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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]

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]