Poster session on Health, mortality and longevity (1)

The conventional trickle-down model of community effects on body weight status is theoretically flawed. A better understanding of the association between community contextual effects and youth’s body weight status is needed to improve the existing theory and inform public health policy. We propose to integrate an ecological approach with a life course perspective and introduce human agency and its dynamic interactions with contextual factors into our model. Drawing upon longitudinal and multilevel data, we study body weight changes captured by both general and central obesity measures in Chinese youth. We employ a difference-in-difference model to adjust for “pretreatment heterogeneity bias”. We examine three dimensions of individual agency and their interactions with urbanization and fast-food restaurant, two important community factors in China, and thereby account for “treatment effect heterogeneity bias”. Our preliminary results highlight some complex patterns of body weight changes as Chinese youth transitioned from early childhood to late adolescence.

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. The prevalence of chronic diseases and risk factors appears to have been increasing in both Europe and other developed countries indicating an expansion of morbidity as indicated by disease. It is likely that better treatment, preventive measures (such as cancer screening and treatment of cardiovascular risk factors) and increases in education levels have contributed to the declines in mortality and increases in life expectancy. It should be noted that, the increases in presence of disease appear to be less associated with disability. This paper examines whether there has been an expansion or compression of morbidity in Spain. It uses trends in mortality and morbidity from major causes of death and links of these with mortality to provide estimates of life expectancy with and without diseases and loss of functioning. The analysis uses a repeated cross-sectional Spanish health survey in 2001 and 2009 for measues of morbidity, the Spanish National Health Survey, mortality information comes from the National Statistics Institute database. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population.

A mid wife is a person trained to provide care to women during pregnancy, labour and after delivery; trained to recognize problems. This study determined the quality of care provided by midwives in Soroti District, Uganda. Specifically, it identified training needs, gaps in knowledge and other barriers to accessibility of emergency obstetric care services in the area. A cross-sectional descriptive study was designed to assess two hospitals, two health centers, and four sub-dispensaries over a two-month period. Data were collected from patients and attendants, midwives, pregnant women exiting from antenatal clinics, and health unit records. The main outcome measures were the ability of midwives to provide antenatal care at a minimum standard, or recall causes, signs, symptoms or the management of common obstetric complications; and patients' and patient attendants' perceptions of care received. Overall, the antenatal care offered was routine, with no emphasis on women at risk. The main factors responsible for the poor quality of care were inadequate pre-service and in-service training, lack of technical support supervision and absence of standard treatment guidelines.
Key Words: Quality Care, Midwifery Care, Soroti District, Uganda

Immunization against common childhood diseases has been an integral component of mother and child health services in India since adoption of the primary health care approach in 1978 being reinforced by the Declaration of Health Policy in 1983. The focus of this paper was to examine the dropout rates in Polio and DPT vaccines status and its determinants in regions of Uttar Pradesh. Data sources on immunization coverage used for this study include secondary data from RCH-3 Surveys in U.P. The analyses reveal that a large number of children in different socio-economic contexts are missed out of subsequent services. There are dropouts of the vaccines due to non availability of services providers. Almost every other child in U.P was incompletely protected from full immunization and one out every of three children was a dropout from the immunization programme. Revitalize and strengthen routine immunization services with particular reference to urban areas, Muslims, illiterate parents, populations residing in the plains, and population groups or areas hitherto not reached. The paper recommends ensuring regular immunization services on a fixed day and fixed place basis and addressing poor utilization of immunization services, lack of awareness or motivation, through professionally–designed behavior change communication interventions.

We provide a joint overview of trends in mortality under age 5 and between ages 15 and 60 in Sub-Saharan Africa using data on the survival of children and siblings collected in Demographic and Health Surveys. Disregarding conspicuous stalls in the 1990s, child mortality levels mostly declined and converged over the last 30–40 years. By contrast, many Eastern and Southern African countries have witnessed an enormous surge in adult mortality that echoed earlier increases in HIV incidence. In Eastern Africa, adult mortality levels have begun to decline again, in some instances before the large-scale expansion of antiretroviral therapy programs. More surprising is the lack of sustained improvements in adult survival in some countries without severe HIV epidemics. Because trends in child and adult mortality do not always evolve in concert, model-based estimates that are inferred from matching indices of child survival onto standard mortality schedules can be very misleading.

One of the main problems concerning the accumulation of population in the urban areas is directly related with the increment of the socio-economic, socio-spatial, and socio-demographic segregation.
The investigation presented here answers those questions by establishing the mortality profile in the four main Colombian cities. This research focuses on georeferencing, presenting the place of residence of the deceased on the city map, determining in this way the differences in the parameters of mortality related to the inhabited space. Building the mortality profile and locating it spatially, keeping in mind the deep socio-spatial segregation that is a constant in Colombian cities, allowed establishing a list of the socio-economic status of the deceased and determine the differences in the mortality parameters as another element contributing the socio-demographic urban segregation.
This study also analyses the question of the difference in life expectancy of population concerning their socio-economic condition. By means of analyzing the differences in the mortality profiles related with the housing site and linking them directly with the socio-economic status it was possible to establish the great differences existing in the life expectancy for someone born in Bogota.

Since the beginning of the 1990s. Poland has been experiencing large-scale social and economic changes associated with the transition to a market economy. A favourable trend in health and mortality observed in Poland are quite similar to those in other Central European Countries. The purpose of the study is to assess whether all socioeconomic groups participated equally in these positive changes or whether certain groups lagged behind.
Healthy life expectancy and concentration index have been employed to measures of social inequality in health. Self-rated health has been adopted as health indicator. Education level, living conditions and marital status have served as a variable describing the social status. To assess the importance of selected socio-economic determinants in explaining differences in health status in Poland multivariate binary logistic was conducted. Presented analyses are based on data from the Health Survey 1996 and the Generation and Gender Survey (GGS-Pl 2011).
The proportion of person years lived in good health increased during the analyzed period and the obtained results suggest the compression of morbidity in Poland. Regarding inequality in health, there is a clear social gradient for both men and women. The odds of education level is more important and weakly dependent on time analysis.

One of the problems in monitoring maternal mortality is lack of reliable estimates. Several studies have provided estimates of maternal mortality from pregnancy related deaths on South Africa utilizing Census and survey data but these estimates have have methodological weaknesses. This study re-examines maternal mortality from pregnancy related deaths at national and provincial levels in South Africa and provides insight into the causes of the maternal mortality deaths.

Data from the 2001 census, 2007 Community survey and death registrations were utilised. Information on household deaths including pregnancy related deaths were collected. Direct and indirect methods were utilised to estimate maternal mortality ratio.
The results indicate that maternal mortality ratio increased from around 150 per 100,000 live births in 1992-1998 to about 764 per 100,000 live births in 2007 and ranged from 102 per 100,000 live births in the Western Cape Province to 1,639 in the Eastern Cape Province in 2007. Maternal infections and parasitic diseases as well as other maternal diseases complicating pregnancy, childbirth and the peurperium are the major causes.
Despite strategies to improve maternal and child health, maternal mortality is increasing and remains a public health challenge in South Africa.

This research is aimed to assess environmental sanitation, the characteristics of mother and children aged 0-59 months with incidence of diarrhea using data from Indonesia DHS of 2007. The sample size was 16.064 children aged 0-59 months with multivariate analysis using binary logistic regression. The results showed the incidence of diarrhea in children about 13.83%. The findings showed, the sanitary conditions of environmental factors, the main source of drinking water, the type of toilet and disposal of children excreta have been associated with diarrhea in children aged 0-59 months.
The children lived in a decent main source of drinking water-household having a lower diarrhea incidence than unfeasible source of drinking water. Children lived in households which toilet equipped with septic tanks have a lower incident of diarrhea than without it. The children whose mothers dump sludge eligible has a lower chance of diarrhea than throwing feces unqualify. The mother and children characteristics related to diarrhea are the level of mother education and children age. Well educated mother (high school and above) have a lower incidence of diarrhea than low educated (less or equal to the elementary school). Children aged 24-59 months have a lower incident of diarrhea than children aged 0-11 months and 12-23 months.

It tries to identify patterns and determinants of gender gap in child health in India. It applies Borda rule, PCA, Logistic regression on 3 NFHS rounds. Children under 3 years are units of analysis.
With 21 indicators, it is shown that there are evidence of gender gap exists in all states of India. It is found that gender gap in various health outcomes are not much related to gender gap in various indicators of health-seeking behaviour. However for girl children’s health achievement, indicators of health-seeking behaviour are significantly related to indicators of health outcome. It is also shown that any consistently robust pattern of gender bias against girl children in child health is not present in India. But there is a consistent pattern of girl children’s absolute health achievement.
Hence we focus on girl children exclusively and tried to identify the determinants of health achievements for girl children. We analyse effects of some selected variables on chance of full immunisation, medical treatment in diarrhoea and fever/ cough, breastfeeding, malnutrition and mortality for girl children. Except for a few cases, the results are consistently robust. It has been found that, among others, female education and women’s empowerment do have a positive role in reducing gender bias in child health in India.