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At least 19 recordsLinked to original sources

Levels and patterns of infant and child mortality in Ghana.

This paper attempts to measure infant and child mortality levels and also to determine their structure by utilizing the results of the 1968-1069 National Demographic Sample Survey which was conducted under the directorship of the author. Among the major problems encountered in the exercise are the adjustment of the current raw mortality data and the estimation of infant and child mortality from independent source material. The estimated infant mortality rates range from 56 per 1,000 live births in the Accra Capital District to 192 in the Upper Region during the late 1960's. The urban rate is lower than the rural rate, 98, as against 161 per 1,000 live births. A large proportion of the deaths among children aged 0-4 occur in the second year of life, and deaths in this age group account for the bulk of the deaths within the age group 1-4 years.

Age Factors

Measuring the impact of child mortality on fertility: a methodological note.

Recent studies of the impact of child mortality on children ever born have used the "replacement factor" to measure mortality. When microlevel data are used, however, use of the replacement factor (or other variables which are nonlinear in the family's experienced child mortality rate) yields biased coefficients. An alternative model suggests a sequential, rather than a static, decision-making process to relate the decision to have an additional child to the reproductive experience to date. In this case, unbiased coefficients are obtained if the functional form is correctly specified. In the abscence of a priori knowledge of the functional form, it is difficult to untangle true effects from spurious ones.

Child

Levels, trends, differentials and causes of child mortality-a survey.

This paper attempts to give an overview of current levels of child mortality prevailing in the world. It also examines trends and socioeconomic differentials in child mortality for selected countries and regions of the world. Lastly it reviews data on causes of child death and related environmental factors. The paper concludes that despite the fact that child deaths are frequently avoidable, mortality differentials between the developed and developing regions of the world are more pronounced in childhood (ages one to under five years) than at any other time of life. While some developing countries have substantially reduced the level of mortality in childhood, in others it remains very high. In contrast, in most developed countries child death rates are now so low, that they no longer serve as useful measures of public health.

Accidents

Mortality in nineteenth century America: estimates from New York and Pennsylvania census data, 1865 and 1900.

Given the lack of information on mortality in the nineteenth century United States, it seems appropriate to apply techniques which have been created for mortality estimation for developing nations with inadequate vital registration data, to the historical American experience. Two such related sets of techniques are the brass, Sullivan, and Trussell methods and the technique here called the Surviving Children Method, which utilizes the age structure of surviving children and the number of children ever born to women in various age or duration of marriage categories. Both techniques estimate child mortality. Coale and Demeny model life tables are used to extend child mortality estimates to adult mortality. The techniques are applied to census manuscript samples from seven New York counties in 1865 and seven Pennsylvania counties in 1900, both censuses having information on children ever born. The estimates confirm a drop in mortality between 1865 and 1900 in New York and large differentials between native and foreigh-born populations as well as between rural and urban populations.

Adult

Social justice and the demographic transition: lessons from India's Kerala State.

Kerala is a small, densely crowded state in South India. It is a poor state, even by Indian standards. Its per capita income of US$80 lies well below the all-India average of US$120, and it suffers from the lowest per capita caloric intake in India. Nevertheless, Kerala has managed to achieve the demographic transition from high (premodern) to low (modern) birth and death rates-something no other Indian state has been able to attain. Indeed, the magnitude of Kerala's fertility decline-the birth rate fell from 39 in 1961 to 26.5 in 1974-has never before been observed in a nation with comparable levels of income and undernutrition. Other indices of Kerala's soical development are equally surprising: levels of literacy, life expectancy, female education, and age at marriage are the highest in India, while mortality rates, including infant and child mortality, are the lowest among Indian states. But Kerala's anomalous and unexpected demographic trends and levels are not the result of the direct interventions designed to influence health and fertility levels elsewhere in India-conventional strategies of population control and health services delivery that thus far are notable for their failure to generate such positive results. Instead, Kerala's demographic levels evidently reflect a broad social response to structural reforms in its political economy.

Birth Rate

[An example of the application of factorial analysis of correspondences to infant mortality and its prevention in a rural area of West Africa].

A retrospective study through questionnaire was made among over 800 women of a Pre-Sahel region of Mali. It confirmed the very high infant and child mortality in this population: over 250% mortality under 1 year of age and over 400% under 6 years of age. The factorial analysis of correspondences proved adequate to determine the main characteristics of the local mortality pattern. In chronological order, the most important causes are obstetrical factors (1st day of life), umbilical tetanus (1 week to 1 month of age), malaria (1 month to 1 year of age), pneumopathies (including pertussis and lung complications of measles), toxicoses and nutritional syndromes (over 1 year of age). Preventive measures at various levels are proposed on the basis of these findings. They belong to three broad groups: -Overall socioeconomic development with effective participation of the rural communities concerned. -Development of an appropriate primary health care structure, with a primary health care team in each village. -Strengthening of the programmes of control of the most important communicable diseases. Such simple and cheap actions should, given a clear political will of the national authorities and a modicum of trust in the future on the part of local leaders, be rapidly implementable even in the most underprivileged countries and bring a significant amount of progress in the rural areas.

Child, Preschool

Feeding practices, nutritional status and mortality in pre-school children in rural East Java, Indonesia.

During the dry season of 1975 and 1976 two nutrition surveys were carried out in nine regencies of the province of East Java, Indonesia. The objective was to assess the geographical prevalence, magnitude and severity of nutritional deficiencies, especially among mothers and children. In this paper childfeeding practices, nutritional status of pre-school children and child mortality are reported. In the rural areas surveyed breastfeeding is commonly practiced for a prolonged period. In the regencies along the south and north coast of East Java 90%, respectively 94% of children aged 19-24 months were still breastfed; in Sidoarjo, a relative 'surplus' area, the corresponding figure was 73% and on the island of Madura 51%. Even in age-group 25-47 months 34% still were nursed in Blitar-Trenggalek regency, 54% in Tuban-Lamongan, 23% in Sidoarjo and 15% in Madura. The variation in the breastfeeding period between the regencies is a matter of further investigation. In these rural areas the roles as competitor of powdered milk is a minor one. It was intriguing that 9% of the pregnant women still nursed their youngest child. Supplementary food was introduced at a very early age, i.e. in the first week. This was, however, insufficient to maintain adequate growth after the age of six months. According to weight-for-age severe malnutrition was diagnosed in respectively 1%, 4% and 10% of age-groups 0-5 months, 6-11 months and 1-3 years. The anthropometric data suggest that lack of calories is more influential than the deficit in protein. Age-specific mortality, according to age at death was about 21% in the perinatal and 16% in the neonatal period; from 1-11 months (inclusive) it was 31%, from 1.5 years 19% and till 12 years 8%.

Age Factors

Weight-for-age as an index of risk of death in children.

Between April, 1968, and May, 1973, the Department of International Health of Johns Hopkins University studied the effects of the interaction of nutrition and infection in fourteen villages of Punjab, North India. Serial anthropometric measurements (used as index of nutritional status) and vital statistics of almost 3000 children aged 1-36 months showed that, on average, child mortality doubled with each 10% decline below 80% of the Harvard weight median. The relation between season and mortality showed that mortality-rates were highest just before and during the main (wheat) harvest, reflecting the effects of food scarcity, relative child neglect, and climate on child deaths among those already underweight.

Age Factors