Mortality decline in developing countries and its theoretical implications

During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity. This achievement is often compared with that of developed countries. However, how far the early advantages in mortality reduction have further enhanced the health status of the people in Kerala remains unknown. In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to mortality shift from adult , older to oldest ages (Olshansky and Ault 1986). However, such exploration on advanced mortality changes are lacking in Kerala. Considering this gap our study focused on changes in longevity and health status in Kerala. We used the methodology given by Olshansky and Ault in 1986, by decomposing the changes in longevity among different age groups (gender and spatial), and causes of deaths. We also estimated Health Adjusted Life Expectancy to understand health status along with longevity in Kerala. We used data from sources like; Census, CRS, DHS and survey data from SRS, MCCD, CDS-R, and NSSO. The paper concludes that though healthcare policies in Kerala are sufficient to address the health issues of infants, children and mothers in reproductive ages, the state also should make necessary policy initiatives to address the health problems of adults especially the males

Pregnant Mother’s Need and Demand Analysis in Utilizing
The Surabaya Maternity Public Health Center (PHC)


ABSTRACT

The function of Maternity PHC is specified at PHCs with strategic locations and certain obligatory requirements. This maternity service helps people to obtain equal healthcare. The purpose of this research is to formulate a recommendation of efforts to increase usage of Maternity PHC based on need and demand analysis at the Surabaya Maternity PHCs. This is a descriptive research using questionnaires, indepth interviews and observations.
The result showed that pregnant mother felt the needed things were childbirth delivery at midwife’s private practice, delivery helper was midwife, the needed facility was medical tool sterility, labor tariff about 100$ and they also needed pregnant mother’s exercise. The prioritized respondent’s demand was at midwife’s private practice and the demand for labor helper was midwife. The demand factor for labor at midwife’s private practice was due to family habit, while the demand factor for labor at PHC was the inexpensive tariff. There were 14 mothers who needed to give birth at PHC but in vain (the demand was not materialized). This was due to non-PHC demand had more experience.

Keywords: Maternity PHC, need, demand

The present paper has explored the possible shift in age-sex structure and morbidity pattern among the population of India and states by 2051. “Morbidity and health care” schedule of NSSO 60th round survey, projected population and SRS reports have been used for analysis purpose. LEB for males and females will increase by 10 and 11years respectively during 2006-51. Proportion of elderly will increase at a rapid pace younger population will decline rather slowly. Age specific morbidity prevalence increases slowly for communicable diseases but the pace is much higher for non-communicable diseases. Disease burden shifts towards NCDs with the change in age structure, which shows some of the states facing NCDs as 3/4th of their disease burden. The shift in the disease burden calls for an urgent need for investment in health infrastructure as most of the NCDs are chronic in nature and seeks long term care.

India is in a race to reduce Infant Mortality Rate (IMR) to ‘28’ and Maternal Mortality Ratio (MMR) to ‘109’, by 2015. Using a standardized de-composition technique and by using latest IMR/MMR data for the states and the nation during the period 1990-2010, we estimated percent net-contribution of 15 populous states and different periods in shaping India’s IMR/MMR. By fitting linear and exponential regression-curves, predicted IMRs/MMRs for India and 15 populous states, for 2015. Due to favourable contribution to maternal mortality reduction efforts from Uttar Pradesh (33%), Bihar/Jharkhand (19%) and Madhya Pradesh/Chhattisgarh (11%) - India is predicted to attain MDG-5 target by 2016, assuming the pace of decline observed in MMR during 1997-2009 continue to follow a linear-trend. However, the wait may continue until 2023-24 if MMR decline in India follows an exponential-trend. Attaining MDG-4 may take until 2023-24/2033-34, due to low acceleration in IMR decline in Bihar/Jharkhand, Uttar Pradesh/Uttarakhand and Rajasthan. Maximum decline in MMR during 2004-09 coincided with up-take of National Rural Health Mission (NRHM) interventions. Although, India as a nation is not predicted to attain MDGs-4&5, four of its states are predicted to do so. During 1990-2010, MMR reduction efforts were more effective than IMR reduction efforts.

Constructing a life table and using it to estimate life expectancy requires valid and detailed data on mortality and population. Iran, similar to other developing countries, does not have a complete death registration system. In an attempt to estimate life expectancy, several studies have been conducted in Iran based on survey or census data. However, due to the inaccuracy and inconsistency of the results, indirect methods have also been used, and in some cases different results, were obtained. In this paper, the details of several studies that have been carried out to construct life tables for Iran and consequently to estimate life expectancy are reviewed. In this study, not only were trends in child mortality re – estimated for the period 1956 – 2021 by using the Brass method (children ever born and children surviving ) based on data from previous surveys, but also life table were estimated for Iran for the period 1956-2021using the West model from the Coale and Demeny regional life table (1983).
In addition, to estimate life expectancy for those years for which there were no observed data and to make projections, the logistic regression model was used.

In the light of growing share of neonatal mortality in Under-5 mortality in recent decades in India, this study attempted to examine the individual, household, and community level factors affecting neonatal mortality in rural India. We analysed information on singleton live births from District Level Household Survey conducted in 2007-08. Multilevel modeling with MCMC procedure was used to examine the factors. The odds of neonatal death significantly decreased with increasing proportion of rich households in the village. Parental education, caste, and employment of the mother were found significant. The odds of death decreased if the households had access to improved sanitation, pucca house and electricity. The odds of death were higher for babies born in a health facility, male neonates, and neonates whose mothers experienced delivery complications. Neonates whose mothers received two tetanus toxoid injections were less likely to die in the neonatal period. Ensuring the consumption of an adequate quantity of tenatnus toxoid (TT) injections, targeting vulnerable groups like young and SC mothers, and improving the overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India.

China’s life expectancy at birth is in debate, and the 2010 census data may exaggerate the figure and the increase pace in it. In this paper, with an extension of Lee-Carter method for limited data, we use China’s 1982, 1990 and 2000 census to forecast mortality pattern and life expectancy for 2000 to 2030 period. We find that the annual gain in life expectancy from 2000 to 2030 is 0.18 years for males, and 0.23 years for females, and the infant mortality rate will decline to 10.39‰ in 2030 for males, and to 20.32‰ for females.

We present data from the 2010 Revision of the World Population Prospects on old age mortality in terms of life expectancy at age 65, age-specific death rates for 13 countries/territories in the region (Cambodia, China, Hong Kong SAR, Indonesia, Japan, Republic of Korea, Myanmar, Malaysia, Mongolia, Philippines, Singapore, Thailand, and Viet Nam) from 1995 to 2010, and data from the WHO on cause-of-death for six countries (China, Hong Kong, Japan, Republic of Korea, Singapore and Thailand) from 1980 to 2010. While mortality transitions in these populations took place in different times and under different political systems, levels of socioeconomic development and living environment, changes in their age patterns and sex differentials in mortality have shown certain similarities: women witnessed a greater decline than men and young elders had a larger decline than the oldest-old. In all six countries examined for cause-of-death except Thailand, most of the increases in life expectancy at age 65 in both men and women were attributable to declines in mortality from stroke and heart diseases. The findings shed light on the relationship between epidemiological transition, changing age patterns of mortality and improving life expectancy in these populations.

Anaemia is a common, multifactorial condition which cuts across all the sections of the population and is associated with a variety of adverse outcomes, including mortality. Globally prevalence of anaemia is 71.25 percent in females while it 40.2 percent in males, making it a major public health issue to the researchers. Considerable changes in growth pattern, lifestyle, food quality, dietary habits and behaviour are likely to influence the gender differences in the prevalence of anaemia. Anaemia is an indicator of poor health and nutrition both. The most dramatic health consequences of anaemia is increased risk of maternal and child mortality. Haemoglobin level is the primary and most reliable indicator of anaemia.
Ayurveda the Ancient Indian Medicine System has several preventive measures to correct the anaemia level in human body. In this study different dynamics of Ayurvada like Dincharya (daily routine), Rhitucharya (seasonal routine) and Aharvidhi (eating habits) have been considered and found effective to combat the disease and address the regression of contributing factor as well. The outcome of this study revealed a new dimension of integrated approach of above measures in reducing the prevalence of global anaemia.

Recent demographic and health surveys have demonstrated massive declines in infant mortality in Kenya and Tanzania. This study employed survival analysis in order to demonstrate how various factors are related to infant mortality in Kenya and Tanzania. Level of education of the mother, occupation of the mother, region and birth order/preceding birth interval were found to be common factors explaining infant mortality in the duo. Unlike in Tanzania, old age at maternity was a significant determinant of infant mortality in Kenya. While the usage of well water was less likely to result to the death of a postneonate in Kenya, it was more likely to result to a postneonate death in Tanzania. The study backs up any health policy scheme that seeks to stimulate use of family planning methods to increase on birth spacing and reduce on higher order births that have been found to be significantly related to infant mortality at 0.01 significance levels.