Identification of the Cause of Infant Mortality in Balangan Regency South Kalimantan Province in 2023

BackgroundThe avoidable causes of infant mortality should be identified, and interventions should be made to improve the infant mortality rate. The cause of infant deaths should be assessed in both...

Preconception care for improving perinatal outcomes: the time to act.

Introduction Haemophilia is associated with a high tendency of acute bleeding episodes which can lead to severe morbidity and mortality in the absence of prompt care. Although delay in seeking care can lead to adverse outcomes, many people with haemophilia (PwH) in Uganda do not report to haemophilia treatment centres (HTCs) for treatment in the event of acute bleeding within the two hours recommended by the World Federation of Hemophilia (WFH). Information on factors associated with delays in seeking care is limited. A study among people with haemophilia presenting at five regional treatment centres across Uganda found transport costs is a major issue impacting treatment seeking for acute bleeds Aims This study aims to determine the extent and factors associated with delays in seeking treatment for acute bleeding among people with haemophilia (PwH) in Uganda to inform appropriate mitigating stratregies and hence improve health outcomes and quality and life. Methods The study was conducted in five haemophilia treatment centres (HTCs) across Uganda and used a cross-sectional design with mixed methods of data collection. PwH seeking care at the HTCs for acute bleeding episodes were consecutively sampled. A pre-tested questionnaire was used to collect data. Alongside this, qualitative interviews explored health workers’ perceptions of factors associated with delays in seeking treatment among patients. Health workers were purposively selected. The quantitative data were analysed using STATA version 16; qualitative data were analysed manually using inductive thematic analysis to generate codes, categories, sub-themes and themes. Multivariate modified Poisson regression analysis was used to determine factors associated with delay to seeking treatment at HTCs. Results 224 male PwH, aged 1 to 67 years (median 11 years) were included in the analysis. The time taken following an acute bleeding symptom to attending the HTC ranged between 1 and 65 hours, with a median of 9 hours. PwH were more likely to delay seeking treatment for acute bleeding episodes if they used public means of transport to the HTC (aPR 1.39; 95% CI 1.22-1.59). PwH who took immediate other actions on recognition of a sign of an acute bleeding episode were less likely to delay seeking treatment at the HTC (aPR 0.75; 95% CI 0.66-0.84). Conclusion Delays in seeking treatment among PwH in Uganda are the result of an interplay between individual and health system factors. Continued information and education programmes are needed to ensure PwH and caregivers understand the benefits of early treatment-seeking, alongside expanding HCP knowledge and capacity building. Mobile clinics and home therapy could reduce travel and waiting times for those needing to access treatment. Addressing these issues could help to provide a level of care for PwH that helps to ensure improved quality of life and better health outcomes.

Brazil had an estimated infant mortality rate (IMR) of 30.4 per 1000 live births in 1998 which declined to 19.8 in 2008; in the latter 68% of all infant deaths...

This study aims to examine the influence of Emotional Intelligence, Professionalism, and Individual Characteristics on the Performance of Employees of the Investment Agency, Integrated One-Stop Service, Trans­-Migration, and Labor in the Balangan Regency, South Kalimantan Province. The population in this study consists of employees of the Investment and Integrated One-Stop Service Agency, Transmigration, and Labor Office in Balangan Regency, totaling 109 individuals. The sampling method used in this research is the census method. The selection of the census method in this study is based on the consideration that all employees of the Investment and Integrated One-Stop Service Agency, Transmigration, and Labor Office in Balangan Regency amount to 109 individuals. Therefore, the entire population is used as the sample. The data analysis used in this research is multiple linear regression with statistical tools facilitated by the IBM SPSS v.21 program. The results of this study indicate that Emotional Intelligence, Professionalism, and Individual Characteristics have an influence on Performance of Employees of the Investment Agency, Integrated One-Stop Service, Trans­-Migration, and Labor in the Balangan Regency, South Kalimantan Province. The Individual Characteristics variable has a dominant influence on the on Performance of Employees of the Investment Agency, Integrated One-Stop Service, Trans­-Migration, and Labor in the Balangan Regency, South Kalimantan Province.

Mortality rates for coronary heart disease are higher in blacks than in whites. To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds ratio = 3.16; 95% CI = 1.49-6.71; P = .003) and left-sided chest pain (odds ratio = 2.55; 95% CI = 1.10-5.91; P =.03). Blacks delayed a mean of 26.8 hours (SD = 30.3; median = 11 hours), whereas whites delayed a mean of 24.4 hours (SD = 41.7; median = 5 hours) in seeking care. Mean delay time was not significantly different for blacks and whites; differences in median delay time were of borderline significance (P = .05). Blacks were more likely than whites to have shortness of breath and left-sided chest pain as the presenting symptoms of coronary heart disease. Differences in delay in seeking treatment were not significant, although blacks tended to delay longer than did whites. The relatively small number of blacks may account for the lack of observed racial differences in both initial symptoms and in delay in seeking treatment.

Patients delay in seeking care increases the transmission of pulmonary tuberculosis and hence the burden of the disease. This study investigates the pattern and determinants of patients delay in seeking treatment among pulmonary tuberculosis cases attending a Government Chest Clinic in Ibadan, Nigeria. A descriptive cross sectional study was employed. A face to face interview of 102 newly diagnosed tuberculosis patients at the clinic was conducted using a structured questionnaire. The mean age of respondents was 45.4 ±13.5 years and 61(59.8%) were females. The overall median delay in seeking treatment among study subjects was 60 days (range 3 to 180 days), with 61.8% patients delaying for more than 30 days. Binary logistic regression model showed that female sex (OR=5.3), place of residence (OR=3.9), outside Ibadan vs. within Ibadan), age group >45 vs. ≤45 years (OR=2.4) and reported stigma (OR=7.6) were significantly associated with longer patients delay. The results showed that delay among patients in seeking care is common and some groups of patients may be experiencing problems in seeking care in our environment.

Causes of infant and early childhood deaths in Sierra Leone

PT Adaro Indonesia is a mining company that conducts coal exploration and mining activities with the 3rd largest production in the world, one of the mining locations is located in Balangan Regency, South Kalimantan, Indonesia, Based on data released by the Central Statistics Agency for South Kalimantan in 2016 - 2019 economic growth balance in Balangan Regency. is the lowest economic growth among other regencies/cities, Bank Indonesia (BI) South Kalimantan region in 2019 the mining sector is still the prima donna of economic growth in the province of South Kalimantan, especially in Balangan Regency, if you look closely this shows that there are problems when viewed from one of the indicators of success community empowerment, theoretically it is stated that empowerment should not create dependence, but must be able to encourage the creation of creativity and community independence. This study aims to (1) analyze the policies of PT Adaro Indonesia's corporate social responsibility (CSR) program in Community Empowerment in Balangan Regency, (2) analyze the impact of PT Adaro Indonesia's corporate social responsibility (CSR) program on Community Empowerment in Balangan Regency and (3) Finding the right program policy evaluation model in community empowerment. The research method used in this study is a descriptive method with a qualitative approach. Determination of informants purposively (purposeful), the analysis technique used is data reduction, data display, verification. The results show that (1) PT Adaro Indonesia's corporate social responsibility (CSR) policy in empowering the people of Balangan Regency has not been implemented optimally, (2) the impact of PT Adaro Indonesia's CSR program has not fully provided a positive impact for the government and the people of Balangan Regency., (3) the program policy evaluation model that researchers offer starts from 1. Management Management, 2. Defined programs, 3. Target groups, 4. Implementation and 5. Impact. The advice given is that the authorities need to redesign the management of PT Adaro Indonesia's CSR funds.

In Brief OBJECTIVE We examined a trend in infant mortality caused by congenital malformations in the United States, particularly for the racial disparity between whites and nonwhites. METHODS We used US annual summary data on cause-specific infant mortality for 1970–97 and detailed birth and infant death linked data for 1985–87, 1989–91, and 1995–97. RESULTS Congenital malformations became a more prominent cause of infant mortality in 1997 and accounted for 22.1% of all infant deaths compared with 15.1% in 1970. Congenital malformations of nervous, cardiovascular, and respiratory systems accounted for more than 60% of all malformation deaths. Malformations incompatible with life (anencephaly, encephalocele, hypoplastic lungs, renal agenesis, and trisomies 13 and 18) were the cause of one-third of all malformation deaths. In 1970–71, infant mortality caused by congenital malformations in nonwhites was lower, 2.6 (confidence interval [CI] 2.5, 2.7) per 1000, compared with whites, 3.1 (CI 3.0, 3.1) per 1000. However, in 1996–97, the rate of congenital malformation-specific infant mortality was higher in nonwhites, 1.7 (CI 1.7, 1.8) per 1000, compared with whites, 1.6 (CI 1.5, 1.6) per 1000. This trend was most pronounced with central nervous system malformations. Although whites had an almost two-fold higher infant mortality rate from central nervous system malformations compared with nonwhites in 1970–71, this disparity was no longer present by 1996–97. CONCLUSION Congenital malformations have become a leading cause of infant mortality in the 1990s. Over the last several decades, this mortality declined more slowly in nonwhites than in whites. Congenital malformations have become a leading cause of infant mortality.

BackgroundEarly diagnosis and timely treatment of malaria is recognized as a fundamental element to the control of the disease. Although access to health services in Tanzania is improved, still many people seek medical care when it is too late or not at all. This study aimed to determine factors associated with delay in seeking treatment for fever among children under five in Tanzania.MethodsA three-stage cluster sampling design was used to sample households with children under five in Dodoma region, central Tanzania between October 2010 and January 2011. Information on illness and health-seeking behaviours in the previous four weeks was collected using a structured questionnaire. A multivariable logistic regression was used to investigate determinants of delay in treatment-seeking behaviour while accounting for sample design.ResultsA total of 287 under-five children with fever whose caretakers sought medical care were involved in the study. Of these, 55.4% were taken for medical care after 24 hours of onset of fever. The median time of delay in fever care seeking was two days. Children who lived with both biological parents were less likely to be delayed for medical care compared to those with either one or both of their biological parents absent from home (OR = 0.42, 95% CI: 0.24, 0.74). Children from households with two to three under-five children were more likely to be delayed for medical care compared to children from households with only one child (OR = 1.54, 95% CI: 1.04, 2.26). Also, children living in a distance ≥5 kilometres from the nearest health facility were about twice (95% CI: 1.11, 2.72) as likely to delay to be taken for medical care than those in the shorter distances.ConclusionLiving with non-biological parents, high number of under-fives in household, and long distance to the nearest health facility were important factors for delay in seeking healthcare. Programmes to improve education on equity in social services, family planning, and access to health facilities are required for better healthcare and development of children.

While overall infant mortality rates (IMR) have declined over the past several decades, birth defects have remained the leading cause of infant death in the United States. To illustrate how this leading cause of infant mortality impacts subgroups within the US population a descriptive analysis of the contribution of birth defects to infant mortality at the national and state level was conducted. Descriptive analyses of birth defects-specific IMRs and proportionate infant mortality due to birth defects were conducted for the US using 1999 mortality data from the National Center for Health Statistics. In 1999, the change to ICD-10 impacted how cause-specific mortality rates were coded. Aggregated 1995-1998 state- birth defects infant death statistics were used for state comparisons. In 1999, birth defects accounted for nearly 1 in 5 infant deaths in the US. Variation in birth defects-specific IMRs were observed by maternal race with black infants having the highest rates when compared with other race groups. However, among black infants prematurity/low birthweight was the leading cause of death, followed by birth defects. There is substantial variation in state-specific birth defects IMRs and the state-specific proportion of infant deaths due to birth defects. Birth defects remain the leading cause of infant death in the United States, despite the changes that resulted in 1999 from an update in the coding of cause of death from ICD-9 to ICD-10. While birth defects-specific IMRs provide an overall picture of fatal birth defects and a gauge of the impact of life-threatening anomalies, they represent only a fraction of the impact of birth defects, missing those who survive past infancy and those birth defects related losses in the antepartum period. Expansion and support of effective birth defects monitoring systems in each state that include the full spectrum of perinatal outcomes must be a priority. However, paralleling these efforts, analyses of this leading cause of infant mortality provide critical insight into perinatal health and should continue, with appropriate adjustments for the 1999 classification changes.

Infant mortality continues to be a significant national public health problem. African-American infant mortality in the United States remains as high as or higher than those of some developing countries. In the state of California the continuing gap between African-American and Caucasian infant mortality rates is cause for alarm among public health providers. Studies repeatedly indicate that the underlying causes of infant mortality are social, economic, environmental, cultural, political, racial and historical, though not in equal measure. Children born at a socioeconomic disadvantage have less chance of survival than have children of any particular race. To address the disproportionate gap between black and white infant mortality, the California Department of Health Services funds Black Infant Health (BIH) projects in sixteen health jurisdictions. The projects implement six best practice intervention models. Plans have been made to assess the interventions' statewide impact by means of the Black Infant Health Evaluation Project. To date, African-American infant mortality research has concentrated almost exclusively on between-race comparisons rather than on the intragroup variability within that community, leading to the erroneous conclusion that race alone explains infant mortality levels. Such an approach hinders the development of culturally appropriate programs designed to address the problems of high African-American infant mortality. To complement the statewide evaluation design, this study researched intragroup variability and the impact of culturally appropriate interventions through a prospective study design of African-American women participating in four of the California BIH intervention models: Outreach and Tracking, Case Management, Health Behavior Modification, Social Support and Empowerment. Fourteen of the California BIH health jurisdictions were included in the research, which was conducted from July 1, 1996 to June 30, 1998. Sociodemographic, behavioral characteristics and reproductive and perinatal factors were studied to identify their association with low birthweight and their usefulness in developing low birthweight predictive models. Results revealed that BIH participants experienced a lower percentage of low birthweight during the two-year study period than the statewide percentage reported for 1996–1997. Univariate analysis and multivariate modeling using logistic regression techniques consistently found that prematurity, history of poor pregnancy outcomes and cigarette, alcohol and drug use during pregnancy were predictors of low birthweight in the BIH population. This study sought to offer a clearer insight into the causes of African-American infant mortality by providing a better understanding of the differences in sociodemographic, behavioral characteristics, reproductive and perinatal factors that continue to place African-American women at greater risk for poor

Infant mortality from congenital malformations in the United States, 1970–1997

Timely treatment of tuberculosis is imperative for its control. This can get delayed due to delay in care seeking, diagnosis or treatment initiation. The study aims to find out the magnitude of delays in care seeking, diagnosis or treatment initiation, and understand the reasons behind these delays in Wardha district of Maharashtra, India. A mixed methods study was conducted among 275 patients selected from those enrolled under Revised National Tuberculosis Control Programme in 2014. We collected information regarding the duration of delays and generated a free list of reasons for delays in care seeking and diagnosis. The free list items were then subjected to pile sorting. Two-dimensional scaling and hierarchical clustering analysis were performed to identify the various domains of reasons for delays. The median delay in initial care seeking and diagnosis was 10 days each, and that for treatment initiation was 2 days. The domains identified for delay in care seeking were negligence toward health, health conditions, facility-related issues, and household and social reasons. The domains identified for delay in diagnosis were system-related reasons; and patient-related reasons, each of them further having two subdomains. Interventions for reducing the knowledge gap and stigma, increasing the accessibility of services, active case finding; capacity building of providers, quality assured sputum microscopy, and communication skills will help reduce these delays.