in breastfeeding prevalence, as well as an increase in the number of diarrhea cases in children between 1 and 5 months of age from 5% (5.67%) on, and an increased number of deaths in children under 5 years (9.04%) with a 50% decrease in the prevalence of exclusive breastfeeding., Conclusions: A lower prevalence of breastfeeding has an impact on infant morbidity and mortality in the short and medium-term. As a public health policy, current maternal and childcare strategies must be kept in order to reduce risks in the pediatric population.

Background: Childhood mortality from tumors has decreased in industrialized countries. The aim of this paper is to study the trend of mortality from tumors in children (under 15 years old) during the period 1975-1992., Methods: Using data from the Department of Health and Social Security's Register of Mortality, age-group standardized (to world population) mortality rates for each sex were analyzed. Analysis was carried out on total mortality caused by childhood tumors and on main causes of death (leukemia, brain cancer, non-Hodgkin lymphoma, bone cancer and non-specified tumors). A Poisson's regression model was used to analyze mortality trends., Results: Childhood tumors caused 8.7% of all deaths in boys and 8.5% of all deaths in girls between 1990-1992. Thus, standardized mortality rates have decreased significantly, in 1975-1977 standardized mortality rates for boys and girls were 71.20 and 68.05 respectively, in 1990-1992 these rates had fallen to 55.45 and 41.30. The annual percentage decrease in cancer mortality rates for boys was 2% and for girls was 3.1%. Main causes of deaths were leukemia and brain cancer., Conclusions: Between 1975-1992 a significant downward trend in childhood tumors mortality has been observed, more prominent in main causes of death and in girls. The principal explanation for this trend is an increased survival, consequence of changes in childhood tumors therapy.