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    Causes of High Infant mortality

    Dr Abdul Aziz Awan
    Dr Abdul Aziz Awan


    Pisces Number of posts : 685
    Age : 56
    Location : WHO Country Office Islamabad
    Job : National Coordinator for Polio Surveillance
    Registration date : 2007-02-23

    Causes of High Infant mortality Empty Causes of High Infant mortality

    Post by Dr Abdul Aziz Awan Mon May 07, 2007 11:42 am

    The international levels of infant mortality, depicted as the number of deaths in a thousand births.
    Infant mortality is the death of infants in the first year of life. The leading causes of infant mortality are dehydration and disease.
    Major causes of infant mortality in more developed countries include congenital malformation, infection and SIDS. The most common cause of infant mortality of all children around the world has traditionally been dehydration from diarrhea. Because of the success of spreading information about Oral Rehydration Solution (a mixture of salts, sugar and water) to mothers around the world, the rate of children dying from dehydration has been decreasing and has become the second most common cause in the late 1990s. Currently the most common cause is pneumonia.
    Infanticide, abuse, abandonment, and neglect may also contribute to infant mortality.
    Related statistical categories:
    • Perinatal mortality only includes deaths between the foetal viability (28 weeks gestation or 1000g) and the end of the 7th day after delivery.
    • Neonatal mortality only includes deaths in the first 27 days of life.
    • Post-neonatal death only includes deaths after 28 days of life but before one year.
    • Child mortality includes deaths within the first five years.
    Infant mortality rate (IMR) is the number of newborns dying under a year of age divided by the number of live births during the year. The infant mortality rate is also called the infant death rate. In past times, infant mortality claimed a considerable percentage of children born, but the rates have significantly declined in the West in modern times, mainly due to improvements in basic health care, though high technology medical advances have also helped. Infant mortality rate is commonly included as a part of standard of living evaluations in economics.
    The infant mortality rate is reported as number of live newborns dying under a year of age per one thousand live births, so that IMRs from different countries can be compared. A good source for the most recent IMR's as well as under 5 mortality rates (U5MR) is the UNICEF publication 'The State of the World's Children' available at http://www.unicef.org/publications/index_18108.html For example, the worst U5MR is 284 in Sierra Leone. (That is, 28% of all children born die before they turn 5 years old.) The 29 countries with the highest U5MRs are in Africa. The U5MR of the United States is 8, and there are 31 countries with lower U5MRs, although many of those use a less stringent definition of mortality than the US. Sweden's is the lowest at 3.

    Comparing infant mortality rates
    The infant mortality rate correlates very strongly with and is among the best predictors of state failure. IMR is also a useful indicator of a country's level of health or development, and is a component of the physical quality of life index. But the method of calculating IMR often varies widely between countries based on the way they define a live birth. The World Health Organization (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and raises their rates of perinatal mortality. The exclusion of any high-risk infants from the denominator or numerator in reported IMR's can be problematic for comparisons.

    A well documented example illustrates this problem. Historically, until the 1990's Russia and the Soviet Union did not count as a live birth or as an infant death extremely premature infants (less than 1,000 g., less than 28 weeks gestational age, or less than 35 cm in length) that were born alive (breathed, had a heartbeat, or exhibited voluntary muscle movement) but failed to survive for at least 7 days. Although such extremely premature infants typically accounted for only about .005 of all live-born children, their exclusion from both the numerator and the denominator in the reported IMR led to an estimated 22-25% lower reported IMR. In some cases, too, perhaps because hospitals or regional health departments were held accountable for lowering the IMR in their catchment area, infant deaths that occurred in the 12th month were "transferred" statistically to the 13th month (i.e., the second year of life), and thus no longer classified as an infant death.
    Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages (spontaneous abortions) or those who die during or immediately after childbirth as stillborn. Therefore, the quality of a country's documentation of perinatal mortality can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the demographer Ansley Coale, who finds dubiously high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries and suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths but also that those countries do not follow WHO recommendations for the reporting of live births and infant deaths.
    Another seemingly paradoxical finding is that when countries with poor medical services introduce new medical centers and services, instead of declining the reported IMR's often increase for a time. The main cause of this is that improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area and not been reported to the government might now be reported by the new medical personnel or facilities. Thus, even if the new health services reduce the actual IMR, the reported IMR may increase.
    These problems of definition and measurement hamper cross-national comparisons of health statistics. Alternative measures of infant mortality may provide better information but cannot completely compensate for differences among countries in the overall rates of reporting of adverse pregnancy outcomes. For example, very premature births are more likely to be included in birth and mortality statistics in the United States than in several other industrialized countries that have lower infant mortality rates.
    Low birthweight is the primary risk factor for infant mortality and most of the decline in neonatal mortality (deaths of infants less than 28 days old) in the United States since 1970 can be attributed to increased rates of survival among low-birthweight newborns. Indeed, comparisons with countries for which data are available suggest that low birthweight newborns have better chances of survival in the United States than elsewhere. The U.S. infant mortality problem arises primarily because of its birthweight distribution; relatively more infants are born at low birthweight in the United States than in most other industrialized countries.
    Global infant mortality trends
    For the world, and for both Less Developed Countries (LDCs) and More Developed Countries (MDC) IMR declined significantly between 1960 and 2001. World infant mortality rate declined from 198 in 1960 to 83 in 2001.
    However, IMR remained higher in LDCs. In 2001, the Infant Mortality Rate for Less Developed Countries (91) was about 10 times as large as it was for More Developed Countries (Cool. For Least Developed Countries, the Infant Mortality Rate is 17 times as high as it is for More Developed Countries. Also, while both LDCs and MDCs made dramatic reductions in infant mortality rates, reductions among less developed countries are much less than are reductions among the more developed countries, on average.




    Infant mortality rate in countries
    Countries and regions with the highest and lowest infant mortality rates (2005 est. CIA Factbook) are shown below.
    Angola 187.49, Afghanistan 163.07, Sierra Leone 162.55, Liberia 161.99, Mozambique 130.79, Pakistan 76, United States of America 6.50, Japan 3.26, Hong Kong 2.96, Sweden 2.77, Singapore 2.29,
    Dr Abdul Aziz Awan
    Dr Abdul Aziz Awan


    Pisces Number of posts : 685
    Age : 56
    Location : WHO Country Office Islamabad
    Job : National Coordinator for Polio Surveillance
    Registration date : 2007-02-23

    Causes of High Infant mortality Empty Re: Causes of High Infant mortality

    Post by Dr Abdul Aziz Awan Mon May 07, 2007 11:44 am

    Rank Country or region Infant mortality rate
    (deaths/1,000 live births)
    1 Angola 197.8
    2 Afghanistan 155.09
    3 Sierra Leone 162.55
    4 Liberia 161.99
    5 Mozambique 130.79
    6 Niger 119.69
    7 Somalia 116.70
    8 Tajikistan 110.76
    9 Mali 109.47
    10 Guinea-Bissau 105.32
    11 Djibouti 104.13
    12 Bhutan 100.44
    13 Nigeria 98.80
    14 Tanzania 98.54
    15 Malawi 96.14
    16 Ethiopia 95.32
    17 Chad 93.13
    18 Burkina Faso 92.94
    19 Guinea 91.45
    20 Rwanda 91.23
    21 Equatorial Guinea 91.16
    22 Côte d'Ivoire 90.83
    23 Congo, Democratic Republic of the 90.66
    24 Lesotho 88.75
    25 Zambia 88.29
    26 Congo, Republic of the 87.41
    27 Central African Republic 87.33
    28 Laos 85.22
    29 Azerbaijan 81.74
    30 Benin 81.29
    31 Madagascar 76.83
    32 Comoros 74.93
    33 Haiti 73.45
    34 Turkmenistan 73.08
    35 Gambia, The 73.07
    36 Swaziland 72.92
    37 Pakistan 72.44
    38 Uzbekistan 71.10
    39 Cambodia 70.89
    40 Mauritania 70.89
    41 Uganda 67.83
    42 Nepal 66.98
    43 Cameroon 64.87
    44 Burundi 64.39
    45 Burma 63.56
    46 Bangladesh 62.60
    47 Sudan 62.50
    48 Mayotte 62.40
    49 Togo 62.20
    50 South Africa 61.81
    51 Yemen 61.50
    52 Kenya 61.47
    53 Maldives 56.52
    54 Ghana 56.36
    55 India 56.29
    56 Gabon 55.35
    57 Vanuatu 55.16
    58 Botswana 54.58
    59 Senegal 54.12
    60 Mongolia 53.79
    61 Bolivia 53.11
    62 Zimbabwe 52.34
    63 Papua New Guinea 51.45
    64 Iraq 50.25
    65 World 50.11
    66 Namibia 48.98
    67 Kiribati 48.52
    68 Cape Verde 47.77
    69 Eritrea 47.41
    70 East Timor 47.41
    71 Sao Tome and Principe 43.11
    72 Morocco 41.62
    73 Iran 41.58
    74 Turkey 41.04
    75 Moldova 40.42
    76 Kyrgyzstan 35.64
    77 Indonesia 35.60
    78 Guyana 33.26
    79 Egypt 32.59
    80 Guatemala 32.00
    81 Peru 31.94
    82 Algeria 31.00
    83 Micronesia, Federated States of 30.21
    84 Brazil 29.61
    85 Syria 29.53
    86 Marshall Islands 29.45
    87 Dominican Republic 29.37
    88 Kazakhstan 29.21
    89 Nicaragua 29.11
    90 Samoa 27.71
    91 Honduras 26.47
    92 Romania 26.43
    93 Vietnam 25.95
    94 Trinidad and Tobago 25.81
    95 Paraguay 25.63
    96 Belize 25.40
    97 Bahamas, The 25.21
    98 El Salvador 25.10
    99 Tunisia 24.77
    100 Libya 24.60
    101 Lebanon 24.52
    102 China 24.18
    103 Korea, North 24.04
    104 Ecuador 23.66
    105 Suriname 23.57
    106 Philippines 23.51
    107 Armenia 23.28
    108 Gaza Strip 22.93
    109 Venezuela 22.20
    110 Albania 21.52
    111 Solomon Islands 21.29
    112 Anguilla 21.03
    113 Colombia 20.97
    114 Mexico 20.91
    115 Bulgaria 20.55
    116 Thailand 20.16
    117 Tuvalu 20.03
    118 West Bank 19.62
    119 Oman 19.51
    120 Antigua and Barbuda 19.46
    121 Saint Helena 19.00
    122 Qatar 18.61
    123 Georgia 18.59
    124 Malaysia 17.70
    125 Jordan 17.35
    126 British Virgin Islands 17.30
    127 Bahrain 17.27
    128 Panama 16.73
    129 Jamaica 16.33
    130 Greenland 15.82
    131 Turks and Caicos Islands 15.67
    132 Seychelles 15.53
    133 Russia 15.39
    134 Argentina 15.18
    135 Mauritius 15.03
    136 Palau 14.84
    137 Saint Vincent and the Grenadines 14.78
    138 Grenada 14.62
    139 United Arab Emirates 14.51
    140 Saint Kitts and Nevis 14.49
    141 Sri Lanka 14.35
    142 Dominica 14.15
    143 Saint Lucia 13.53
    144 Belarus 13.37
    145 Saudi Arabia 13.24
    146 Serbia and Montenegro 12.89
    147 Fiji 12.62
    148 Tonga 12.62
    149 Brunei 12.61
    150 French Guiana 12.07
    151 Uruguay 11.95
    152 Barbados 11.72
    153 Ukraine 10.11
    154 Macedonia 10.09
    155 Bosnia and Herzegovina 10.07
    156 Netherlands Antilles 10.03
    157 Costa Rica 9.95
    158 Kuwait 9.95
    159 Nauru 9.95
    160 Latvia 9.55
    161 Puerto Rico 9.28
    162 American Samoa 9.27
    163 Chile 8.80
    164 Guadeloupe 8.60
    165 Hungary 8.57
    166 Bermuda 8.53
    167 French Polynesia 8.44
    168 Cayman Islands 8.19
    169 Virgin Islands 8.03
    170 Estonia 7.87
    171 Reunion 7.78
    172 New Caledonia 7.72
    173 Saint Pierre and Miquelon 7.54
    174 Slovakia 7.41
    175 Poland 7.36
    176 Montserrat 7.35
    177 Cyprus 7.18
    178 Northern Mariana Islands 7.11
    179 Martinique 7.09
    180 Israel 7.03
    181 Guam 6.94
    182 Lithuania 6.89
    183 Croatia 6.84
    184 United States 6.50
    185 Taiwan (Republic of China) 6.40
    186 Cuba 6.33
    187 Korea, South 6.28
    188 Faroe Islands 6.24
    189 Italy 5.94
    190 Man, Isle of 5.93
    191 Aruba 5.89
    192 New Zealand 5.85
    193 San Marino 5.73
    194 Greece 5.53
    195 Monaco 5.43
    196 Ireland 5.39
    197 Jersey 5.24
    198 United Kingdom 5.16
    199 Gibraltar 5.13
    200 European Union 5.10
    201 Portugal 5.05
    202 Netherlands 5.04
    203 Luxembourg 4.81
    204 Canada 4.75
    205 Guernsey 4.71
    206 Liechtenstein 4.70
    207 Australia 4.69
    208 Belgium 4.68
    209 Denmark 4.56
    210 Slovenia 4.45
    211 Spain 4.42
    212 Switzerland 4.39
    213 Macau 4.37
    214 France 4.26
    215 Austria 4.18
    216 Andorra 4.05
    217 Germany 3.93
    218 Czech Republic 3.93
    219 Malta 3.89
    220 Norway 3.10
    221 Finland 3.00
    222 Japan 2.80
    223 Sweden 2.43
    224 Hong Kong 2.40
    225 Iceland 2.34
    226 Singapore 2.10

    source: http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

      Current date/time is Thu Nov 21, 2024 2:52 pm