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At least 19 recordsLinked to original sources
PubMed2003

Knowledge into action for child survival.

The child survival revolution of the 1980s contributed to steady decreases in child mortality in some populations, but much remains to be done. More than 10 million children will die this year, almost all of whom are poor. Two-thirds of these deaths could have been prevented if effective child survival interventions had reached all children and mothers who needed them. Translation of current knowledge into effective action for child survival will require leadership, strong health systems, targeted human and financial resources, and modified health system to ensure that poor children and mothers benefit. A group of concerned scientists and policy-makers issues a call to action to leaders, governments, and citizens to translate knowledge into action for child survival.

Child↗
PubMed1995

'Parental incompetence' and 'selective neglect': blaming the victim in child survival.

The Child Survival Revolution has produced inconsistent results in reducing global infant and child morbidity and mortality rates. Several recent studies employ concepts of 'parental incompetence' and 'selective neglect' as catch-phrases to account for variations in the outcome of family health programs. This concept shifts liability for illness from health agencies and providers to beneficiaries. It associates program failure with noncompliance resulting from parental ignorance or indifference to the welfare of offspring. This paper presents data which support a view of parents as concerned and pro-active health seekers whose parenting standards sometimes conflict with those of external health agents, and whose caretaking decisions sometimes force them to weigh concerns for individual children against demands of the family as a whole. Implications of parental accountability for child survival are discussed as they shape research and health policy.

Child↗
PubMed1975

The effect of intrauterine hypoxia on the child surviving to 4 years.

Intrauterine hypoxia/asphyxia is an unchallenged cause of perinatal death, but whether sublethal degrees of hypoxia result frequently in brain damage in surviving infants is less certain. To test this hypothesis, obstetric patients with abruptio placentae, placenta previa, and prolapse of the umbilical cord were computer matched on several factors with normal control patients to determine the degree of risk of lower 4 year Stanford-Binet I. Q. scores or abnormalities on the 4 year fine motor and gross motor testings. The mean I. Q. score of babies born of mothers with one of these complications was no different from that of the normal controls. Similarly negative results were recorded on the 4 year fine motor and gross motor testings. Children of low birth weight in either group experienced lower I. Q. scores and higher risk of abnormal findings on the motor tests at 4 years than the babies of mature birth weight. Intrauterine hypoxia/asphyxia apparently is not a major cause of neurologic dysfunction in the surviving child.

Abruptio Placentae↗
PubMed1991

Surviving child from tubal pregnancy.

A case report of a 1150 g child surviving from a tubal pregnancy in the 30th week of gestation, delivered by cesarean laparotomy, is described. A review of the literature disclosed nine other cases.

Adult↗
PubMed1993

Socioeconomic and environmental determinants of child survival in Bangladesh.

Differentials in child survival in Bangladesh have been examined using a number of socioeconomic and environmental factors on data from the 1989 Bangladesh Fertility Survey. Multivariate analysis reveals that both wife's and husband's education and household electricity show a significant positive association with child survival. The respondent's working status exerts a significant negative influence. Wife's education has a greater influence on child survival in Bangladesh than that of husband's education.

Adult↗
PubMed1997

A nested frailty model for survival data, with an application to the study of child survival in northeast Brazil.

"This article presents a multivariate hazard model for survival data that are clustered at two hierarchical levels.... We apply the model to an analysis of the covariates of child survival using survey data from northeast Brazil collected via a hierarchically clustered sampling scheme. We find that family and community frailty effects are fairly small in magnitude but are of importance because they alter the results in a systematic pattern."

Americas↗
PubMed1997

The effect of child survival on fertility in Zimbabwe: a micro-macro level analysis.

The literature on the effect of fertility on child survival is extensive especially since the accumulation of data from the World Fertility, and Demographic and Health Surveys. Comparatively, empirical studies examining the other side of the relationship--the effect of child survival on fertility--are sparse although theoretical considerations suggest the interdependence of child survival and fertility. Furthermore, the relationship of child survival and fertility is often examined at the micro-level. There is growing recognition, however, that this relationship may be also influenced by macro-level factors. This study attempts to measure the effect of child survival on birth intervals in Zimbabwe using a micro-macro analytical approach based on the individual and community data from the 1988 Zimbabwe Demographic and Health Survey, and the 1989/1990 Zimbabwe Service Availability Survey, respectively. The multivariate analysis showed that there is a replacement effect in the relationship between child survival and fertility independent of individual characteristics of women in Zimbabwe. The analysis also showed that health interventions as measured by coverage and visit by a mobile family planning clinic, and access to a health service have differential impact on fertility in Zimbabwe controlling for the survival status of the previous to the last child and individual characteristics of the women.

Adolescent↗
PubMed1997

Impact of maternal and child health strategy on child survival in a rural community of Pondicherry.

OBJECTIVE: To determine the impact of Maternal and Child Health (MCH) services on child survival in a socio-economically backward rural community. SETTING: Twelve villages in Pondicherry with a population of 16,803. DESIGN: Prospective study. SUBJECTS: A birth cohort of 356 live births (LB) born between January 1st and December 31st 1988. METHODS: The live births were followed-up from birth to five years age (1988-1993). The health care received by this cohort and the antenatal services received by the cohort mothers was reviewed. Outcome measures related to child survival were determined and their changing trend since 1967 was examined. RESULTS: Fifty-four per cent of the cohort children were from families below the poverty line. Antenatal registration and tetanus immunization coverage of the mothers of the cohort was 100%. Immunization coverage of the cohort children was more than 98% for BCG, DPT (three doses) and OPV (three doses) and 82% for measles. The infant mortality rate had reduced from 201/1000 LB in 1967 to 64/1000 LB (95% CI 58.9-68.1) in 1989. The child death rate decreased from 29.4/1000 children 1-4 years of age (1970) to 18/1000 (95% CI 13.9-22.1) in 1992. There were no deaths due to neonatal tetanus or measles. Neonatal mortality (35/1000 LB; 95% CI 29.9-40.1) was higher than the post-neonatal mortality (29/1000 LB; 95% CI 24.1-33.9). Fifty eight per cent of the neonatal deaths were due to non-infective causes like prematurity, birth asphyxia, birth injuries and congenital anomalies. Eighty per cent of post neonatal deaths were due to infections. Overall, the child survival index was high (91.27%; 95% CI 88.14-94.26). This was inspite of the low socio-economic background of the children's families. CONCLUSIONS: Good MCH services can substantially improve child survival inspite of prevailing low socio-economic situations. Inputs for neonatal care need to be strengthened to further enhance child survival.

Cause of Death↗
PubMedDate not supplied

The status of child health and child survival and development programs in Turkey.

"Child Survival Activities in Turkey" are: growth monitoring programs, expanded programs of immunization (elimination of neonatal tetanus, reducing morbidity and mortality of measles, eradication of polio), control of diarrheal diseases (oral rehydration therapy), control of deaths from pneumonia (ARI), baby-friendly hospitals initiative and promotion of breast-feeding, salt iodization programs, elimination of vitamin A deficiency, safe motherhood projects, and phenylketonuria screening programs. Furthermore, family planning, nutrition and education of the mother were among the subjects covered because of their role in child health. The activities, aims and strategies related to these programs are taken up separately. The status of child health and some of the child survival and development programs (growth monitoring program, expanded program of immunization, control of diarrheal diseases, control of deaths from pneumonia, baby-friendly hospitals initiative and promotion of breast-feeding) are discussed in the article.

Child↗
PubMed2006

Countdown to 2015: tracking intervention coverage for child survival.

BACKGROUND: The fourth Millennium Development Goal (MDG) calls for a two-thirds' reduction between 1990 and 2015 in deaths of children younger than five years; achieving this will require widespread use of effective interventions, especially in poor countries. We present the first report of the Child Survival Countdown, a worldwide effort to monitor coverage of key child-survival interventions in 60 countries with the world's highest numbers or rates of child mortality. METHODS: In 2005, we developed a profile for each of the 60 countries to summarise information on coverage with essential child survival interventions. The profiles also present information on demographics, nutritional status, major causes of death in children under 5 years of age, and the status of selected health policies. Progress toward the fourth MDG is summarised by comparing the average annual rate of reduction in under-5 mortality in each country with that needed to achieve the goal. The profiles also include a comparison of the proportions of children in the poorest and richest quintiles of the population who received six or more essential prevention interventions. Each country's progress (as measured by defined indicators of intervention coverage) was put into one of three groups created on the basis of international targets: "on track"; "watch and act"; and "high alert". For indicators without targets, arbitrary thresholds for high, middle, and low performance across the 60 countries were used as a basis for categorisation. FINDINGS: Only seven countries are on track to met MDG-4, 39 countries are making some progress, although they need to accelerate the speed, and 14 countries are cause for serious concern. Coverage of the key child survival interventions remains critically low, although some countries have made substantial improvements in increasing the proportion of mothers and children with access to life saving interventions by as much as ten percentage points in 2 years. Children from the poorest families were less likely than those from wealthier families to have received at least six essential prevention interventions. INTERPRETATION: Our results show that tremendous efforts are urgently needed to achieve the MDG for child survival. Profiles for each country show where efforts need to be intensified, and highlight the extent to which prevention interventions are being delivered equitably and reaching poor families. This first report also shows country-specific improvements in coverage and highlights missed opportunities. The "Countdown to 2015" will report on progress every 2 years as a strategy for increasing accountability worldwide for progress in child survival.

Child Mortality↗
PubMedDate not supplied

The effects of improved child survival on family planning practice and fertility.

The relationship between improvements in child survival, family planning, and fertility is viewed here as the outcome of a process of family building that evolves through distinct phases as the mortality transition progresses. The speed with which family building strategies evolve from "family building by fate" to "family building by design" and from "insurance" to "replacement" as child survival improves depends on the pattern (by age and causes of death) of mortality decline and the sociocultural context. While child survival improvements will not lead to compensatory declines in fertility when fate or replacement behavior govern family building, more than compensatory fertility declines can result when families shift to family building by design, which, in its initial phases, is manifested by so-called insurance behavior. A literature review supports these hypotheses and identifies family planning availability as a critical additional factor. These results provide strong support for an integrated approach to the delivery of health and family planning services.

Adolescent↗
PubMed1994

Fertility, infertility and child survival of Somali women.

The relationship of reproductive patterns, some socio-economic factors and child survival was studied in 766 rural Somali women. A structured questionnaire was the method of data collection. Teenage marriage was the norm for the women, and divorce was very common. The mean number of live births was 5.2, and the mean number of surviving children was 3.7. 2/3 of the women aged 45+ had a parity of 6 or more, about one third had had at least one miscarriage and one fifth had experienced one stillbirth. Primary infertility was observed in 7% of the women aged 45+, while 20% were considered subfertile. Verbal autopsy showed that mortality was highest among infants and accounted for 63% of the child deaths. Major causes of death were neonatal tetanus, diarrhoea and respiratory diseases. Child survival and reproductive outcome ratios were found to be negatively related to the increasing age of the mother and parity. Divorce and widowhood were also found to be associated with low child survival.

Abortion, Spontaneous↗