Decline In Infant Mortality Research Articles

Monthly Tracking of Infant Mortality in Portugal: Post-COVID Trends

Abstract Background The Infant Mortality Rate (IMR) is a fundamental health indicator that reflects the overall well-being of populations. Recognizing the need for more timely data to inform public health strategies, the authors have presented a novel method for monitoring IMR monthly instead of traditional annual reporting. Our work aims to increase further the robustness of a novel method for monitoring IMR monthly. Methods This new approach leverages the Portuguese E-Death Certification System (SICO) and Statistics Portugal (2016-2024) data. It provides the most recent insights into IMR trends in Portugal, highlighting the post-pandemic period. This method allows for the analysis of cumulative deaths under one year of age against live births over the previous 12 months, offering a more responsive metric to guide interventions. Results The updated analysis reveals a continued pattern influenced by the dynamic public health landscape of the COVID-19 pandemic, including the phasing out of restrictions and the end of mandatory mask usage. The pandemic has significantly impacted IMR trends, with Portugal experiencing a decline in IMR during the stringent phases, reaching historically low levels. This trend slightly reversed following the lifting of restrictions, underscoring the urgent need for understanding the complex interplay between public health policies and infant mortality. In the post-pandemic period, the IMR increased until October 2023, showing a later (up to February 2024) global decreasing trend within the range of 2.5 and 2.9 deaths per 1000 live births. Conclusions Recent updates confirm the effectiveness of real-time IMR monitoring as a vital tool for policymakers and health professionals. Portugal’s experience underscores the importance of real-time health indicators in managing public health crises. It stresses the need for further research to understand factors affecting IMR and to continue reducing infant mortality. Key messages • COVID-19 restrictions correlated with a historical low in Portugal’s IMR, showcasing the impact of stringent public health measures. • Post-lockdown, the rise in IMR after the phasing out COVID-19 restrictions and later stabilization underscores the challenges and the necessity for dynamic health policies.

Health benefits of air pollution reduction: Evidence from economic slowdown in India

This paper evaluates health benefits associated with the impact of air pollution reduction on infant mortality in India. Leveraging plausibly exogenous geographic variation in air pollution due to the post-2010 economic slowdown—a period largely overlooked in the literature—I find that improvements in air quality resulted in a significant decline in infant mortality, particularly through respiratory diseases and biological pathways such as in utero and post-birth exposure. The associated health benefits correspond to 1338 saved infant lives, translating to monetary gains of $312.5 million. The paper advances our understanding of the link between air pollution and human health in settings with elevated air pollution and suboptimal regulatory frameworks.

Temporal Trends of Infant Mortality Secondary to Congenital Heart Disease: National CDC Cohort Analysis (1999-2020).

Infant mortality continues to be a significant problem for patients with congenital heart disease (CHD). Limited data exist on the recent trends of mortality in infants with CHD. The CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was queried to identify deaths occurring within the United States with CHD listed as one of the causes of death between 1999 and 2020. Subsequently, trends were calculated using the Joinpoint regression program (version 4.9.1.0; National Cancer Institute). A total of 47,015 deaths occurred in infants due to CHD at the national level from the year 1999 to 2020. The overall proportional infant mortality (compared to all deaths) declined (47.3% to 37.1%, average annual percent change [AAPC]: -1.1 [95% CI -1.6 to -0.6, p < 0.001]). There was a significant decline in proportional mortality in both Black (45.3% to 34.3%, AAPC: -0.5 [-0.8 to -0.2, p = 0.002]) and White patients (55.6% to 48.6%, AAPC: -1.2 [-1.7 to -0.7, p = 0.001]), with a steeper decline among White than Black patients. A statistically significant decline in the proportional infant mortality in both non-Hispanic (43.3% to 33.0%, AAPC: -1.3% [95% CI -1.9 to -0.7, p < 0.001]) and Hispanic (67.6% to 57.7%, AAPC: -0.7 [95% CI -0.9 to -0.4, p < 0.001]) patients was observed, with a steeper decline among non-Hispanic infant population. The proportional infant mortality decreased in males (47.5% to 53.1%, AAPC: -1.4% [-1.9 to -0.9, p < 0.001]) and females (47.1% to 39.6%, AAPC: -0.9 [-1.9 to 0.0, p = 0.05]). A steady decline in for both females and males was noted. Our study showed a significant decrease in CHD-related mortality rate in infants and age-adjusted mortality rate (AAMR) between 1999 and 2020. However, sex-based, racial/ethnic disparities were noted, with female, Black, and Hispanic patients showing a lesser decline than male, White, and non-Hispanic patients.

Trends and distribution patterns of infant mortality and maternal HIV positivity in South Africa: A decade review (2007 - 2016).

The infant mortality rate (IMR) (24 per 1 000 live births) remains high in South Africa (SA), well above the recommended sustainable development goal (SDG) 3 of 12 deaths per 1 000 live births. High infant mortality is a poor indicator of the health of a population and will hamper attainment of the SDGs. To investigate the trends and distribution patterns of IMR between 2007 and 2016 and its association with HIV-positive pregnant mothers in SA. This study used a cross-sectional study design by analysing secondary data on infant mortality from the 2007 and 2016 Statistics South Africa Community Surveys (CSs), as well as data from the 2007 National Antenatal Sentinel HIV and Syphilis Prevalence Survey. (Antenatal HIV Sentinel Survey - ANCHSS). Line charts with descriptive statistics were used to detail trends in IMRs, and multiple logistic regression models were used to identify risk factors for infant mortality in the 2007 and 2016 CS datasets. Spearman's rank-order correlation (rho) was used to correlate infant mortality with data from the 2007 ANCHSS. All analyses were performed with Stata version 16.0. A total sample of 87 805, comprising 43 922 males and 43 883 females, was included in the analysis. The results revealed a decline in IMR from 55 deaths per 1 000 live births in 2007 to 32 in 2016. Overall, there was a significant decrease in the mortality rate from 2007 to 2016. The infant mortality proportions by province showed KwaZulu-Natal Province having the highest IMR (17.5 deaths per 1 000 live births in 2007 and 6.3 in 2016). Males had a higher IMR (28 deaths per 1 000 live births in 2007 and 17.7 in 2016) compared with females at 26.7 deaths per 1 000 live births in 2007 and 13.8 in 2016. IMR data from the 2007 CS was correlated with the 2007 ANCHSS (28% HIV prevalence in 2007), using Spearman's rank-order correlation, which showed a moderate correlation of 0.58 (p<0.001). The study findings showed a reduction in the trends of infant mortality between 2007 and 2016 in SA; despite the reduction, health inequalities persist. There is a correlation evident between maternal HIV prevalence and IMR in SA. We recommend the use of disability-adjusted life expectancy in SA to measure population health and introduce robust data sets that can better inform policy.

Infant Mortality Decline in Zambia: To What Extent Did Maternal Education Influence Infant Mortality Rate Decline for the Period 1992 to 2018?

Purpose: In Zambia, infant mortality has reduced from 107 per 1000 live births in 1992, to 42 per 1000 live births during the 2018 period. Across the Globe, it is argued that maternal education (ME) contributes to the reduction in infant mortality (IM). However, the extent to which maternal education influenced the decline in infant mortality in Zambia for the period 1992 to 2018 was not clear. Therefore, this study sought to investigate the extent to which ME influenced the decline in IM in Zambia from 1992 to 2018. Materials and Methods: This study was a secondary data analysis (Trend Analysis). Zambia Demographic and Health Survey (ZDHS) data sets: 1992 to 2018 were used in the analyses. The unit of analysis was IM with sample sizes: 6169, 7066, 6526, 6025,12916 and 9959 respective to the ZDHS years. All analyses were done using SPSS version 25.0. Univariate analysis was done for descriptive statistics. Bivariate analysis, Chi-square was used at 5% level of significance for associations. Point Bi-serial Correction was done between ME and IM at 1% and/or 5% levels of significance. Binary logistic regression at 5% level of significance was used to determine the influence of predictors on IM. Findings: It was found that ME was (negatively) related to IM from 1992 to 2001-2. The correlation coefficients were smaller negatives indicating a very weak negative relationship between ME and IM. In multivariate analysis ME was found to be negatively associated with IM, from 1992 to 2001-2 only. Among the interactions, only the interactions between ME and contraceptive use; ME and preceding birth interval; ME and breast feeding; and ME and antenatal care (visits) significantly influenced the decline in IM from 1992 to 2018. Singularly, ME influenced the decline in IM rate to a lesser extent (only marginally). When interacted with contraceptive use, preceding birth interval, breast feeding and antenatal care, ME influenced the decline in IM to a larger extent. Implications to Theory, Practice and Policy: in order to come up with more robust interventions to further reduce IM in the country, these interactions should be considered in the planning and implementation of child health programs such as the child health nutrition, national partnership for maternal, new-born and child health, child health week, Integrated Community Case Management of Childhood Illnesses (ICCM), and the Support to Safe motherhood and New-born Health among others.

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization

WHO, as requested by its member states, launched the Expanded Programme on Immunization (EPI) in 1974 to make life-saving vaccines available to all globally. To mark the 50-year anniversary of EPI, we sought to quantify the public health impact of vaccination globally since the programme's inception. In this modelling study, we used a suite of mathematical and statistical models to estimate the global and regional public health impact of 50 years of vaccination against 14 pathogens in EPI. For the modelled pathogens, we considered coverage of all routine and supplementary vaccines delivered since 1974 and estimated the mortality and morbidity averted for each age cohort relative to a hypothetical scenario of no historical vaccination. We then used these modelled outcomes to estimate the contribution of vaccination to globally declining infant and child mortality rates over this period. Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10·2 billion years of full health gained. We estimate that vaccination has accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood. Since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality. WHO.

Unveiling the health consequences of air pollution in the world’s most polluted nations

Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Modeling time to death for under-five children in Malawi using 2015/16 Demographic and Health Survey: a survival analysis

BackgroundMalawi has one of the highest under-five mortality rates in Sub Sahara Africa. Understanding the factors that contribute to child mortality in Malawi is crucial for the development and implementation of effective interventions to reduce child mortality. The aim of this study is to use survival analysis in modeling time to death for under-five children in Malawi. In turn, identify potential risk factors for child mortality and inform the development of interventions to reduce child mortality in the country.MethodThis study used data from all births that occurred in the five years leading up to the 2015/16 Malawi Demographic and Health Survey. The Frailty hazard model was applied to predict infant survival in Malawi. In this analysis, the outcome of interest was death and it had two possible outcomes: "dead" or "alive". Age at death was regarded as the survival time variable. Infants who were still alive at the time of the study as of the day of the interview were considered as censored observations in the analysis.ResultsA total of 17,286 live births born during the 5 years preceding the survey were analysed. The study found that the risk of death was higher among children born to mothers aged 30–39 and 40 or older compared to teen mothers. Infants whose mothers attended fewer than four antenatal care visits were also found to be at a higher risk of death. On the other hand, the study found that using mosquito nets and early breastfeeding were associated with a lower risk of death, as were being male and coming from a wealthier household.ConclusionThe study reveals a notable decline in infant mortality rates as under-five children age, underscoring the challenge of ensuring newborn survival. Factors such as maternal age, birth order, socioeconomic status, mosquito net usage, early breastfeeding initiation, geographic location, and child's sex are key predictors of under-five mortality. To address this, public health strategies should prioritize interventions targeting these predictors to reduce under-five mortality rates.

Social fund and infant mortality: Evidence from an anti-poverty policy in Northeast Brazil.

This paper evaluates the effects of a social fund that meets the needs of the poor in Northeast Brazil, the Fundos Estaduais de Combate e Erradicação da Pobreza (FECEP). The program could have improved infant health by reducing poverty and improving access to health care, sanitation, food, and housing. Using a difference-in-differences approach robust to heterogeneous treatment effects, we confirm that the program has effectively reduced poverty in treated areas. Furthermore, we document that this poverty reduction is associated with a significant decline in infant mortality. These findings provide consistent evidence that targeted public investments can improve living conditions in vulnerable regions.

Uncovering the rural–urban gap in determinants of infant mortality in Punjab-Pakistan

ObjectiveThe main objective of this research is to observe the various socio-economic, demographic, health-seeking, and environmental factors influencing infant mortality and the rural–urban division in Punjab, Pakistan. MethodsThe study used the data of 38,405 households from the Multiple Indicator Cluster Survey that was conducted by the Bureau of Statistics Punjab during 2017–18. This survey assessed 125 indicators i.e., health, education, etc. created by UNICEF to assess the well-being of mothers and children in Punjab, Pakistan. Results and conclusionThe mother, the child, and the family are the three main risk factors for infant death, according to our research in Pakistan. The socioeconomic position of the household, social practices, environment, and usage of medical services are the key factors that help in reducing infant death. Women's education, birth spacing, and household economic position all played a significant role in the decline in infant mortality. The health of infants born in rural Punjab is at risk due to a large rural–urban gap in the determinants of infant mortality. Uncovering and addressing this disparity has become a pressing health priority in Pakistan.

Economic shocks and infant health: Evidence from a trade reform in Brazil

Using a uniquely rich set of data sources spanning more than 3,000 Brazilian municipalities over a horizon of 25 years, we investigate the effects of changes in local economic conditions generated by a trade liberalization reform on infant mortality. We exploit variation in import tariff reductions, together with differences in the baseline industry composition across locations, for identification. We find that areas with greater exposure to the trade-induced economic shock experienced a larger decline in infant mortality. In our exploration of mechanisms, we find the most support for the hypothesis that worse labor market opportunities make it less costly undertake health-improving behaviors that are time intensive. Consistent with this hypothesis, we observe a significant decline in female employment rates and an increase in the use of basic health services among women of childbearing ages and infants. We also document that the rollout of a community-based intervention that brings basic health services to the home in a flexible fashion lowers the magnitude of the mortality effect, providing further evidence in favor of the parental time mechanism.

Environmental implication of energy policies and private and public subsidies on infant mortality rate: a sustainable development study of India.

India has remarkably achieved some level of decline in infant mortality rate and increase in aged person through increase in life expectancy due to improvement on its health care sector but still remain amongst the countries with the highest rate of infant mortality within the Asian countries. Literature on environmental implication remains scarce, and for this we utilised India's data from 1975 to 2020 to research on this topic. Relevant scientific methods (residual Augmented Least Squares - RALS, Engle and Granger - EG, and its newly augmented version - RALS-EG) are adopted in this study. Further, to estimate the long-run elasticities of the regressors, the symmetric analyses, i.e., dynamic ordinary least squares (DOLS) and Engle and Granger causality test techniques, are employed. Findings according to DOLS revealed that renewable energy sources and social (GDP per capita) and public subsidies (general government final consumption expenditure) have lessening effect on infant mortality in India, whilst the private subsidies (gross capital formation), fossil fuels, and carbon dioxide cause an increase in infant mortality in India. This exposes renewable energy source as a mitigating factor in Indian environmental degradation which as well lessen the infant mortality level in India; hence, policy is suggested to be framed on improving renewable energy and health sectors. The graphical presentation of the abstract is done with the diagram below. The graph shows the interactions amongst the selected variables in this study. The impacts of the explanatory variables on the dependent variable are shown with different colours showing positive (green) and negative (red) impacts.

Compulsory education reform and child mortality in Peru.

The government of Peru amended its constitution to increase compulsory education from six to 11 years in 1993. This constitutional amendment provides a natural experiment to investigate the impact of maternal education on child mortality. Exploiting differences in the reform exposure by age, I find that mothers who were exposed to the reform were less likely to experience the death of a child. There is also evidence that the reform caused a decline in infant mortality. These results are not driven by the age difference between mothers who were treated by the reform and those who were not treated. Additional analyses reveal that the reform increased age at first birth, decreased desired fertility, reduced smoking, and improved economic opportunities for women. The results demonstrate that compulsory schooling may be a useful policy tool to improve women's education, which can, in turn, enhance the survival of their children.

The Epidemiologic Transition in French Guiana: Secular Trends and Setbacks, and Comparisons with Continental France and South American Countries

There are great variations between population subgroups, notably in poorer countries, leading to substantial inconsistencies with those predicted by the classical epidemiologic transition theory. In this context, using public data, we aimed to determine how the singular case of French Guiana fit and transitioned in the epidemiologic transition framework. The data show a gradual decline in infant mortality to values above 8 per 1000 live births. Premature mortality rates were greater but declined more rapidly in French Guiana than in mainland France until 2017 when they reascended in a context of political turmoil followed by the COVID-19 pandemic and strong reluctance to get vaccinated. Although infections were a more frequent cause of death in French Guiana, there is a marked decline and circulatory and metabolic causes are major causes of premature death. Fertility rates remain high (>3 live births per woman), and the age structure of the population is still pyramid-shaped. The singularities of French Guiana (rich country, universal health system, widespread poverty) explain why its transition does not fit neatly within the usual stages of transition. Beyond gradual improvements in secular trends, the data also suggest that political turmoil and fake news may have detrimentally affected mortality in French Guiana and reversed improving trends.

Младенческая смертность в Московской области: анализ ситуации, основные тенденции, перспективы снижения

The analytic data on monitoring infant mortality in the Moscow region and an analysis of its causes in 2019, 2020 and 2021 are presented on the article. The early neonatal period accounts for 25–29% of all infant deaths. The late neonatal period accounts for 22–26%. At the age of 1 month to a year are 50% of all infant deaths. No trend was found in changing the age structure within 3 years. There is a decrease in infant mortality by 16.4% in 2021 compared to 2019. The causes of death of children are estimated, among which certain conditions that occur in the perinatal period are in the lead. The steady decline in infant mortality, including in the most significant group of newborns, is due to the development of the neonatological service in the Moscow region within the framework of a three-level system for organizing medical care for women and children. Newly opened perinatal centers had an impact on the reduction of neonatal mortality in the Moscow region. Key words: neonatology, perinatology, infant mortality, post-neonatal period

Racial Inequality in the Prime of Life: Infectious Disease Mortality in U.S. Cities, 1906–1933

AbstractIn the first half of the twentieth century, deaths from infectious disease, especially among the very young, fell dramatically in American cities. However, as infant mortality fell and life expectancy rose, racial inequality in urban infectious disease mortality grew. In this paper, we show that the fall in mortality and the rise in racial inequality in mortality reflected two countervailing processes. The dramatic decline in infant mortality from waterborne diseases drastically reduced the total urban infectious disease mortality rate of both Black and white Americans while having a comparatively small effect on the total racial disparity in urban infectious disease mortality. In contrast, the unequal fall in tuberculosis mortality, particularly in the prime of life, widened racial inequality in infectious disease mortality in US cities.

Modernisation Factors of Infant Mortality Transition in Late Imperial Perm Province

This article studies urban infant mortality in the post-reform period of Perm Province. The work reconstructs the dynamics of infant mortality in cities and villages of the Middle Urals, highlighting the patterns of individual cities and identified factors of evolution. It is based on published state and zemstvo statistics, archival documents from medical institutions and public organisations, as well as Orthodox Church parish records from Ekaterinburg. Methodologically, the work relies on general demographic indices, descriptive statistics techniques, seasonality coefficients, and dynamic series analysis. During the first half of the nineteenth century, the mining Urals had extremely high birth and death rates and the highest infant mortality rate in European Russia. The Great Reforms launched the demographic transition in the region, resulting, among other things, in the Empire’s most significant infant mortality decline in the early twentieth century. The earliest and fastest infant mortality decline took place in cities. Small towns had slightly better rates than rural areas, while Perm and especially Ekaterinburg had significant reductions. The main reasons behind the changes in infant mortality were economic employment diversification, the weakening of ethno-religious traditions, and the creation of medical infrastructure. In daily life, these factors manifested in the smoothing of demographic seasonality, increased period between birth and baptism, the introduction of artificial nourishment with the help of glass feeding bottles and rubber comforters, and moving childbirths and infant care to hospitals. Ekaterinburg, the economic capital of the region, was the place where these factors had the best effect.

Tendência temporal da mortalidade infantil em Pernambuco, 2001-2019: um estudo ecológico de base populacional

Abstract Objectives: to analyze the temporal trend and spatial distribution of infant mortality in Pernambuco from 2001 to 2019. Methods: an ecological study involving all deaths in children under one year of age living in the state. Data were collected from the Mortality Information System and the Live Birth Information System. Four mortality rates were calculated and the temporal analysis was performed by applying the regression model by inflection points of the rates at different spatial levels. Results: 47,949 deaths were recorded, of which 51.0% (n=24,447) occurred in the first six days of life. A statistically significant downward trend was observed in all the rates analyzed (-4.5%/year in overall mortality, -3.6%/year in early neonatal mortality, -1.9%/year in the late neonatal component, and -6.3%/year in the post-neonatal component). Additionally, 64.3% of the municipalities (n=119) showed a declining trend in the overall infant mortality rate. Less than 50% of the municipalities showed a downward trend in early neonatal and late neonatal mortality (41.08%; n=76 and 43.2%; n=80, respectively). In post-neonatal mortality, 57.3% (n=106) showed decreasing trends. Conclusions: there was a temporal trend of decline in overall infant mortality, although there is an important portion of municipalities with a stationary trend, justifying the need to reduce social inequalities and geographical asymmetries.

Смертність немовлят в Україні на тлі пандемії COVID-19: не втрачати пильності

Purpose - to highlight the peculiarities of mortality of children in the first year of life (absolute number and level by individual causes and gender) in Ukraine in 2019-2020; to find out whether there have been changes during the year of the COVID-19 pandemic in the country that could hinder the achievement of the SDGs in the area of reducing child mortality. Materials and methods. The information base of the study was the official data from the State Statistics Service of Ukraine regarding the distribution of deceased children by sex, age groups, place of residence and causes of death in 2019-2020. For comparative analysis were used a data from the Statistics Poland and World Population Review (USA) databases. In the course of the analysis were used the following methods: systematic approach, bibliosemantic, epidemiological, statistical, graphical representation. Results. It has been shown that approximately 80% in the structure of mortality under the age of 1 year in Ukraine are accounted for by two main causes: certain conditions that occur in the perinatal period - 58.5% (in 2019 - 54%) and congenital malformations - 22.3% (in 2019 - 25%). The focus is on preventable causes (first of all, external causes and infectious diseases). In 2020 were reported six deaths under the age of 1 year due to COVID-19 firstly. Despite the decline in infant mortality in 2019-2020 from 7.0 to 6.7 per 1000 live births, indicates the likelihood of a negative impact of the COVID-19 pandemic on infant mortality in Ukraine, primarily as a result of the influence of indirect factors, and the need for actions to eliminate or minimize such influence. Conclusions. An analysis of the spectrum and weight of the contribution of the causes of death is a tool for determining the lines and scope of intervention to prevent them on the way to Ukraine achieving by 2030 the declared indicator of infant mortality in children aged 0-4 years old of 6.7 per 1000 live births. No conflict of interests was declared by the authors.

Trend and future of infant mortality in Pakistan

In South Asia, Pakistan is contributing to the highest childhood mortality, including infant mortality. Child mortality has been declined globally, but Pakistan is still struggling and far behind the targets of Sustainable Development Goals. There are several reasons behind high childhood mortality, including socioeconomic determinants and a lack of effective implementation of health-related policies, particularly in primary health care settings. In the present study, we use the stochastic univariate models to uncover the trend of infant mortality by using more than half of the century data from 1960-2017.The secondary data on infant mortality rate from 1960 to 2017 was extracted from World Bank Dataset. Descriptive and time series analysis were applied by using the programming language R. The median infant mortality rate was 109 per 1,000 live births, whereas a higher mortality rate (189.8/1000) was reported in 1960. A gradual decline in infant mortality rates is experienced every year. The mortality rate went down below 100/1,000 live births from 1993 and remained 61.2/1,000 in 2017. ARIMA (1, 2, 2) is an adequate forecasting model selected by using the Auto ARIMA function with a root mean square error is 0.1006. Five years ahead forecast is obtained and yielded that infant mortality rate is expected to remain in 2018 [59.54, C.I (59.34 - 59.73)], 2019 [57.93, C.I (57.47 - 58.40)], 2020 [56.39, C.I (55.48 - 57.30)], 2021 [54.90, C.I (53.35 - 56.45)] and 2022 [53.47, C.I (51.05 - 55.88)]. The decreasing trend is expected in the infant mortality rate in Pakistan.