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Aim Methods Results Conclusion Child mortality declined significantly in Finland in 1969–2004. We investigated whether the already low mortality rate could still decline from 2005 to 2020.This was a nationwide register‐based study. The subjects were children under 16 years of age who had resided in Finland between 2005 and 2020. The study population was identified from Finland's Population Information System of the Digital and Population Data Services Agency. Causes of death were obtained from Statistics Finland. Changes in annual overall and cause‐specific mortality rates were evaluated.3685 children (55% boys) under 16 years of age died in Finland in 2005–2020 from 325 causes. Overall annual child mortality declined by 50% (95% confidence interval 37 to 64%) during the study period, from 0.31/1000 in 2005 to 0.16/1000 in 2020. The mortality rate in children under one year of age declined from 3.1/1000 in 2005 to 1.8/1000 in 2020. The deaths from sudden infant death syndrome fell by 84%, congenital malformations by 62%, infectious diseases by 60%, external causes by 52%, and perinatal disorders by 41%.Finland's low child mortality further declined over the past two decades. Contributing factors likely include achievements in paediatric research, public health, and clinical practice. [ABSTRACT FROM AUTHOR]

Background and Aims: Since 1990, global child and infant mortality rates have typically stabilized or decreased due to improved healthcare, vaccination rollouts, and international funding. However, Afghanistan continues to face the highest child and infant mortality rates globally, with 43 deaths per 1000 live births. This study aims to examine the factors contributing to this high mortality rate and propose interventions to address the issue. Methods: A comprehensive literature search was conducted using databases such as Google Scholar and PubMed, focusing on articles published in English within the last 10 years (2013–2023). The search terms included "Child mortality," "Infant mortality," "SIDS," "COVID‐19," and "Afghanistan." Original studies, systematic reviews, case studies, and reports meeting the inclusion criteria were selected for analysis. Additional sources from organizations such as UNICEF, the World Bank Group, WHO, and EMRO were also reviewed. Results: The study findings reveal significant challenges contributing to Afghanistan's high infant and child mortality rates. These challenges include birth defects, preterm birth, malnutrition, sudden infant death syndrome (SIDS), traumatic injuries, fatal infections, infanticide, and abuse. The ongoing conflict, insecurity, and humanitarian crises further exacerbate the situation, leading to increased child casualties. Despite efforts by international agencies like UNICEF to provide vaccines and maternal education, the infant mortality rate remains high. Conclusion: In conclusion, Afghanistan's child and infant mortality rates are of significant concern, and it is imperative that action be taken to reduce the incidence of child and infant mortality rates. [ABSTRACT FROM AUTHOR]

Background: The United Nations' Millennium Development Goals and Sustainable Development Goals both underscore the critical need to reduce the under-five mortality rate globally. China has made remarkable progress in decreasing the mortality rate of children under five. This study aims to examine the trends in child mortality rates from 2002 to 2022 and the causes of deaths among neonates, infants, and children under 5 years of age from 2013 to 2022 in Huangshi. Methods: The data resource was supported and provided by the Huangshi Health Commission, Huangshi Maternal and Child Health Hospital, and the Huangshi Statistics Bureau. Figures were drawn using Origin 2021. Results: The mortality rate among children under 5 years old significantly decreased, from 21.38 per 1,000 live births in 2002 to 3.53 per 1,000 live births in 2022. The infant mortality rate also saw a significant decline, to 15.06 per 1,000 live births. Among the 1,929 recorded child deaths from 2013 to 2022, the top three causes were: F2 (Disorders related to short gestation and low birth weight), accounting for 17.26% (333 deaths); I1 (Accidental drowning and submersion), for 14.83% (286 deaths); and I3 (Other accidental threats to breathing), for 12.29% (237 deaths). Of the 1,929 deaths, 1,117 were male children, representing 57.91%. The gender disparity in the Under-5 Mortality Rate (U5MR) was calculated to be 1.38 (boys to girls). The leading causes of death under the age of five shifted from F2 (Disorders related to short gestation and low birth weight) to I1 (Accidental drowning and submersion) as children aged, highlighting the need for policymakers and parents to intensify care and vigilance for children. Conclusions: Huangshi has achieved significant progress in lowering child mortality rates over the past two decades. The study calls for policymakers to enact more effective measures to further reduce the mortality rate among children under 5 years of age in Huangshi. Furthermore, it advises parents to dedicate more time and effort to supervising and nurturing their children, promoting a safer and healthier development. [ABSTRACT FROM AUTHOR]

Children are not born equal in their likelihood of survival. The risk of mortality is highest during and shortly after birth. In the immediate postnatal period and beyond, perinatal events, nutrition, infections, family and environmental exposures, and health services largely determine the risk of death. We argue that current public health programmes do not fully acknowledge this spectrum of risk or respond accordingly. As a result, opportunities to improve the care, survival, and development of children in resource-poor settings are overlooked. Children at high risk of mortality are underidentified and commonly treated using guidelines that do not differentiate care according to the magnitude or drivers of those risks. Children at low risk of mortality are often provided with more intensive care than needed, disproportionately using limited health-care resources with minimal or no benefits. Declines in newborn, infant, and child mortality rates globally are slowing, and further reductions are likely to be incrementally more difficult to achieve once simple, high impact interventions have been universally implemented. Currently, 63 countries have rates of neonatal mortality that are off track to meet the Sustainable Development Goal 2030 target of 12 deaths per 1000 livebirths or less, and 54 countries have rates of mortality in children younger than 5 years that are off track to meet the target of 25 deaths per 1000 livebirths or less. If these targets are to be met, a change of approach is needed to address infant and child mortality and for health-care systems to more efficiently address residual mortality. [ABSTRACT FROM AUTHOR]

The world's main indicator of children's health and general development is the infant mortality rate for infant under the age of five. Infant mortality is the term used to describe the death of a child before their first birthday. The infant mortality rate (IMR), which is the number of deaths of infants under one year of age per 1,000 live births, can be used to describe the prevalence of infant mortality in a population. Comparing the death rate of children under the age of five is the child mortality rate, commonly referred to as the under-five mortality rate. Nigeria, one of the nations with a high under-five mortality rate of 117 per 1,000 live births in 2019, is among those nations. The nation is among the top five nations with the highest mortality rate for children under five in 2019. This study aims to model infant mortality(Live birth and Still birth) rate using time series models and to predict the mortality rate using these models. Adeoyo Maternity Hospital Yemetu in Ibadan provided the data for this study. The data set is a monthly data and also a secondary data span for a period of 12 years (2009 to 2020). The time plot showed visual inspection and non-stationarity. Differencing was done and the unit root test performed for the purpose of comparison thereafter. Augmented-Dickey Fuller test and Phillip Perron unit root test was further tested for the establishment of stationarity in order to the main objectives. Three time series methods are the Autoregressive Integrated Moving Average Model(ARIMA), Exponential Smoothing and the Holt-Winters Method were used to model and predict the infant mortality rate data. The result shows that ARIMA order=c(0,0,1) with zero (0) mean for stillbirth and ARIMA order=c(1,0, 2) for live birth with the smallest AIC = (9.102 and 13.991). Akaike Information Criterion(AIC) values of (9.289, 14.139) and (9.102, 13.991) for live birth and still birth, respectively, were derived by exponential smoothing and Holtwinters technique. This means that Holtwinters' technique, which yielded the lowest AIC when compared to ARIMA and exponential smoothing, is the most accurate predictor of both stillbirth and live birth data. Given the high mortality rate for children under the age of five, it is crucial for the government to place more of an emphasis on health issues and to solve the problems plaguing Nigeria's child health care system. [ABSTRACT FROM AUTHOR]

the research aims to compare the estimators of robust regression methods (the robustM method - the robust MM method - the robustS method), the detection of the nature of the distribution of data, the discovery of abnormal and extreme data of the study variables, in addition to revealing the stability of time chains, and testing a relationship Joint integration by analyzing the relationship between the studied demographic variables represented in (infant mortality - the number of maternal deaths - raw death rate - the rate of widespread malnutrition - female death rate - child mortality rate under the age For every 1,000 neighborhood births) as independent variables, and the total fertility rate as a variable in the Republic of Yemen for the period (1990-2015). The research concluded with many results, the most important of which is that the best way to estimate the features of the stoned slope is the m fort- as it achieved the best values of the comparison standards of (RMSE-Mae-MAPE Theil Coefficient), and tests of abnormal values represented in (H) HAT showed -Matrix- Covratio - DFFITS) The study data suffers from abnormal values, and the study showed that the studied demographic variables affect the total fertility rate by 84%, while 14% belong to other factors that are not included in the estimated form. [ABSTRACT FROM AUTHOR]

Objective: Child mortality and stillbirth rates (SBR) remain high in low‐income countries but may be underestimated due to incomplete reporting of child deaths in retrospective pregnancy/birth histories. The aim of this study is to compare stillbirth and mortality estimates derived using two different methods: the method assuming full information and the prospective method. Methods: Bandim Health Project's Health and Demographic Surveillance Systems (HDSS) follows women of reproductive age and children under five through routine home visits every 1, 2 or 6 months. Between 2012 and 2020, we estimated and compared early neonatal (ENMR, <7 days), neonatal (NMR, <28 days), and infant mortality (IMR, <1 year) per 1000 live births and SBR per 1000 births. Risk time for children born to registered women was calculated from birth (the method assuming full information) versus date of first observation in the HDSS (the prospective method), either at birth (for pregnancy registration) or registration. Rates were calculated using the Kaplan–Meier estimator and compared in generalised linear models allowing for within‐child correlation obtaining relative risks (RR). Results: We registered and followed 29,413 infants (1380 deaths; 1459 stillbirths) prospectively. An additional 164 infant deaths and 129 stillbirths were registered retrospectively and included in the method assuming full information. The ENMR was 24.5 (95%CI: 22.6–26.4) for the method assuming full information and 25.8 (23.7–27.8) for the prospective method, RR = 0.96 (0.93–0.99). Differences were smaller for the NMRs and IMRs. For SBRs, the estimates were 53.5 (50.9–56.0) and 58.6 (55.7–61.5); RR = 0.91 (0.90–0.93). The difference between methods became more pronounced when the analysis was limited to areas visited every 6 months: RR for ENMR: 0.91 (0.86–0.96) and RR for SBR: 0.85 (0.83–0.87). Conclusions: Assuming full information underestimates SBR and ENMR. Accounting for omissions of stillbirths and early neonatal deaths may lead to more accurate estimates and improved ability to monitor mortality. [ABSTRACT FROM AUTHOR]

Infant mortality is analyzed as a public health problem in Santiago between 1930-1970 with the aim of reflecting on the factors that caused its permanence and subsequent decline. For this, the environment where the children lived, their illnesses, and the medical and State action to cure them are characterized, based on newspapers, medical literature and state documentation. This study reveals the serious food and housing problem suffered by infants, resulting in a very high mortality rate. The conclusions highlight the importance of national health programs --and international support to implement them-- focused on mothers and children, which created an idea about the importance of disease prevention and various ad hoc practices that decreased infant mortality. [ABSTRACT FROM AUTHOR]

Copyright of Neurologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In South Asia, Pakistan is contributing to the highest childhood mortality, including infant mortality. Child mortality has been declined globally, but Pakistan is still struggling and far behind the targets of Sustainable Development Goals. There are several reasons behind high childhood mortality, including socioeconomic determinants and a lack of effective implementation of health-related policies, particularly in primary health care settings. In the present study, we use the stochastic univariate models to uncover the trend of infant mortality by using more than half of the century data from 1960-2017. The secondary data on infant mortality rate from 1960 to 2017 was extracted from World Bank Dataset. Descriptive and time series analysis were applied by using the programming language R. The median infant mortality rate was 109 per 1,000 live births, whereas a higher mortality rate (189.8/1000) was reported in 1960. A gradual decline in infant mortality rates is experienced every year. The mortality rate went down below 100/1,000 live births from 1993 and remained 61.2/1,000 in 2017. ARIMA (1, 2, 2) is an adequate forecasting model selected by using the Auto ARIMA function with a root mean square error is 0.1006. Five years ahead forecast is obtained and yielded that infant mortality rate is expected to remain in 2018 [59.54, C.I (59.34 - 59.73)], 2019 [57.93, C.I (57.47 - 58.40)], 2020 [56.39, C.I (55.48 - 57.30)], 2021 [54.90, C.I (53.35 - 56.45)] and 2022 [53.47, C.I (51.05 - 55.88)]. The decreasing trend is expected in the infant mortality rate in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Despite the declining trends worldwide, infant and child mortality rates are still high in many African countries. These high rates are problematic; therefore, this study attempts to explore the contributing factors that cause high infant and child mortality rates in 14 African countries using panel data for the period of 2000-2018. In particular, the role globalisation is explored.Methods: The panel corrected standard error (PCSE), the Feasible generalized least square (FGLS) models, and the pair-wise Granger causality test have been applied as methodological approaches.Results: The public health expenditure, numbers of physicians, globalization, economic development, education, good governance, and HIV prevalence rate have been revealed as the determinants of infant and child mortality in these countries. All these variables except the HIV prevalence rate negatively affect the infant and child mortality rates, while the HIV prevalence rate is found to be positive. Bidirectional and unidirectional causal relationships between the variables are also attained.Conclusions: Effective socio-economic policy priority with due consideration of globalization should be emphasized to reduce infant and child mortality rates in these countries. [ABSTRACT FROM AUTHOR]

This paper examines the effect of public and private health spending on health outcomes measured by infant and child mortality rate using a panel of 37 African countries over the period 1995–2018. Based on both system generalized method of moments and least squared dummy variable corrected bias estimators, we find that the level of public health expenditures has statistically significant positive effects on mortality reduction. However, private health spending has a statistically significant positive effect on infant and child mortality rates when it interacts with public health spending. This means that the health effect of private health expenditure is strengthened by public health spending. Conditioning on the level of private health expenditure, the total effect of public health expenditure on child mortality reduction is slightly higher in absolute value than that of private health expenditure. The main policy implication that emerges from our results is the need to increase public health expenditure and support the effectiveness of private health expenditure. This additional fund should be allocated to some specific expenditure categories which have a very direct link with child and infant mortality rates. [ABSTRACT FROM AUTHOR]

Background: The infant mortality rate (IMR) is considered a basic measure of public health for countries around the world. The specific aim of our study was to provide an updated description of infant mortality rate among different regions in rural China, and assess the trends and causes of the IMR geographical disparities.Methods: Data were collected from China's Under-5 Child Mortality Surveillance System(U5CMSS). The annual number of deaths and causes of death were adjusted using a 3-year moving average underreporting rate based on annual national data quality control results. The average annual decline rate (AADR) and the relative risk (RR) of the IMR and cause-specific infant mortality were calculated by Poisson regression and the Cochran-Mantel-Haenszel method. Data analysis was completed by SAS software.Results: There was an apparent decrease in infant mortality in rural China from 2010 to 2018, at the AADR of 11.0% (95%CI 9.6-12.4), 11.2% (95%CI 10.3-12.1) and 6.6% (95%CI 6.0-7.3) in the eastern, central and western rural areas, respectively. The IMR was highest in the western rural area, followed by the central and eastern rural areas. Compared with the eastern rural area, the RR of infant mortality in the central rural area remained at 1.4-1.6 and increased from 2.4 (95%CI 2.3-2.6) in 2010-2012 to 3.1 (95% CI 2.9-3.4) in 2016-2018 in the western rural area. Pneumonia, preterm birth /LBW and birth asphyxia were the leading causes of infant deaths in the western rural area. Mortality rates of these three causes fell significantly in 2010-2018 but contributed to a higher proportion of deaths in the western rural area than in the central and western rural ares.Conclusions: Our study indicated that the infant mortality rate dropped significantly from 2010 to 2018, however, geographical disparities of IMR in rural China are still persist. Therefore, there is an urgent need for public health programmes and policy interventions for infants in western rural China. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the spatio-temporal distribution of infant mortality and its components in the city of Rio de Janeiro, Brazil, in 2010 and 2019. Methods: Infant mortality rate and the neonatal and postneonatal components were estimated. The standardized mortality rate was calculated to detect excess child mortality in the planning areas. Poisson regression was performed to estimate the effect of these planning areas on the years 2010 and 2019. Spatial analysis per neighborhoods was performed to identify the spatial autocorrelation rates, using the Moran's Index and local indicator of spatial association (LISA). Results: The planning areas are very heterogeneous, depending on the history and evolution of occupation. There is an excess of mortality in planning areas with greater social vulnerability. In the Poisson model, it was observed that in all components, the planning area (PA) of residence was statistically significant as well as the year. Moran's index did not show global spatial autocorrelation. However, when applying the LISA method, autocorrelation was observed at the local level and spatial clusters in the municipality of Rio de Janeiro. Conclusions: The spatial heterogeneity of the infant mortality rate in Rio de Janeiro suggests that local health policy strategies of each region consist in an efficient measure for reducing this rate. [ABSTRACT FROM AUTHOR]

Health resources are an important factor to reduce infant and child mortality. However, taking into account budget constraints, it is very difficult to increase public health resources for all regions within a country at the same time. For this reason, in this paper, we assess the effects of the regional health government expenditure assignment as well as the regional health resources available such as beds or paediatricians. We estimate a dynamic model using a system-GMM (Generalised Method of Moments) to explain infant and child-mortality in Kazakhstan during the period 2000–2018. In this period, Kazakhstan experiences a sharp decrease in infant and child mortality reaching the target values from sustainable development goals (SDG). We evaluate several variables to capture the effects of public health resources assignment, such as expenditure per capita, expenditure depending on previous year mortality rates as well as health facilities resources for children by region. Results show that an increase in health expenditure per capita in those regions with high mortality levels is particularly relevant to reduce infant mortality while health facilities are actually more important to reduce an under-5 mortality rate. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors related to the infant mortality rate (IMR) and under-five mortality rate (U5MR) in Turkey. Material and Methods: An ecological study was conducted using the provincial data of the Turkish Statistical Institute (TURKSTAT) and the Ministry of Health. Results: IMR and U5MR (r values for these two parameters are respectively mentioned in parenthesis) had a statistically significant relationship with total fertility rate (TFR) (r=0.661 and 0.718), ratio of adolescent births to total births (r=0.542 and 0.587), gross domestic product (GDP) per capita (r=-0.555 and -0.591), proportion of women aged =18 with high school or higher education (r=-0.434 and -0.470), number of physicians per 100,000 people (r=-0.352 and -0.398), number of hospital beds per 100,000 people (r=-0.244 and -0.286), and number of newborn intensive care beds per thousand births (r=-0.324 and -0.359). In bivariate models for IMR, the effect of all of the abovementioned parameters on the model was statistically significant, except for the number of hospital beds per 100,000 people. In bivariate models for U5MR, the effect of all the above-mentioned parameters on the model was statistically significant. TFR was the only variable with a statistically significant effect on the multivariate model for both IMR (standardized β=0.621, R2=0.385) and U5MR (standardized ß=0.667, R2=0.445). Conclusion: The results showed the presence of a weak correlation for the variables related to the numbers of healthcare professionals and hospital beds, thereby indicating that the effect of healthcare service provision is rather indirect. Health promotion programs can be developed for infant and child mortality with the aim of changing high fertility preferences and preventing adolescent pregnancies. Economic policies that improve income distribution and initiatives to increase education levels of girls can be life-saving for infants and children. [ABSTRACT FROM AUTHOR]

Within the UK, child mortality from all causes has declined for all ages over the last three decades. However, distinct inequality remains, as child mortality rates are generally found to be higher in males. A significant proportion of childhood deaths in the UK occur in Paediatric Intensive Care Units (PICU). We studied the association of sex with infant mortality in PICUs. We included all infants (0 to 12 months old) admitted to UK PICUs from 01/01/2005 to 31/12/2015 using the Paediatric Intensive Care Audit Network (PICANet) dataset. We considered first admissions to PICU and fitted a cause-specific-hazard-ratio (CSHR) model, and a logistic model to estimate the adjusted association between sex and mortality in PICU. Pre-defined subgroups were children less than 56-days old, and those with a primary diagnosis of infection. Of 71,243 cases, 1,411/29,520 (4.8%) of females, and 1,809/41,723 (4.3%) of males died. The adjusted male/female CSHR was 0.87 (95%-CI 0.81 to 0.92) representing a 13% higher risk of death for females. The adjusted OR for male to female mortality is 0.86 (95%-CI 0.80 to 0.93). Analyses in subgroups yielded similar findings. In our analysis, female infants have a higher rate of PICU mortality compared to male infants. [ABSTRACT FROM AUTHOR]

With improved surgical outcomes, infants and children with congenital heart disease (CHD) may die from other causes of death (COD) other than CHD. We sought to describe the COD in youth with CHD in North Carolina (NC). Patients from birth to 20 years of age with a healthcare encounter between 2008 and 2013 in NC were identified by ICD-9 code. Patients who could be linked to a NC death certificate between 2008 and 2016 were included. Patients were divided by CHD subtypes (severe, shunt, valve, other). COD was compared between groups. Records of 35,542 patients < 20 years old were evaluated. There were 15,277 infants with an annual mortality rate of 3.5 deaths per 100 live births. The most frequent COD in infants (age < 1 year) were CHD (31.7%), lung disease (16.1%), and infection (11.4%). In 20,265 children (age 1 to < 20 years), there was annual mortality rate of 9.7 deaths per 1000 at risk. The most frequent COD in children were CHD (34.2%), neurologic disease (10.2%), and infection (9.5%). In the severe subtype, CHD was the most common COD. In infants with shunt-type CHD disease, lung disease (19.5%) was the most common COD. The mortality rate in infants was three times higher when compared to children. CHD is the most common underlying COD, but in those with shunt-type lesions, extra-cardiac COD is more common. A multidisciplinary approach in CHD patients, where development of best practice models regarding comorbid conditions such as lung disease and neurologic disease could improve outcomes in this patient population. [ABSTRACT FROM AUTHOR]

Previous studies show that children in lower socioeconomic status families reveal higher rates of mortality. We complement the income-mortality literature by establishing a causal link between income and child mortality. Our instrument for income is based on time-series global shocks to oil prices combined with the cross-sectional share of employment in manufacturing across US states as their exposure to oil price changes. Using the universe of death records between the years 1975-2004, we find the OLS results of income-child-mortality relationships are under-biased. The 2SLS-IV results suggest that a $1,000 increase in income per capita at the state level reduces child mortality and infant mortality by 0.87 and 0.53 fewer incidences per 1,000 population of agespecific children. [ABSTRACT FROM AUTHOR]

Purpose: This article examines whether increasing the income of the poor – measured as the income of the lowest quintile – is more beneficial in reducing infant and child mortality rates compared with increases in average income. Given the global importance in reducing infant mortality, the value of this research is important to academics, policymakers and practitioners alike. Design/methodology/approach: Using a sample of 86 countries from 1995–2014 inclusive, our preferred estimation strategy uses an instrumental variable fixed-effects estimator. Findings: Our results propose that the elasticity of the income of the lowest quintile never exceeds that of average income. Therefore, if reducing infant and child mortality is a key policy goal, then boosting average income may be preferable to raising incomes at the lower end of the distribution. Originality/value: Given these findings, we open a gateway for new literature to add to this unexplored area of research in the income and health relationship. [ABSTRACT FROM AUTHOR]

This study examined the bio-demographic, socioeconomic, environmental, and health-related determinants of infant mortality in the Kingdom of Bhutan. The nationally representative dataset of the 2012 National Health Survey (NHS), Ministry of Health of Bhutan, was used. Cox proportional hazards regression from survival analysis, accounting for the complex study design of the NHS, was performed using a stepwise approach to identify the determinants associated with infant mortality. The weighted infant mortality rate from November 2009 to October 2011 was 34 per 1,000 live births. Children born to uneducated mothers (aHR=2.27; 95%CI=1.16-4.47) and mothers who experienced domestic violence during pregnancy (aHR=4.24; 95%CI=1.45-12.41) were more likely to die before reaching their first birthday. Those infants born in households that used solid fuel were 2.16 times (95%CI=1.21-3.85) more likely to die than their counterparts. Relative to those born in the central region, children born in western (aHR=6.13; 95%CI=2.84-13.20) and the eastern (aHR=5.13; 95%CI=2.81-9.35) regions had a greater risk of dying. The results showed that education, domestic violence experience, solid fuel use, and region of residence are the key determinants of infant mortality in Bhutan. Policies that facilitate education and empowerment of women, prevent domestic violence, reduce solid fuel use, and equitable regional socioeconomic development policies may help accelerate the reduction of child mortality. [ABSTRACT FROM AUTHOR]

The world is today a healthier and safer place than ever, and children have the chance to become responsible adults and to enjoy their lives. Romania has made unquestionable progress, especially in the last two decades, with infant mortality rates increasingly approaching the European average. However, our country still occupies leading places across the European continent on child deaths, with children remaining in our society, the most vulnerable social category. Strong territorial and social disparities mark this positive development. In our study we intend to identify the particularities (ethnic and confessional) that influence, in some cases, child mortality in Iași county (four types of communes with distinct ethnic and confessional). Whereas a clearing-up is taking place in Iași county between vulnerable socio-economic communities and those with higher levels of development. The results of the study show a stronger correlation between the ethnic factor and the level of infant mortality as opposed to the confessional factor, closely linked to the incidence of educational, economic or demographic factors. [ABSTRACT FROM AUTHOR]

Maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine confers protection to young infants. We aimed to describe trends in pertussis incidence and associated mortality in children aged <12 months before and after introduction of maternal Tdap immunization in Bogotá, Colombia. Data on pertussis-related cases/deaths in infants aged <12 months were collected from SIVIGILA for the period 2005–2016, and compared incidence for the pre-vaccine introduction (2005–2012) and post-maternal Tdap vaccination (2014–2016) periods in infants aged <12 months and in three distinct age-strata; ≤6 weeks, 7–<28 weeks, and 28–52 weeks. Mortality comparisons were performed in all infants <12 months. From 2005 to 2016, 2315 laboratory or clinically-confirmed pertussis cases were reported in infants <12 months of age (278 cases in young infants aged ≤6 weeks); 55 pertussis deaths were reported in children aged <12 months. No pertussis deaths were reported in the 2014–2016 period. Since maternal Tdap introduction in 2013, a consistent decline in pertussis incidence and mortality was observed. In the time-series analysis, incidence declined from 209.4/100,000 persons (2005–2012) to 49.1/100,000 persons (2014–2016) in all children <12 months; a 87.5% (95%CI: 77.2-93.2%) reduction. For these same period's incidence in young infants ≤6 weeks declined from 196.7 to 89.6/100,000 person-years (an 54.4% [95% CI: 35.4–67.9%] reduction). Greater incidence reductions were observed in older infants; 73.4% (95% CI: 68.4–77.6%) in those aged 7–<28 weeks, and 100% in those aged 28–52 weeks. A 100% reduction in Pertussis mortality in infants <12 months was observed. Since Tdap introduction, maternal vaccine coverage rose from <60% in 2013–2015 to 80% in 2016. Implementation of maternal immunization in Bogotá may have contributed to the reduction in pertussis incidence and mortality among infants <12 months of age (ClinicalTrials.gov: NCT02569879). An Audio Summary linked to this article that can be found on Figshare https://doi.org/10.6084/m9.figshare.12943316 [ABSTRACT FROM AUTHOR]

Child mortality is very important to be considered by policymakers, especially for developing countries, like Indonesia. Child mortality rates reflect the level of health development of a country and the quality of life of its people. The Government of Indonesia through the 2015-2019 National Medium-Term Development Plan (RPJMN) has set a target of achieving a reduction in infant mortality of 24 per 1000 births in 2019. Achievement targets that have been made, are intended to follow the major goals of the Sustainable development goals (SDGs) in health and welfare. The government has issued a policy to reduce child mortality through programs such as Healthy Indonesia with a family approach through Permenkes no.39 of 2016. Based on data obtained by the Indonesian Central Statistics Agency (BPS), it was found that neonatal mortality, infant mortality, and infant mortality from 1991 to 2017 there was a decline which meant that there was progress in efforts to reduce child mortality. The success of the Government of Indonesia in reducing child mortality can not be separated from the use of expert theory well. the theories used as references are those of Mosley and Chen, and Filmer who states that children's survival is influenced by social, economic, and biomedical factors. [ABSTRACT FROM AUTHOR]

Achieving sustained improvements in health outcomes remains a challenge for sub-Saharan Africa, where diarrhoea remains a leading cause of death in children under the age of five. This paper examines the impact of foreign aid to the health sector on diarrhoea mortality in children under five in 47 sub-Saharan African countries, using panel data on the sectoral allocation of official development assistance in conjunction with country-level data on health outcomes. After controlling for fixed effects and the potential endogeneity of health aid, we find that increased health aid and increased public health expenditure are associated with lower diarrhoea mortality in children under five. In addition, health aid increases government spending on health, suggesting that the overall impact of health aid on diarrheal death rates could exceed the direct effect. Furthermore, increased access to improved sources of water and sanitation are important in reducing child mortality from diarrhoea. [ABSTRACT FROM AUTHOR]

Age specific mortality curves exhibit an age t c (about 10 years) which plays a crucial role in that the mortality curve decreases hyperbolically in the age interval A before t c and increases exponentially in the interval B following t c . For those familiar with reliability theory, region A is called the “burn in” phase and B is the “wear out” phase. Using the exponents of the hyperbolic and exponential phases, we introduce a new 2 dimensional map of diseases. This permits the classification of diseases into three broad classes: AS1, AS2 and S. Class AS1 includes all diseases arising from congenital malformations which dominate infant and child mortality; class AS2 includes degenerative diseases such as dementia and Alzheimer’s which dominate old age mortality. In class S, which includes most infectious and metabolic diseases, the exponents from both aging phases contribute to positions on the map. Cancer is one of these mixed cases but is closer to class AS2 than AS1. A second line classification is needed to resolve S cases and to this end we introduce a 3rd dimension, namely (calendar) time. Using historical data we show that in their response to treatment (particularly vaccination), S diseases fall into three sub-classes. (i) Class E diseases (e.g. measles or meningococcal disease) which have been almost eliminated at all ages (ii) class C diseases (e.g. tuberculosis) which can be cured but whose cure becomes less effective at old age. (iii) Class U diseases for which radical cures are still unknown. Regarding the future, the fact that the wear-out process of numerous diseases already starts around the age of 25 means that a major extension of the human lifespan beyond 120 certainly also requires to uncover the secret of the “elixir of eternal youth” which has driven timeless human efforts and still seems unlikely in the foreseeable future. [ABSTRACT FROM AUTHOR]

Background: Infant and child mortality rates are among the health indicators of importance in a given community or country. It is the fourth millennium development goal that by 2015, all the United Nations member countries are expected to have reduced their infant and child mortality rates by two-thirds. Uganda is one of those countries in Sub-Saharan Africa with high infant and child mortality rates, therefore it is important to use sound statistical methods to determine which factors are strongly associated with child mortality which in turn will help inform the design of intervention strategiesMethods: The Uganda Demographic Health Survey (UDHS) funded by USAID, UNFPA, UNICEF, Irish Aid and the United Kingdom government provides a data set which is rich in information on child mortality or survival. Survival analysis techniques are among the well-developed methods in Statistics for analysing time to event data. These methods were adopted in this paper to examine factors affecting under-five child mortality rates (UMR) in Uganda using the UDHS data for 2011 in R and STATA software.Results: Results obtained by fitting the Cox-proportional hazard model with frailty effects and drawing inference using both the frequentists and Bayesian approaches at 5 % significance level, show evidence of the existence of unobserved heterogeneity at the household level but there was not enough evidence to conclude the existence of unobserved heterogeneity at the community level. Sex of the household head, sex of the child and number of births in the past one year were found to be significant. The results further suggest that over the period of 1990-2015, Uganda reduced its UMR by 52 % .Conclusion: Uganda has not achieved the MDG4 target but the 52 % reduction in the UMR is a move in the positive direction. Demographic factors (sex of the household head) and Biological determinants (sex of the child and number of births in the past one year) are strongly associated with high UMR. Heterogeneity or unobserved covariates were found to be significant at the household but insignificant at the community level. [ABSTRACT FROM AUTHOR]

Tanzania’s child mortality rate—between 103 and 130 deaths per 1000 live births–is well above the world average. The data from the Tanzania HIV/AIDS and Malaria Indicator Survey 2007/08 were used in order. There were 27,511 children included in the analysis. Regression analysis focused on child mortality based on maternal and fertility behaviours. Children belonging to the group of higher birth order faced 0.17 odds of dying. A birth spacing of 24 months or longer was observed in the successive birth interval for 76% of the respondents. Focusing on the study’s findings, encouraging longer breastfeeding practice is one way to help produce a healthy baby. [ABSTRACT FROM AUTHOR]

Background: The rate of decline in child mortality is too slow in most African countries to achieve the Millennium Development Goal of reducing under-five mortality by two-thirds between 1990 and 2015. Effective strategies to monitor child mortality are needed where accurate vital registration data are lacking to help governments assess and report on progress in child survival. We present results from a test of a mortality monitoring approach based on recording of births and deaths by specially trained community health workers (CHWs) in Malawi. Methods and Findings: Government-employed community health workers in Malawi are responsible for maintaining a Village Health Register, in which they record births and deaths that occur in their catchment area. We expanded on this system to provide additional training, supervision and incentives. We tested the equivalence between child mortality rates obtained from data on births and deaths collected by 160 randomly-selected and trained CHWs over twenty months in two districts to those computed through a standard household mortality survey. CHW reports produced an under-five mortality rate that was 84% (95%CI: [0.71,1.00]) of the household survey mortality rate and statistically equivalent to it. However, CHW data consistently underestimated under-five mortality, with levels of under-estimation increasing over time. Under-five deaths were more likely to be missed than births. Neonatal and infant deaths were more likely to be missed than older deaths. Conclusion: This first test of the accuracy and completeness of vital events data reported by CHWs in Malawi as a strategy for monitoring child mortality shows promising results but underestimated child mortality and was not stable over the four periods assessed. Given the Malawi government's commitment to strengthen its vital registration system, we are working with the Ministry of Health to implement a revised version of the approach that provides increased support to CHWs. [ABSTRACT FROM AUTHOR]

Background: Life table is a multilateral demographer's tool and also a non parametric method. Some of the estimates of the mortality are obtained from the statistical form famous as life table. Aim of the Study: The main purpose of this study is to find the mortality rate and the remaining expected life of the children in Multan. Study Design: Study was conducted for a period of six months from 1st January 2010 to 30th June 2010 in Pediatric Unit II from ward 19 and 20 in Nishter Hospital Multan Pakistan. Subject and Methods: A total of 484 children with different diseases were included in this study. Among 484 subjects, 232 cases were reported as death. The study subjects were less than or equal to one year of age. Duration of illness and mortality was analyzed for all the cases. We have studied survival and dying probabilities patterns under different diseases by using life table analysis. These life tables are constructed on all children diseases with age interval in days, weekly and Monthly. Graphically we plot px, qx, dx against time. Results: 86 children were died on first day of their birth, 163 were died before reached their first week of birth while 192 children were died before reaching their first month of birth. The probability of dying is higher in the new born babies as other age children. Conclusion: Our study shows that probability of dying of children is higher at the start of their life, as their chances of death are greater in the beginning of their life, and probability of surviving of children is low at the neonatal period. [ABSTRACT FROM AUTHOR]

The purpose of this article is to explore the connection between household composition and infant mortality in the first half of the twentieth century in Taiwan. The research results claim that illegitimate infants have higher death risk than legitimate infants; that contrary to expectation female infants have mortality rates as high as boys; and that same sex sibling order effects are approximately same among boys and girls. The significance for infant mortality of the sex of household head is the other major finding of this article: female-headed families have higher rates of infant mortality. [ABSTRACT FROM PUBLISHER]

Background: There has been a considerable decline in fetal and neonatal mortality in the Western world. The authors hypothesized that this decline has been largest for boys, since boys have a higher risk of fetal and neonatal death. Methods: The authors used data from the Medical Birth Registry about all births in Norway to study changes during 1967-2005 in mortality for boys and girls from the 23rd week of pregnancy until one month after birth. Absolute and relative yearly changes in fetal and neonatal death rates were estimated separately for boys and girls. Results: From 1967 to 2005, the average annual reduction in the overall death rate was greater for boys: 0.47 per 1000 boys (95% CI: 0.45, 0.48) and 0.37 per 1000 girls (95% CI: 0.35, 0.39). These estimates were not affected by adjustments made for changes over time in maternal characteristics. The convergence in death rates by sex was strongest for the first week after birth: average annual reduction in the early neonatal death rate was 0.24 per 1000 boys (95% CI: 0.23, 0.25) and 0.17 per 1000 girls (95% CI: 0.16, 0.18). The death rates for boys and girls also converged during pregnancy and from one week to one month after birth. The relative reduction in death rates was quite similar for boys and girls: the overall death rate fell annually by 4.4% (95% CI: 4.3, 4.6%) for boys and by 4.2% (95% CI: 4.0, 4.4%) for girls. Conclusions: During the period 1967-2005, the absolute reduction in fetal and neonatal death rates was greatest for boys. The relative reduction in mortality was about the same for both sexes, but the absolute reduction was greatest for boys since the mortality for boys began at a higher level. The convergence of death rates was not due to changes in the composition of mothers, suggesting that convergence has been caused by technological progress. [ABSTRACT FROM AUTHOR]

In the light of Mozambique's progress towards the achievement of Millennium Development Goal 4 of reducing mortality of children aged less than five years (under-five mortality) by two-thirds within 2015, this study investigated the relationship between the province of mother's residence and under-five mortality in Mozambique, using data from the 2003 Mozambican Demographic and Health Survey. The analyses included 10,326 children born within 10 years before the survey. Results of univariate and multivariate analyses showed a significant association between under-five mortality and province (region) of mother's residence. Children of mothers living in the North provinces (Niassa, Cabo Delgado, and Nampula) and the Central provinces (Zambezia, Sofala, Manica, and Tete) had higher risks of mortality than children whose mothers lived in the South provinces, especially Maputo province and Maputo city. However, controlling for the demographic, socioeconomic and environmental variables, the significance found between the place of mother's residence and under-five mortality reduced slightly. This suggests that other variables (income distribution and trade, density of population, distribution of the basic infrastructure, including healthcare services, climatic and ecologic factors), which were not included in the study, may have confounding effects. This study supports the thought that interventions aimed at reducing under-five mortality should be tailored to take into account the subnational/regional variation in economic development. However, research is warranted to further investigate the potential determinants behind the observed differences in under-five mortality. [ABSTRACT FROM AUTHOR]

Background This study used national data to determine if violent child death rates fell between 1974 and 2008. Design Using mortality data from the Office of National Statistics, categories potentially containing violent child deaths were analysed for children aged <1, 1-14 and 15-19 years. These data were compared with Home Office data on recorded homicides in children aged <1 and 1-15 years. Results Annual rates of infant deaths registered as due to assault fell between 1974 and 2008 from 5.6 to 0.7 per 100 000 infants; those in children (1-14 years) fell from 0.6 to 0.2 per 100 000. When these deaths are combined with those registered as undetermined intent, rates are higher but still show a decline in both groups. There is a slight fall in the rates of police recorded homicides in infants, but no observable change in childhood rates. In adolescents, the rates of death from assault fell during the 1970s and have since remained static in females but have risen in males. When these deaths are combined with those registered as undetermined intent, the rates for adolescent women have remained static at 2.0 per 100 000, while for young men they increased from 3.3 to 5.7 per 100 000 before declining to 4.2 per 100 000. Conclusion These data provide evidence that rates of violent death in infancy and middle childhood have fallen over the past 30 years. In contrast, rates in adolescence have remained static or risen over the same period. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the levels and trends in child mortality in 187 countries from 1970 to 2010. Study authors utilized a database containing 16,174 measurements of mortality in children younger than five years and used Gaussian process regression to generate estimates. They found that the worldwide mortality of children younger than five years decreased from 11.9 million in 1990 to 7.7 million in 2010. Global decline in neonatal mortality was 2.1 percent, 2.3 percent in postneonatal mortality and 2.2 percent in childhood mortality. Study authors also concluded that the declining rates of child mortality should be given more policy attention.

The association between birth cohort and subsequent mortality has been of interest especially following publication of studies around 1930 of cohorts born up to the latter part of the nineteenth century, particularly for England and Wales. Updated results are presented for this population, together with those for two other cohorts, twentieth-century Japanese and British populations born about 1930, which have been identified as having particularly clear-cut birth cohort patterns, and which are used to underpin incorporation of cohort effects in both British official and actuarial mortality forecasts. Graphical methods used to identify cohort patterns are discussed. A number of limitations and difficulties are identified that mean that the conclusions about the predominance of cohort effects are less robust than often assumed. It is argued that alternative explanations should be considered and that the concentration on birth cohorts with particularly advantaged patterns may distort research priorities. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to study the cross-country relation between initial levels of infant-, child- and maternal-mortality and their rates of decline so as to see whether the so-called Matthew effect or the inverse-care principle operates relative to these three important health indicators. Design/methodology/approach - Data on the three variables for a large number of countries covering several periods between 1950 and 2007 are considered. Signs and significance of correlations between initial levels and the rates of decline over the period, and of coefficients of initial levels in regressions of rates of decline on the initial level, are studied. Findings - First, in a broad global context, higher initial levels of mortality are associated with significantly lower rates of decline in each of the three indicators for every period, thus providing strong support to the operation of the inverse-care principle and the Matthew effect. Second, the high-income countries (and transition economies) deviate from the global pattern. Third, following Hart's suggestion, the parametric contrast between the high income and the developing groups may be interpreted as indicative of stronger government intervention in the healthcare sector in high-income countries. Fourth, the contrast may thus indicate the desirability of greater government intervention in provision of healthcare in developing countries. Fifth, operation of the inverse-care principle and the Matthew effect is observed even in the absence of high-HIV prevalence. Sixth, the observed negative covariation between initial mortality and its rate of decline implies cross-country divergence in these core indicators of health. Originality/value - First, this is the only study to investigate the operation of the inverse-care principle relative to infant mortality for such a large number of countries and such a long period. Second, it is also the only study to extend the investigation to child-mortality and maternal-mortality, which are heavily emphasized in the millennium development goals. Third, the patterns are studied not only merely for the entire set of countries, but also for several subgroups. Fourth, the observed parametric contrasts are interpreted as possibly reflecting the importance of government intervention in the healthcare sector in mitigating the operation of the inverse-care phenomenon. Fifth, an effort is made to factor out the role of HIV so as to show that the pattern is not significantly altered by high prevalence of HIV in poor countries. Sixth, the implied cross-country divergence in these important health variables is suggestive of the need for caution in interpreting the conclusions stated by some scholars about convergence in several quality-of-life indicators. Last, contrary to what some scholars have suggested, not merely does it not seem to be the case that the inverse-care proposition relative to infant mortality is observed only in exceptional cases, but the reported evidence suggests that the proposition holds globally over long periods even for child- and maternal-mortality. [ABSTRACT FROM AUTHOR]

Despite this generally positive trend, our country continues to have the highest rates of infant mortality between countries and EU candidate countries, with a better reporting system of infant mortality. The study aims to identify and assess infectious risk factors affecting the survival chances of the child. This study is a descriptive epidemiological study of Cluj district population of children under 1 year, born between 2001-2007. In Cluj district, birth rate is rising slightly from 8.8 ‰ in 2000 to 9.3 ‰ in 2007, with a peak in rural areas (10.3 ‰ in 2000 and a minimum urban areas (7.8 ‰) in 2001. Infant mortality rate gradually decreases (29.7 ‰ in 1990 to 14.1 ‰ in 2007) but remains much higher in rural compared to urban (24.1 ‰ in 1990 to 10.2 ‰ in 2007). In the evolution of infant mortality depending on the causes of death between 1991-2007 there was a decrease in deaths due to respiratory disease, due to perinatal pathology and due to infectious and parasitic diseases. Congenital malformations death rate remains high and at constant level. Infant mortality is obviously decreasing, but its value remains among the highest in Europe. There is a very high proportion of deaths from respiratory diseases. These deaths are considered avoidable. [ABSTRACT FROM AUTHOR]

Data on under five mortality in the twelve countries of the Commonwealth of Independent States show important fluctuations over time due to variations in quality of data, definitions of neonatal deaths and methods of mortality estimation. Despite the uncertainties regarding mortality trends, the analysis of health and social information from different sources offers clues to identify priority areas and key strategic directions for accelerating the achievement of the 4th Millennium Development Goal. Neonatal deaths represent from 40% to over 50% of under five deaths in all these countries. Maternal mortality was above 50 per 100,000 in 2005, despite the good coverage with antenatal care and births assisted by skilled birth attendants. The scanty information on quality of perinatal care indicates widespread substandard care at all levels. Stunting in children under five is above 10% in ten out of twelve countries and coexists with emerging overweight. Exclusivity and duration of breastfeeding fall short of what is recommended. There are important inequalities in child and maternal mortality, malnutrition and access and use of health services within countries. Taken as a whole, the available information clearly indicates that priority should be given to improvement of the health of women in reproductive age and of the quality of perinatal care, including the establishment of reliable data collection systems. To achieve this, action will need to focus on strengthening the capacity of the health system to improve the technical content of service provision, and on improving access and appropriate use of services by the most disadvantaged groups. The involvement of other sectors will be necessary to improve reproductive health and nutrition at community level and to tackle inequity. Comparisons between countries with similar socioeconomic background but different health policies seem to indicate that gradual progression towards universal coverage with essential health care through a national health insurance system is associated with larger reduction of child mortality than troubled transition towards a privatized and unregulated health system. [ABSTRACT FROM AUTHOR]

High infant mortality rates were traditionally considered as a matter of fate and the death of an infant was accompanied by paternal indifference. Declining birth rates at the beginning of the twentieth century and continuing high infant mortality rates, particularly when assessed from an international perspective, led to the emergence of an increasing infant welfare movement in Imperial Germany. This paper assesses the scope and the broad impact of the movement focussing on three selected subject areas: (1.) the commencement of the infant welfare movement as "Volksbelehrung", (2.) the 1911 heat wave with increased infant mortality and its medial representation, and (3.) the level and trend of infant mortality in the course of the First World War, or the issue whether war is good for infants and babies. In this context, the extend and duration of breastfeeding functioned as key variable determining the health of the infant. [ABSTRACT FROM AUTHOR]

The purpose of this study was to show the differences in the mortality rates of children from Catholic and Lutheran families in 19th century Poznań, and to elucidate the causes of these differences. Data from Catholic and Lutheran parish death registers were used. The infant death rate (IDR), neonatal and postneonatal death rates and life table biometric functions were calculated and causes of deaths were characterized. The worst child mortality values (IDR=394.4; neonatal and postneonatal death rates, respectively, 117.1 and 277.4; e0=16.14 years; Crow's Index=2.47) were obtained for the poor Catholic Parish of St Margaret. The lowest infant and neonatal and postneonatal death rates were observed to have occurred in the Catholic Parish of St Maria Magdalena situated in the city's more affluent central area (mortality rates, respectively, 269.9, 93.1 and 176.9; e0=24.63 years; Crow's Index=0.96). The widest range of differences with regard to death rates was found for the Lutheran Parish of St Cross (the infant, neonatal and postneonatal death rates were, respectively, 293.1, 99.1 and 193.9; e0=28.03 years; Crow's Index=0.92). The St Cross Parish encompassed a fairly large area of the city characterized by varying ecological conditions. Among infants and young children from the three studied populations a high frequency of deaths due to infectious diseases, diarrhoeas, dysenteries and tuberculosis were observed. Differences in the mortality of children from Catholic and Lutheran families in 19th century Poznań resulted from ecological conditions, among which water played the most important role, rather than from religious differences. [ABSTRACT FROM AUTHOR]

Objective: To use publicly available secondary data to assess the impact of Brazil's Family Health Program on state level infant mortality rates (IMR) during the 1990s. Design: Longitudinal ecological analysis using panel data from secondary sources. Analyses controlled for state level measures of access to clean water and sanitation, average income, women's literacy and fertility, physicians and nurses per 10 000 population, and hospital beds per 1000 population. Additional analyses controlled for immunisation coverage and tested interactions between Family Health Program and proportionate mortality from diarrhoea and acute respiratory infections. Setting: 13 years (1990-2002) of data from 27 Brazilian states. Main results: From 1990 to 2002 IMR declined from 49.7 to 28.9 per 1000 live births. During the same period average Family Health Program coverage increased from 0% to 36%. A 10% increase in Family Health Program coverage was associated with a 4.5% decrease in IMR, controlling for all other health determinants (p<0.01). Access to clean water and hospital beds per 1000 were negatively associated with IMR, while female illiteracy, fertility rates, and mean income were positively associated with IMR. Examination of interactions between Family Health Program coverage and diarrhoea deaths suggests the programme may reduce IMR at least partly through reductions in diarrhoea deaths. Interactions with deaths from acute respiratory infections were ambiguous. Conclusions: The Family Health Program is associated with reduced IMR, suggesting it is an important, although not unique, contributor to declining infant mortality in Brazil. Existing secondary datasets provide an important tool for evaluation of the effectiveness of health services in Brazil. [ABSTRACT FROM AUTHOR]

New micro-level data have recently become available for three provinces of The Netherlands for the period 1812–1912, which allow the study of the evolution of socio-economic differentials in infant and childhood mortality. The authors found significant differences in the levels of infant mortality by social group between the three provinces, and a wide variety in the pattern of social inequality. This showed the importance of the regional environment for the level of infant mortality in the nineteenth century. Contrary to expectations, strong social differences were also observed in neonatal mortality. Being born in an urban environment did not have a strong effect on survival during the first year of birth. [ABSTRACT FROM AUTHOR]

An analysis of the 1980 Uganda Population Census for South Kampala through indirect techniques provided estimated 1q0 values of 0·0860, 0·0680 and 0·0774 for male infants, female infants and both sexes respectively. The estimated level of 4q1 is 0·0491. The level of adult mortality, especially from age 5 to 19, is lower than infant and child mortality. There is a clear evidence of a sex differential in mortality, males experiencing higher mortality than females. Estimates of expectation of life at birth provided further evidence of sex differences in mortality. The estimated life expectation for males is 54·7 years, for females 59·3 years, and for both sexes 57·0 years. [ABSTRACT FROM PUBLISHER]

This paper reports estimates of the biological and behavioral linkages between infant mortality and fertility in the U.S., which take into account heterogeneity in health and parents choice of health inputs. It discusses preliminary estimates of the biological effects of birth order on infant death in the U.S. and the effects of changes in the expected exogenous component of mortality on fertility. To obtain the instrumental variables needed to estimate the mortality production function, state and county level information on health programs and prices were merged-with the household socioeconomic and health data. The regressors in the demand equations for the six health-related behavioral variables included the schooling of the parents, the age-adjusted income of the father, local governmental health and hospital expenditures per capita, and the regional mix of employment by industry group. Results suggest that the average number of children per mother would increase by one-sixth of a child if an infant mortality rate of 0.1 were anticipated. The positive associations between infant mortality and fertility seen in the gross correlations and in ordinary least squares estimates appear to mask a negative biological effect of birth order on infant mortality and a substantial positive behavioral response of fertility to the anticipation of a higher mortality risk.

A two parameter model of mortality is presented which is a simplification of an earlier three parameter model formulated by Mitra (1983). It expresses ℓn(x) as a linear function of ℓn(x) and ℓn(α-x) where x is age, α is the upper limit of life and ℓ(x) is the probability of surviving from birth to age x. This is accomplished by constraining the model to reproduce the given value of infant mortality. The parameters measure two dimensions: the level and the pattern of mortality. The model is applied to real and model life tables and compared with Brass's logit model. The model is shown to fit as well as the Brass model without the difficulty of choosing a standard table. [ABSTRACT FROM AUTHOR]

The observed joint distribution of births and child deaths for a cohort of women at a given point in time depends on the number of children that would have been born had the family experienced no deaths, the number of child deaths experienced, and the proportion of these deaths that are replaced by a subsequent birth. In this paper we estimate the parameters of the assumed distributions of these three events using a minimum distance estimation model and data from the 1970 Brazilian census. The parameter estimates are shown to be similar to those obtained previously using a maximum likelihood estimation model. When the data are subdivided according to women's years of schooling, estimates of probability of a child death and mean and variance of children born if no deaths decrease while estimates of probability of replacement of a dead child increase as years of schooling increase. [ABSTRACT FROM AUTHOR]

This study summarizes differences between Sweden and the United States regarding certain aspects of infant mortality. Sweden has the lowest infant mortality rate (IMR) and the United States is number 16. Both the neonatal and postneonatal mortality rates of Sweden are considerably lower. Since 1960, the neonatal mortality rate of Sweden was reduced by a greater percentage. The incidence of low birth weight in Sweden is considerably lower. In the United States, no state has an IMR as low as that of Sweden. Nonwhite babies, babies born out of wedlock, and those of teenage or ‘old’ mothers have a higher IMR. The article describes in some detail the organization and network of services in Sweden that may be playing an important role in Sweden's low IMR. [ABSTRACT FROM AUTHOR]