LBW may be the leading cause of infant deaths, and it is greatly preventable. Preterm birth is the leading cause of newborn deaths worldwide. Even though America excels past many other countries in the care and saving of premature infants, the percentage of American woman who deliver prematurely is comparable to those in developing countries.
Reasons for this include teenage pregnancy, increase in pregnant mothers over the age of thirty-five, increase in the use of in-vitro fertilization which increases the risk of multiple births, obesity and diabetes. Also, women who do not have access to health care are less likely to visit a doctor, therefore increasing their risk of delivering prematurely. Low birth weight makes up 60–80% of the infant mortality rate in developing countries. Along with birth weight, period of gestation makes up the two most important predictors of an infant's chances of survival and their overall health.
Access to vital registry systems for infant births and deaths is an extremely difficult and expensive task for poor parents living in rural areas. It is also argued that the bureaucratic separation of vital death recording from cultural death rituals is to blame for the inaccuracy of the infant mortality rate . Vital death registries often fail to recognize the cultural implications and importance of infant deaths. "Popular death reporters" is an alternative method for collecting and processing statistics on infant and child mortality.
Baby Died From Lack Of Attention Many regions may benefit from "popular death reporters" who are culturally linked to infants may be able to provide more accurate statistics on the incidence of infant mortality. Numbers are exaggerated when international funds are being doled out; and underestimated during reelection. Collecting the accurate statistics of infant mortality rate could be an issue in some rural communities in developing countries. Among the world's roughly 200 nations, only Somalia showed no decrease in the under-5 mortality rate over the past two decades.
The lowest rate in 2011 was in Singapore, which had 2.6 deaths of children under age 5 per 1,000 live births. The highest was in Sierra Leone, which had 185 child deaths per 1,000 births. For the United States, the rate is eight per 1,000 births. It has been well documented that increased education among mothers, communities, and local health workers results in better family planning, improvement on children's health, and lower rates of children's deaths. High-risk areas, such as Sub-Saharan Africa, have demonstrated that an increase in women's education attainment leads to a reduction in infant mortality by about 35%. Similarly, coordinated efforts to train community health workers in diagnosis, treatment, malnutrition prevention, reporting and referral services has reduced infant mortality in children under 5 as much as 38%.
Increased intake of nutrients and better sanitation habits have a positive impact on health, especially developing children. Educational attainment and public health campaigns provide the knowledge and means to practice better habits and leads to better outcomes against infant mortality rates. All of the countries named adopted the WHO definitions in the late 1980s or early 1990s, which are used throughout the European Union. However, in 2009, the US CDC issued a report that stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries. Rather, the report concluded that the primary reason for the United States' higher infant mortality rate when compared with Europe was the United States' much higher percentage of preterm births. Greatest percentage reduction of infant mortality occurs in countries that already have low rates of infant mortality.
In the United States, a primary determinant of infant mortality risk is infant birth weight with lower birth weights increasing the risk of infant mortality. The determinants of low birth weight include socio-economic, psychological, behavioral and environmental factors. In 2013, the leading cause of infant mortality in the United States was birth defects. One of the most common preventable causes of infant mortality is smoking during pregnancy. Lack of prenatal care, alcohol consumption during pregnancy, and drug use also cause complications which may result in infant mortality.
Many environmental factors contribute to infant mortality, such as the mother's level of education, environmental conditions, and political and medical infrastructure. Improving sanitation, access to clean drinking water, immunization against infectious diseases, and other public health measures can help reduce high rates of infant mortality. It was in the early 1900s that countries around the world started to notice that there was a need for better child health care services. Europe started this rally, the United States fell behind them by creating a campaign to decrease the infant mortality rate. With this program, they were able to lower the IMR to 10 deaths rather than 100 deaths per every 1000 births.
Infant mortality was also seen as a social problem when it was being noticed as a national problem. American women who had middle class standing with an educational background started to create a movement that provided housing for families of a lower class. By starting this, they were able to establish public health care and government agencies that were able to make more sanitary and healthier environments for infants. Medical professionals helped further the cause for infant health by creating a pediatrics field that was experienced in medicine for children. What this also means is that the share of child deaths from older or younger children also depends on how much progress countries have made on vaccine coverage and other interventions. There, neonatal deaths account for only 37% of under-5 deaths, whereas in most Asian, European and American countries this share is 50% or higher.
This is because many countries across Sub-Saharan Africa still have significant progress to make in the prevention of vaccine-preventable diseases. The vast majority of newborn deaths take place in low and middle-income countries. In settings with well-functioning midwife programmes the provision of midwife-led continuity of care can reduce preterm births by up to 24%. MLCC is a model of care in which a midwife or a team of midwives provide care to the same woman throughout her pregnancy, childbirth and the postnatal period, calling upon medical support if necessary.
With the increase in facility births (almost 80% globally), there is a great opportunity for providing essential newborn care and identifying and managing high risk newborns. However, few women and newborns stay in the facility for the recommended 24 hours after birth, which is the most critical time when complications can present. In addition, too many newborns die at home because of early discharge from the hospital, barriers to access and delays in seeking care. The four recommended postnatal care contacts delivered at health facility or through home visits play a key role to reach these newborns and their families. In 1990, 8.8 million infants younger than 1 year died globally.
Until 2015, this number has almost halved to 4.6 million infant deaths. Over the same period, the infant mortality rate declined from 65 deaths per 1,000 live births to 29 deaths per 1,000. Globally, 5.4 million children died before their fifth birthday in 2017.
More than 60% of these deaths are seen as being avoidable with low-cost measures such as continuous breast-feeding, vaccinations and improved nutrition. Reductions in infant mortality are possible in any stage of a country's development. Rate reductions are evidence that a country is advancing in human knowledge, social institutions and physical capital.
Governments can reduce the mortality rates by addressing the combined need for education , nutrition, and access to basic maternal and infant health services. A policy focus has the potential to aid those most at risk for infant and childhood mortality allows rural, poor and migrant populations. Big countries like Brazil and China reduced their child mortality rates 10-fold over the last 4 decades. Other countries – especially in Africa – still have high child mortality rates, but it's not true that these countries are not making progress. In Sub-Saharan Africa, child mortality has been continuously falling for the last 50 years (1 in 4 children died in the early 60s – today it is less than 1 in 10). Over the last decade this improvement has been happening faster than ever before.
Rising prosperity, rising education and the spread of health care around the globe are the major drivers of this progress. Further, a history of abuse in childhood is linked to the development of other medical disorders as well. To summarize the latest data on prevalence rates of childhood maltreatment, in 2015, the U.S. Department of Health and Human Services documented 3.4 million referrals to child protective services, with 683,000 children determined to be victims of child abuse and neglect. Among these cases, 75.3% were neglected, 17.2% were physically abused, and 8.4% were sexually abused. Globally, varying rates of childhood sexual abuse are reported, with the highest overall rates being reported in Australia, Africa, and the United States.
With the exceptions of Africa and South America, girls are sexually abused at a higher rate than boys. Lastly, bullying is an increasingly recognized form of ELS not previously included in many studies. Although many countries have vital registration systems and certain reporting practices, there are many inaccuracies, particularly in undeveloped nations, in the statistics of the number of infants dying.
Studies have shown that comparing three information sources that the "popular death reporters" are the most accurate. Popular death reporters include midwives, gravediggers, coffin builders, priests, and others—essentially people who knew the most about the child's death. In developing nations, access to vital registries, and other government-run systems which record births and deaths, is difficult for poor families for several reasons. These struggles force stress on families, and make them take drastic measures in unofficial death ceremonies for their deceased infants. As a result, government statistics will inaccurately reflect a nation's infant mortality rate. Genetic components results in newborn females being biologically advantaged when it comes to surviving their first birthday.
Males, biologically, have lower chances of surviving infancy in comparison to female babies. As infant mortality rates saw a decrease on a global scale, the gender most affected by infant mortality changed from males experiences a biological disadvantage, to females facing a societal disadvantage. Some developing nations have social and cultural patterns that reflects adult discrimination to favor boys over girls for their future potential to contribute to the household production level. A country's ethnic composition, homogeneous versus heterogeneous, can explain social attitudes and practices.
Heterogeneous level is a strong predictor in explaining infant mortality. Cultural influences and lifestyle habits in the United States can account for some deaths in infants throughout the years. According to the Journal of the American Medical Association "the post neonatal mortality risk was highest among continental Puerto Ricans" compared to babies of the non-Hispanic race. Examples of this include teenage pregnancy, obesity, diabetes and smoking.
All are possible causes of premature births, which constitute the second highest cause of infant mortality. Ethnic differences experienced in the United States are accompanied by higher prevalence of behavioral risk factors and sociodemographic challenges that each ethnic group faces. High rates of infant mortality occur in developing countries where financial and material resources are scarce and there is a high tolerance to high number of infant deaths.
There are circumstances where a number of developing countries to breed a culture where situations of infant mortality such as favoring male babies over female babies are the norm. In developing countries such as Brazil, infant mortality rates are commonly not recorded due to failure to register for death certificates. Failure to register is mainly due to the potential loss of time and money and other indirect costs to the family.
Even with resource opportunities such as the 1973 Public Registry Law 6015, which allowed free registration for low-income families, the requirements to qualify hold back individuals who are not contracted workers. However, many other significant factors influence infant mortality rates in war-torn areas. Health care systems in developing countries in the midst of war often collapse. Attaining basic medical supplies and care becomes increasingly difficult. During the Yugoslav Wars in the 1990s Bosnia experienced a 60% decrease in child immunizations.
Preventable diseases can quickly become epidemic given the medical conditions during war. Two hundred years ago the child mortality rate was extremely high around the world –more than 40% of all children died. Since then the child mortality rate has declined more than 10-fold. Because we need to further reduce child deaths we are studying the causes of death of children today and how it was possible to improve child health so very substantially in the past in ourentry on child mortality. China's one-child policy, adopted in the 1980s, negatively impacted its infant mortality.
Women carrying unapproved pregnancies faced state consequences and social stigma and were thus less likely to use prenatal care. Early childhood trauma includes physical, sexual, and psychological abuse of a child ages zero to five years-old. Trauma in early development has extreme impact over the course of a lifetime and is a significant contributor to infant mortality. When an infant is shaken, beaten, strangled, or raped the impact is exponentially more destructive than when the same abuse occurs in a fully developed body. Studies estimate that 1–2 per 100,000 U.S. children annually are fatally injured.
Unfortunately, it is reasonable to assume that these statistics underrepresent actual mortality. Three-quarters (70.6 percent) of child fatalities in FFY 2018 involved children younger than 3 years, and children younger than 1 year accounted for 49.4 percent of all fatalities. Our concern will then turn towards countries where the chances of child mortality is high, and the number of births increasing. Countries where children are most likely to die – Somalia, Chad, Central African Republic, Sierra Leone, Nigeria, and Mali – will all have an increasing number of children in the coming decades.
Progress on reducing child deaths will here therefore become a race between declining child mortality rates and an increasing number of children. Communities and decision makers need to be informed that neonatal deaths are a huge portion of child deaths, and need therefore to receive adequate attention. Infant mortality rate is not only a group of statistic but instead it is a reflection of the socioeconomic development and effectively represents the presence of medical services in the countries. IMR is an effective resource for the health department to make decision on medical resources reallocation.
IMR also formulates the global health strategies and help evaluate the program success. The existence of IMR helps solve the inadequacies of the other vital statistic systems for global health as most of the vital statistic systems usually neglect the infant mortality statistic number from the poor. There are certain amounts of unrecorded infant deaths in the rural area as they do not have information about infant mortality rate statistic or do not have the concept about reporting early infant death. Abstinence from alcohol can also decrease the chances of harm to the fetus during pregnancy. Drinking any amount of alcohol during pregnancy may lead to fetal alcohol spectrum disorders or alcohol related birth defects .
Tobacco use during pregnancy has also been shown to significantly increase the risk of a preterm or low birth weight birth, both of which are leading causes of infant mortality. Pregnant women should consult with their doctors to best manage any existing health conditions that they have to avoid complications of both their health as well as the fetus. Obese women are at an increased risk of developing complications during pregnancy, including gestational diabetes or pre-eclampsia. Additionally, they are more likely to experience a pre-term birth or have a child with birth defects. Focusing on preventing preterm and low birth weight deliveries throughout all populations can help to eliminate cases of infant mortality and decrease health care disparities within communities. In the United States, these two goals have decreased infant mortality rates on a regional population, it has yet to see further progress on a national level.
Congenital malformations are birth defects that babies are born with, such as cleft lip and palate,Down Syndrome, and heart defects. Some congenital malformations may be more likely when the mother consumes alcohol, but can also be caused by genetics or unknown factors.Congenital malformations have had a significant impact on infant mortality. Malnutrition and infectious diseases were the main cause of death in more undeveloped countries. In the Caribbean and Latin America, congenital malformations only accounted for 5% of infant deaths, while malnutrition and infectious diseases accounted for 7% to 27% of infants deaths in the 1980s. In more developed countries such as the United States, there was a rise in infant deaths due to congenital malformations.
These birth defects were mostly due to heart and central nervous system problems. In the 19th century, there was a decrease in the number of infant deaths from heart diseases. From 1979 to 1997, there was a 39% decline in infant mortality due to heart problems.
