Reduce Infant Mortality Research Articles

Reducing the equity gap in child health care and health system reforms in Latin America

BackgroundDuring the first decade of the current century, Latin American countries have shown high and consistent economic growth rates, increasing per capita GDP and reducing poverty. Social indicators improved in even the poorest and least equitable countries in the region. In terms of health care results, marked advances were made in infant mortality rates.ObjectiveThe aim of this paper is to identify if decreasing poverty rates in Latin America and the Caribbean during the first decade of the century have had an effect on health inequality, specifically by reducing the health care equity gap and, if so, whether that trend and its effects were distributed evenly at the sub-national level.MethodsBasic statistical tools were applied to national and sub-national administrative data for eleven Latin American countries (Argentina, Belize, Bolivia, Brazil, Colombia, Dominican Republic, El Salvador, Mexico, Nicaragua, Peru, and Uruguay) to compare the evolution of a set of social determinants with a classic health care outcome, such infant mortality) during the period 1995–2012. This document proposes a set of indicators to analyze relative evolution of results and convergence to equity, and to discuss general trends in health care reforms across the region.ResultsThe document shows a correspondence between poverty reduction, and improvement of health care indicators at a regional level, though national differences persist. In some cases, like Brazil and Peru, the reduction in infant mortality rates is coupled with significant movements towards health equity. This trend is different in Bolivia, where the drop in poverty is not followed by better outcomes in poor departments. At the same, results are not necessarily linked to health systems organization and/or specific reforms. For instance, both Brazil and Peru pursue in applying decentralized solutions, although the incentive mechanisms are quite different: the former has a supply side structure at the public provision level while the latter has implemented mixed payment systems.ConclusionWhile some of the same instruments and measures of effectiveness in health care reforms appear across the region, specific impact evaluations should be performed. To reduce the equity gap in Latin America requires not only major improvements in social determinants but also the design and implementation of sound institutional policy and more robust regulatory frameworks (institutional determinants) so that more resources yield better practices.

Accredited Social Health Activist: Combatant for Reducing IMR and MMR in 21st Century Under the Programme Janani Suraksha Yojana - A Study Under Jharadihi C.H.C of Bahalda Block, Odisha

Janani Suraksha Yojana as literary implies Maternal Protection Scheme being employed in rural community is now-a-days so much familiar in rural medically challenged area that 95% of mothers are choosing for institutional delivery at Primary Health Center (N) or Community Health Center. It employs cash assistantship nutritious food for the mother with free medical facility from primary stage to delivery including transportation where ASHA is the real combatant of frontline introducer and manager of the scheme basically in this type of undeveloped area. ASHA serves as the real guide starting from pregnancy to the period of birth age of the infant for six month covering the crucial period prior to one month of expected date of delivery to puerperal period. In this present study the role of ASHA being evaluated in 21st century how they are managing in reducing Infant Mortality Rate and Maternal Mortality Rate by suitably managing the condition of irregular fetal development, eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage, postpartum haemorrhage, Pre and Post anemia. Counseling of mother by ASHA for self taking care of health, consumption of nutritious food with vitamins and minerals, routine checkup and providing IEC materials to create awareness for save delivery and infant care are the key factors for reduction of the IMR and MMR in rural undeveloped area of the nation as applicable to our population sample area.

Hubungan Manajemen Pelaksanaan Pemantauan Pertumbuhan Terhadap Partisipasi Masyarakat Dalam Kegiatan Posyandu Di Dusun 03 Desa Manislor

Posyandu is a form of Community-Based Health Efforts (UKBM) which is managed and organized from, by, for and with the community in carrying out community health development, community empowerment and providing convenience for the community in obtaining basic health services to accelerate the reduction of maternal and infant mortality. (Ministry of Health, 2011). In general, this study aims to determine the relationship between management and implementation of growth and development monitoring on the achievement of the presence of mothers and children under five at the Posyandu Dusun 03 Manislor Village, Jalaksana District. The method used in collecting data in this research is a qualitative method. Posyandu Dusun 03 Manislor Village, community participation in participating in posyandu activities is quite good, because the number of visits every month reaches 70.5% - 88.2% although it often goes up and down, but the number of visits by mothers and toddlers to posyandu has never been <50%. Growth monitoring management in terms of the management system as described includes elements (Input, Process, Output) and includes 6M elements (Man, Money, Material, Machine, Method, Market). The lack of participation of mothers in posyandu can result in low monitoring of growth and development in toddlers and is closely related to the facilities and infrastructure available for growth monitoring activities.

Infant Mortality Rates and GDP Per Capita in Kenya: An Empirical Investigation Based on Fractional Integration.

This paper deals with the analysis of the relationship between the infant mortality rates and the GDP per capita in Kenya using fractional integration and cointegration techniques. The results show that the two series are highly persistent, with the effects of the shocks persisting forever. However, the multivariate work reveals that the two series are fractionally counteracted, showing a long run equilibrium relationship that tends to persist and disappear slowly in the long run. This relationship is important for public policy implying a synergy of development outcomes since it suggests that the current emphasis in Kenya’s Vision 2030 on raising per capita income is likely to have positive and long-term effects on the vital health outcome of infant mortality. Our analysis therefore provides additional support for the growth approach to reducing infant mortality. It reinforces the view that growth in per capita income is considered as necessary for sustaining infant mortality improvements although not necessarily sufficient.

Zinc Supplementation and the Prevention and Treatment of Sepsis in Young Infants: A Systematic Review and Meta-Analysis

Background: Prematurity and low birth weight are major risk factors for neonatal sepsis. Zinc supplements have been previously shown to be beneficial in pregnancy and small for gestational age birth outcomes. There is sparse information, however, on the potential benefits of zinc supplementation to prevent or treat serious infections in this age group. Objective: The aim of this study was to assess the efficacy of preventive and therapeutic zinc supplementation in young infant (<4 months) sepsis. Methods: MEDLINE, Cochrane CENTRAL, and other databases were searched from inception until 18 June 2021. Studies assessing preventive and therapeutic zinc supplementation in young infants in relation to incidence and outcomes of suspected sepsis were included. Meta-analyses of pooled effects were calculated for sepsis-related outcomes. Results: Nine randomized controlled trials involving 2,553 infants were included. Six studies reported therapeutic efficacy, whereas 3 evaluated preventive benefits of zinc supplementation. Preventive studies suggest a protective effect of zinc supplementation on neonatal mortality rate (NMR) (risk ratio (RR) 0.28; 95% CI 0.12–0.67, LOW certainty), but with no effect on the incidence of sepsis, both in preterm neonates. Among young infants, therapeutic zinc was associated with significant reductions in treatment failure (RR 0.61; 95% CI 0.44–0.85; MODERATE certainty) and further subgroup analysis showing significant reduction in infant mortality rate with 3 mg/kg/twice a day dosage only (RR 0.49; 95% CI 0.27–0.87, LOW certainty). Therapeutic zinc supplementation in neonates did not show any effect on hospital stay or NMR. Conclusion: Zinc supplementation could potentially reduce mortality and treatment failure in young infants but has no noteworthy influence on hospital stay and in the prevention of sepsis. Further studies with larger sample sizes are needed to confirm the direction and magnitude of effects if any.

Pemberdayaan Kader Posyandu dalam Pemberian ASI Eksklusif

Exclusive breastfeeding is the best food for infants breast milk (breast milk) is given for 6 months without other additional food and continued until the age of 2 years, breastfeeding can reduce infant mortality and can increase growth and development in children. at this time there are still many mothers who do not give exclusive breast milk to their babies. Based on data obtained by one of the health centers in Jambi from 111 babies who were given exclusive breast milk 63 babies and who did not give exclusive breastfeeding 28 babies, although most have given exclusive breast milk there are still babies who are not given exclusive breast milk, this can be influenced by the condition of mothers who work outside the home that makes the mother can not breastfeed her baby beside the mother's knowledge of the importance of exclusive breast milk is still not optimal, the busyness of working mothers makes mothers prefer formula milk that is more practical for the baby. Related to the problem, it is necessary to empower cadres so that cadres can play an active role in providing information to mothers who are in the integrated service center area. This service is done to improve the knowledge, understanding, and skills of integrated service center cadres. This activity was carried out in the Working Area of Simpang Kawat Health Center held in March to August 2020, the target in this activity posyandu cadres use the method of lectures, discussions, question and answer with leaflet media and laptop. As a result of this activity increased the knowledge, understanding, and skills of cadres about exclusivebreast milk and will be published in the form of journals to be easily accessed by the community.

The Effect of Education on the Utilization of Posyandu during the Covid 19 Pandemic in Sei Rotan Village, Percut Sei Tuan District, Deli Serdang Regency

Integrated Healthcare Center is a form of health service where the management and implementation come from, by and with the community to improve health development, improve public health by empowering the community, and become a basic service for the community in order to accelerate the reduction of maternal and infant mortality. This type of research is a pre-experiment using a one group pretest posttest design. The population in this study were mothers who attended the Integrated Healthcare Center, amounting to 35 people using the Sampling Technique: Purposive Sampling. The purpose of this study was to determine whether there was an effect of providing education on the use of Integrated Healthcare Center during the covid 19 pandemic. The results of the research on the use of Integrated Healthcare Center during the Covid 19 pandemic before providing education, the majority were classified as low as many as 18 respondents (46.2%), while the use of Integrated Healthcare Center during the Covid 19 pandemic after providing education increased to a high category of 20 respondents (51.3 %). Conclusion There are differences in the quality of Integrated Healthcare Center utilization during the Covid 19 pandemic before and after being given education, with a p value (0.000) &lt; (0.05). These results prove that there is a significant influence between the provision of education on the use of Integrated Healthcare Center during the COVID-19 pandemic in Sei Rotan Village. These results prove that the provision of education can provide positive changes to the use of Integrated Healthcare Center during the covid pandemic.

The effect of emission trading system on infant health: evidence from China.

Although existing literature has explored the effect of the emission trading system (ETS) on economic growth and pollution emissions, little is known about the impact of the ETS on residents' heath, especially infant health. Based on a "big sample" data set from 1773 county-level administrative regions in China from 2001 to 2012 and a differences-in-differences (DID) strategy, for the first time, this paper investigates the effect of China's SO2 ETS pilot policy on infant health measured by infant mortality. In particular, from the perspectives of pollution emission reduction and green and high-quality economic growth, we empirically identify the mechanism through which the ETS influences infant mortality. The results show that the implementation of the ETS pilot policy significantly reduces infant mortality, and with the implementation of the pilot policy, such a health improvement effect is strengthened. This finding is consolidated through a series of robustness checks, including employing the method of the propensity score matching combined by the DID, using the thermal inversion strength as the instrumental variable, excluding the impacts of other environmental policies, and conducting a placebo test. In addition, the results of the mechanism analysis indicate that the ETS pilot policy significantly lowers SO2 emission density and PM2.5 concentration and raises energy efficiency and per capita GDP. Therefore, the ETS pilot policy can improve infant health by promoting pollution emission reduction and green and high-quality economic growth. This study provides some empirical evidence for the causal relationship between environmental regulation policies and infant health, as well as some reference for the formulation and improvement of related environmental regulation policies.

Overview of the mortality from external causes of reproductive-age women in Brazil.

Studies have shown that a new demographic and epidemiological profile has been emerging in women of childbearing age, mainly due to the increase in life expectancy, reduction in infant mortality, higher survival in old age, and the drop in fertility rate.To evaluate the external (violence) causes of mortality among women in Brazil from 2007 to 2016.This is a quantitative, ecological study of temporal trends and correlations of the main causes of mortality of women of childbearing age and their association with age, from 2007 to 2016 in Brazil. The collected data were extracted from the Departamento de Informática do Sistema Único de Saúde database called the Mortality Information System.It was possible to identify a considerable increase among the Brazilian states, with the highest coefficient of mortality from external causes, especially the northern regions. The highest coefficient identified among the evaluated states was 3.57 per 10,000, and in the northeast and southeast, external causes mainly affected young women aged 10 to 29 years.It is necessary for managers and health professionals to be more aware of the diseases that affect this population.

Peningkatan Kemampuan Kader Melalui Edukasi Pemanfaatan Bahan Alam Untuk Meningkatkan Produksi ASI Di Kelurahan Banjarsari Surakarta

Background: The benefits of breastfeeding for infants include reducing infant mortality due to diarrhea and infection, reducing mortality among malnourished children, protecting against gastrointestinal infections, as well as being a source of energy and nutrition for infants aged 6 to 23 months. While the benefits for mothers who are breastfed are reducing the risk of ovarian cancer and providing breast support after milk production, as a natural prevention method in the first six months of birth, and helping to lose weight faster with pregnancy. Vegetables / natural plants that are easily available around us that can be used to increase breast milk production. Research in addition to carbohydrates, these vegetables also contain protein, minerals (phosphorus, calcium and iron, as well as a number of vitamins A, B1 and C). Methods: The method used is to present a booklet through education. The number of respondents was 20 mothers of health cadres. Results: The result of this community service activity is an increase in knowledge about the use of style materials for breastfeeding from 75% sufficient knowledge to 80% good knowledge. Conclusion: increasing knowledge and understanding of health cadres before and before providing education through natural plant booklets to increase breast milk.

Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030.

Accelerating Upstream Together: Achieving Infant Health Equity in the United States by 2030.

Tackling Persistent and Large Disparities in Birth Outcomes in Allegheny County, Pennsylvania.

Based in Allegheny County, a coalition of local stakeholders took note of the region's infant mortality rates, particularly the stark disparities observed by race, and established a vision to reduce infant mortality in the region. The group undertook a multi-faceted effort to (1) develop predictive models of infant mortality risk; (2) evaluate the effectiveness of available interventions; and (3) combine these tools in order to tailor intervention referrals based on maternal risk profiles. With this effort, the coalition sought to address the apparent disconnect between the region's robust maternal and child health care system and relatively poor birth and infant outcomes and racial disparities. The effort started with the integration of data from a variety of sources into an integrated database built specifically for this research effort covering the period 2003 to 2013. With the database, researchers linked each individual's data across multiple data sources, including the Allegheny County Health Department, the University of Pittsburgh Medical Center, the Allegheny County Department of Human Services Data Warehouse, and individual programs. With these data, we used a standard method for comparing outcomes and measuring the racial disparity between Black and white infants that involved calculating a ratio by dividing the rate or percentage for Black infants by the rate or percentage for white infants. Overall, the results showed that between 2003 and 2013 in Allegheny County disparities were more pronounced for infant mortality (3.25) than low birthweight (1.88) or preterm birth (1.49). Among the different potential causes of infant mortality, the most pronounced disparity was for SIDS (1.78). Among maternal health factors, pre-pregnancy obesity and gestational diabetes had the highest infant mortality disparity. The low birthweight disparity was similar and lower than the infant mortality disparity across all of the maternal health factors, while the preterm birth disparity was even lower. For the maternal behavioral and contextual factors, the infant mortality disparity ranged from 1.5 to 2.3. The 11-year span of data reported in the IMPreSIv database and the breadth of intervention data included allowed us to report granular information on birth outcomes within Allegheny County over this time period. The database also allowed us to summarize the various factors associated with the range of birth outcomes and describe the participation rates in the medical and community setting interventions. Against this backdrop of pronounced disparities in birth outcomes across a range of factors, we examined the effectiveness of interventions for women with different risk factors (e.g. substance use disorders) in order to develop a tool to facilitate individualized referrals to the interventions that will help the most for a specific risk profile.

Моделирование потенциального влияния паливизумаба на снижение показателя младенческой смертности и частоты госпитализаций в связи с респираторно- синцитиальной вирусной инфекцией

Objective. To assess the impact of preventive therapy with palivizumab against respiratory syncytial viral (RSV) infection on the indicator of the implementation of the Unified plan to achieve national goals of the Russian Federation and on the infant mortality rate. Patients and methods. Preterm infants born prior to 35 weeks gestation were considered as target population for immunization with palivizumab. We modeled an increase in palivizumab coverage to 25% by 2024 and calculated the expected number of deaths and hospitalizations that can be prevented using palivizumab. We also calculated targeted values of infant mortality reduction (for the entire country and individual regions) that can be achieved by increasing palivizumab coverage. Results. Annual increase of RSV prophylaxis coverage will prevent 49, 63 and 76 deaths in Russia in 2022, 2023, and 2024, respectively. This will ensure a 36.3%, 48.4%, and 60.5% reduction in infant mortality in 2022, 2023, and 2024, respectively, which will facilitate the achievement of targeted indicators specified in the National development goals of the Russian Federation. Moreover, it will prevent 904, 1142, and 1381 hospitalizations due to RSV in 2022, 2023, and 2024, respectively. Conclusion. Wider use of palivizumab will decrease the hospitalization rate and will facilitate the achievement of the targeted indicator ‘reduction of infant mortality’ within the Federal Project ‘Improvement of children's healthcare.’ Key words: infant mortality, preterm infants, palivizumab, prevention, respiratory syncytial virus infection

Анализ младенческой смертности в Иркутской области и резервы по ее снижению

The aim of the research. Determination of reserves for reducing infant mortality based on the results of its analysis. Material and methods. An analysis of infant mortality dynamics in the Irkutsk Region for 2018-2020 was made as well as of medical documentation of 51 cases of death from external causes in the postneonatal period. Results. In 2020, the structure of the causes of infant mortality has changed due to its increase from external causes, which took the first place in the postneonatal period. Infant mortality outside medical institutions has a negative trend: 19.8% in 2018, 24.5% in 2019 and 25.1% in 2020. Analysis of medical records revealed that children aged 1 to 3 months (52.9%) and 4 to 6 months (35.3%) died more often, being mostly full-term children (84.3%), among whom 27.9% were with intrauterine development delay. The largest number of deaths occurred from accidental suffocation at home – 86.3%. A total of 35 (68.6%) children were brought up in families of high social risk, while 25 (71.4%) families were not registered by social protection authorities and were deprived of the opportunity to receive social support. Conclusion. The reduction of infant mortality from external causes largely depends on organisation of interdepartmental interaction of medical organisations with bodies and institutions of the neglect prevention system for monitoring families in socially dangerous situations. For timely identification of families of high social risk and the transfer of information to the custody and guardianship authority and the social protection management authority, medical organisations must be staffed with social workers.

Dekomponovanje osnovnih pokazatelja smrtnosti u Srbiji u periodu 1990-2021

The research of thirty-year changes in the mortality of the population of Serbia (1990-2021) is given through two basic indicators of mortality. Using the decompose method to calculated the effect of population aging on the difference between crude mortality rates, as well as the contributions of specific mortality rates and leading causes of death in the changes in life expectancy. The crude death rate shows that the intensity of dying in Serbia is very high. The pandemic contributed to record values in the last two years. Overall, in the period 1990-2019, the negative contribution of the age structure is twice as intense as the positive effect of age-specific mortality rates. Aging is more intense in the female population, which explains the greater increase in the crude death rate in women. The data show that the importance of demographic aging has always been more pronounced. The main characteristic in the observed time interval is that mortality decreases at all ages and that all age groups had a positive effect on life expectancy, as well as that men and women in Serbia have a different pattern of decreasing mortality by age. The most significant effect on life expectancy was the reduction of infant mortality (a fifth of the total contribution), a common feature of the male and female populations. In other age groups, men have more pronounced contributions up to the age of 50, and women in older cohorts. Due to higher mortality rates, the space for improving mortality is greater in young and middle-aged men than in women, so the positive effects are more pronounced at these ages. The largest number of leading causes of death burdens the population of Serbia less now than three decades earlier. Cardiovascular diseases, as the leading cause of death, contributed the most to positive changes in mortality. The biggest effect of life expectancy is the reduction of mortality rates due to diseases of the circulatory system in the 65-79 year old population. Observed by gender, the effect is greater in the female population, where cardiovascular diseases contribute to the extension of life expectancy by as much as 67% or by 2.4 years, while in the male population the importance of cardiovascular diseases in the extension of life expectancy is lower and amounts to 42% or by 1.9 years. Tumors, as the second most common cause of death in Serbia, contribute negatively to those aged 50 and over and positively to younger age groups. The overall effect on life expectancy is positive, and mortality rates in men decline until the age of 60. In women, rates increase from age 50 or older, and of all causes of death, only tumors have an overall negative effect on life expectancy growth. Among the other causes, the importance of violent deaths and their positive effect should be singled out, due to the reduction of mortality rates at all ages, especially among the younger population. Positive changes in the age of 15-49 years in the male population contribute to an increase in life expectancy of even 1 year. In the female population, a positive contribution is also present at all ages, but the effect is significantly lower. The COVID-19 pandemic brought the highest increase in mortality in Serbia in the last 70 years. Mortality increased by 14% in the first year of the pandemic, and by 34% in the second, compared to the 2017-2019 average. The crude death rate has increased tremendously and for men in 2020 it is 18.0‰, and in 2021 it will show a maximum value of 21 deaths per 1,000 persons. For women, this mortality rate is 15.9‰ and 19.0‰ (in 2020 and 2021, respectively). Changes compared to the values from 2019, for both sexes, are solely the result of the increase in mortality by age, while changes in the distribution of the population by age had a negligible effect in this period. The last analyzed year (2021) brings a drop in life expectancy for men of as much as 3.4 years compared to the period before the pandemic. Women in Serbia have a slightly smaller decline in life expectancy in this period of 2.9 years.

The impact of socially accountable health professional education: Systematic review.

Medical education is socially responsible for a global educational movement that transforms the development and presentation of medical schools in higher education. Therefore, in the present systematic review, we aimed to evaluate the impact of socially accountable health professional education. Published research articles were reviewed by searching the relevant terms invalid databases. In the initial search, 2340 records were obtained. At this stage, 1482 records were deleted due to duplication, and 773 records were removed due to indirect connection with the subject. Then, 85 articles were retrieved for full-text review. Finally, the complete review led to the selection of nine studies that met all inclusion criteria. Based on the results of the present systematic review, among the nine reviewed articles, four studies (44.44%) evaluated the effectiveness of social accountability on increasing the sense of empowerment, self-confidence, competencies such as teamwork, communication skills, and readiness for work. Three studies (33.333%) assessed the effectiveness of social accountability on providing further and better medical services and reducing infant mortality. Also, in two articles (22.22%), students' lack of knowledge about social accountability was studied. Social accountability can help cultivate a healthy and skilled medical workforce and be effective in improving health services provided to the people. On the other hand, there are different perceptions and views on what social responsibility really is and how its effectiveness can be measured. Also, it is highly important to provide awareness in this regard for students.

Neonatal Mortality in Rural Area in Senegal

Most newborn deaths occur in two regions of the world, South Asia and sub-Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However, the decline in neonatal mortality has been slower during the same period. The objective of this study is to assess neonatal mortality, to determine the different causes and to make recommendations for improving care in rural areas. This is a retrospective study with a descriptive and analytical aim carried out in the pediatrics department of the Diourbel regional hospital, 130 km from Dakar, the Senegalese capital, over a 12-month period from January 1 to January 31, December 2018. All newborns hospitalized in the pediatric ward during the study period were included. Overall mortality was 30.6%, newborns between 0 and 7 days accounted for 90.6% of deaths, INBORNs accounted for 62.3% of deaths. Newborns whose mother’s age was between 20 and 35 years of age accounted for 69.3% of deaths. Newborns of first-time mothers accounted for 40.2% of deaths and those of multiparous mothers 31%. Newborns who did not reach term accounted for 58.9% of deaths. Newborns admitted for respiratory distress represented the majority of deaths 45.5% (n = 93) followed by those with low birth weight 32.5 (n = 65) followed by those with neurological manifestations 30.5 (n = 62). Conclusion: Neonatal mortality is very high in the Diourbel region and the main cause is the lack of human resources and a very insufficient technical platform. The fight against this mortality involves improving the technical platform and recruiting sufficient and well-trained staff.

Достижения и проблемы калининградского здравоохранения в период «развитого социализма»

The article identifies and examines a number of trends in the development of healthcare system in the Kaliningrad region in the second half of the 1960s and the first half of the 1980s in comparison with the national tendencies. The processes of this time, unlike the years of early development of Kaliningrad healthcare, are poorly studied. The main sources are the documents of the Health Department of the Kaliningrad region, Oblispolkom (Regional Executive Committee) and the Bureau of Medical Statistics from the respective funds of the State Archive of the Kaliningrad Oblast. Further development of the health infrastructure, the reduction of infant and maternal mortality, the success in developing the ambulance system, a significant increase in the number of doctors and paramedics, and the expansion of access to basic healthcare for citizens are the features of the period under review. However, not all staff problems had been solved. The weak point of the regional healthcare was oncological and dental care, the need for which was constantly increasing. There were difficulties with implementing construction plans for new objects of public health services, some of which had turned into real long-term projects. The lack of financing made it impossible to solve a number of problems related to the obsolescence of equipment and medical technology. Despite successes in the control of infectious diseases, there was a high incidence of dysentery and other intestinal infections in the region. The 1970s saw further development of the system of sanitary education, which reached a large proportion of the population of the region. However, the sources do not allow to assess the efficiency of this measure. Processes that were taking place in Kaliningrad regional healthcare system were typical for the country as a whole, showing slow increase in the manifestations of a systemic crisis. The peculiarities of the region, which mitigated this tendency, included high indicators of provision of medical workers in the region, a closer connection between rural and urban healthcare and a younger average age of the population.

Magnitude of admission, premature mortality and potential years of life lost due to acute diseases among pediatric patients admitted to public hospitals in Jimma City, Southwest Ethiopia

although evidence suggests recent reductions in infant and child mortality, little is known about the magnitude, and causes of pediatrics admission, premature mortality, and associated years of potential life lost among hospitalized children in Ethiopia, particularly in Jimma City. a retrospective cross-sectional study was conducted on hospital's care registries of pediatric patients who presented with acute disease over three years period, from September 7th, 2014, to September 10th, 2017, at Jimma Medical Canter and Shenen Gibe Hospital in Jimma City. The data were cleaned and imported to statistical package for the social sciences (SPSS) V.23.0 for descriptive statistical analysis. a total of 7612 children were admitted to two public hospitals in Jimma City during the study period. Among them, 4457(58.6%) were males. The mean (SD) age of the children at admission was 4.1± (4.25) years. The major cause of admission was pneumonia in 2274 (29.9 %) children. The major causes of premature mortality were Pneumonia 36 (22.1%), sepsis 25 (15.3%), and severe acute malnutrition 25 (15.3%). A total of 9633 years were lost due to premature deaths, of which the majority 7663 (79.6%) were attributed to communicable and nutritional diseases. Pneumonia was responsible for the highest proportion of years of life lost 2178 (22.1%). it is indicated that the leading causes of hospital admissions and deaths were communicable and nutritional diseases. A significant number of years of life have been lost because of preventable and curable diseases. Therefore, early detection and initiation of an appropriate intervention could reduce the hospital´s burden and years of potential life lost due to these diseases.

Effet de l'accès aux services de soins de santé sur mortalité infantile au Togo

Cet article vise à analyser les effets d'un accès sans restriction aux soins de santé sur la mortalité infantile au Togo. Nous nous sommes appuyés sur un modèle de duré à risque proportionnel pour évaluer ces effets. A la suite des estimations de ce modèle à partir des données de l'Enquête Démographique et de Santé réalisée au Togo en 2013, nos résultats montrent que naître en présence d'un personnel de santé qualifié contribue à réduire le risque de mortalité des enfants de moins d'un an. Par ailleurs, une amélioration de l'éducation des mères améliore la probabilité de survie des enfants au-delà de leur premier anniversaire. Ce travail permet de souligner la nécessité d'investir dans la formation du personnel soignant et aussi encourager l'éducation des filles. De tels investissements permettront de réduire significativement la mortalité infantile.