Neo-Natal and Post-Neo-Natal Mortality in a Rural Area of Bangladesh

Abstract

Factors concerning neonatal and post-neonatal mortality in rural Bangladesh were based on data obtained from matched birth and death certificates registered in a population of 117000 in 132 villages of Matlab thana between May 1968 and April 1969. Neonatal deaths are those occuring at ages 0-29 days. Post-neonatal deaths are those occuring from 30 days to 12 months. Neonatal deaths comprised 3/5 of all infant deaths in the period under study. This concentration of deaths in the first month is unusual in an undeveloped country where deaths from environmental and infectious causes usually loom larger than birth-related factors and gastric and respiratory ailments. As total infant mortality accounts for almost 40% of the death rate efforts in death control must be accompanied by birth control efforts if the growth rate is not to skyrocket. When the relationship between maternal age and neonatal mortality was considered the high-risk ages appeared in the younger portion of the structure while for women 25 years and older risk was evenly distributed. The pattern for post-neonatal risk differs slightly. Risk drops abruptly between the ages of 20 and those of 20-24 then rises again to almost the same level in the next 2 age groups and increases sharply at ages 35-39. In the oldest group the rate falls to approximately the level of ages 25-34. This surprising revelation is attributed to the existence of a number of older women with high parity and low mortality that is women who are highly successful at childbearing. Neonatal mortality exhibits the standard U shaped distribution with parity; for post-neonatal mortality the pattern is not as apparent. Risk remains relatively unchanged between parity 1 and 3 then increases for parities 4 and 5 and drops again for parity 6. This drop in the mortality rate is again attributed to the presence of high parity women with low child mortality in the larger family sizes contributing to the reduction of the overall rate.