Abstract
OBJECTIVES: This research analyzed trends of the mortality spectrum resulted from dynamics of the health care service for children under 5 years.METHODS: It was sampled 23 surveillance sites to establish a population-based surveillance network for children under 5 years by implementing a multistage randomized, stratified and cluster sampling since 1990 in Hubei province of China.RESULTS: Among children under 5 years, the mortality rates of pneumonia, birth asphyxia, preterm birth/low birth weight and accidental asphyxia declined from 12.9, 6.6, 4.3 and 3.5 in 1990 to 0.9, 0.7, 1.1 and 0.7 per 1,000 live births in 2015 respectively, and manifested a distinguished milestone at which pneumonia and birth asphyxia had been replaced by preterm birth/low birth weight after 2005 (P<0.05). The death proportions of pneumonia and birth asphyxia decreased from 22.2% and 11.4% in 1990 to 10.3% and 7.7% in 2015, while the death proportions of preterm birth/low birth weight and accidental asphyxia increased from 7.4% and 6.0 % in 1990 to 12.9% and 8.6% in 2015 accordingly. The proportions of clinical diagnosis, emergence treatment and death place at the county/district hospitals increased from 9.0%, 27.4% and 28.7% in 1990 to 75.5%, 67.7% and 60.4% in 2015, and had the significant differences between 1990 and 2015 in Hubei province (P<0.01).CONCLUSIONS: It was suggested that the trends of the mortality spectrum were mainly due to the improvement of the health care service for children under 5 years in Hubei province.
Highlights
Since child health and wellbeing continued to be one of the internationally recognized health challenges, the government of China formulated the National Program of Action for Child Development in which under-5-mortality rate (U5MR) decreased one-third from 1990 to 2000, one-fifth from 2000 to 2010 respectively
Among children under 5 years, the mortality rates of pneumonia, birth asphyxia, preterm birth/low birth weight and accidental asphyxia declined from 12.9, 6.6, 4.3 and 3.5 in 1990 to 0.9, 0.7, 1.1 and 0.7 per 1,000 live births in 2015 respectively, and manifested a distinguished milestone at which pneumonia and birth asphyxia had been replaced by preterm birth/low birth weight after 2005 (P
The death proportions of pneumonia and birth asphyxia decreased from 22.2% and 11.4% in 1990 to 10.3% and 7.7% in 2015, while the death proportions of preterm birth/low birth weight and accidental asphyxia increased from 7.4% and 6.0 % in 1990 to 12.9% and 8.6% in 2015
Summary
Since child health and wellbeing continued to be one of the internationally recognized health challenges, the government of China formulated the National Program of Action for Child Development in which under-5-mortality rate (U5MR) decreased one-third from 1990 to 2000, one-fifth from 2000 to 2010 respectively. The government of China established a nationwide surveillance network in 1990 to monitor the mortality rates of the primary death causes for children under 5 years (Wang et al, 2011). It possessed the considerable application value, and provided the precious history data on child health and development in China. This research was aimed to analyze the trends of the mortality spectrum of the major death causes, to provide the scientific basis for the government at all levels to develop the necessary policies of maternal and child health in Hubei province
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