Historical Perspectives

This study identified factors contributing to the rapid decline in infant mortality in New York City from 1989 to 1992. Changes in birthweight distributions and in birthweight/age-, cause-, and birthweight/age/cause-specific mortality rates from 1988/89 (before the mortality reduction) to 1990/91 were identified from New York City vital statistics data. Infant, neonatal, and postneonatal mortality of very-low-birthweight (< 1500 g) and normal-birthweight infants decreased significantly. The declines were almost entirely due to decreases in birthweight-specific mortality rates, rather than increased birthweights. All races experienced most of these reductions. Mortality decreased significantly for 6 causes of death. These decreases were consistent with the birthweight/age groups experiencing mortality declines. Widespread, multiple perinatal and postnatal factors contributed to the decline in infant mortality.

This article examines the impact of development and population policies on fertility decline and regional variations in India during the 1970s. Indicators of development at the household level include female literacy and education, infant mortality, and poverty; at the village level they include availability of such social services as schools, medical facilities, and transportation and communication facilities. Multiple regression analysis of data aggregated at the state level demonstrates that conditions conducive to fertility decline include high adult female literacy and low infant mortality as indicators of social development, and high contraceptive use and, to a lesser extent, high female age at marriage as proximate determinants of fertility. There are reasons to believe that India's national family planning program contributed to the decline in fertility observed since the 1960s. The pace of fertility decline in the future will depend upon the pace of infant mortality decline, enhancement in female education, and improvements in family planning programs.

Transmission of infections during pregnancy is known to alter the development and functioning of the fetus immune system, resulting in an inadequate immune response to common childhood infections and immunizations. Although it is a developing and actively researched topic, maternal parasitic infections remain poorly understood. Millions of women of reproductive age are currently at risk of parasite infection, while many pregnant, chronically infected women are excluded from mass drug administration due in part to a lack of resources, as well as fear of unknown adverse fetal outcomes. infection, there is no clear mechanism for understanding how maternal infection reprograms offspring immunity. Purpose - to determine the currently studied mechanisms of the influence of parasitic infections transmitted during pregnancy on the immune system of the fetus and to describe the possible effects of these influence in the long term on the health of children. Conclusions. The study of maternal parasitic infections is a rapidly developing field. Although infant mortality rates are declining, areas with endemic parasites still have the highest infant mortality rates. As antiparasitic therapy is not always curable, there is a critical need to understand the effects of maternal infection on offspring immune development. Due to the increased risk of immune alteration due to maternal inflammation and reduced passive antibody transmission, maternal parasitic infections and their mechanism of adverse immunomodulation must be uncovered to improve vaccination regimens and reduce childhood morbidity in endemic regions. No conflict of interests was declared by the author.

This article summarizes aspects of the decline in infant mortality in the five Nordic countries. During the nineteenth century, both the levels of infant mortality and its development differed among the Nordic countries. At an early date, Denmark, Norway and Sweden stood out as the countries with the lowest levels in Europe whereas levels of infant mortality in Iceland and Finland were comparatively high. Within the countries there were large regional differences that often crossed national borders. Artificial feeding characterized most of the areas with the highest infant mortality. Within the different countries the high infant mortality came to be seen as a problem during the eighteenth and nineteenth centuries. The spread of information, midwives as agents of change and high literacy are factors that have been proven important in explaining the subsequent decline.

Infant Mortality Rate is a reflection of infant survival which will determine the quality of life of human resources. North Maluku Province is an archipelago province with a relatively high infant mortality rate. The still high infant mortality rate in North Maluku is influenced by several factors, apart from the low equity and affordability of health services, socio-economic factors also greatly affect infant and under-five mortality rates. North Halmahera District is one of the highest IMR contributors in North Maluku Province. This study aims to mathematically analyze the infant mortality rate in North Halmahera. The results showed that all predictor variables had an effect on infant mortality. The analysis results found the best model with three point knots with a determination coefficient of 93% and a minimum GCV value of 1.52.

Breast milk is the best source of nutrition for newborns. Breast milk content is composed of water, protein, carbohydrates, fats, vitamins, minerals, antibodies, and enzymes. Breast milk also contains white blood cells and substances that make up the baby`s immune system such as immunoglobulins and lysozyme. The composition of breast milk can change depending on the needs and ages of the baby. Exclusive breastfeeding is recommended by many doctors and other healthcare professionals. One of the factors that influence exclusive breastfeeding is the mother`s knowledge about the content of breast milk. Most breastfeeding mothers do not know the nutritional content of breast milk, both macronutrients, and micronutrients. Breast milk is also rich in immune cells, antibodies, and other bioactive ingredients that help protect the baby from infection until the baby has an effective antibody response in the first few months of life. Breast milk is an ideal nutrient for babies. The mixture of vitamins, proteins, and fats in breast milk can provide the nutrients and calories the baby needs to grow. Babies who have been breastfed for 6 months are more likely to reach their ideal weight.Therefore, the government recommends exclusive breastfeeding for infants up to the age of 6 months.

This paper examines the determinants of infant and child mortality variations in Jordan Yemen Egypt and Tunisia using data from WFS surveys. The analysis considers biological correlates of mortality--mothers age birth order birth interval and previous infant loss--and several social factors--mothers and fathers education mothers residence fathers occupation and mothers work experience since marriage. The estimates for the 4 countries show large variations in the mortality rates and an expected pattern of declining infant and child mortality during the period of 20 years prior to the survey. Further the proportionate decline in child mortality in each country was generally greater than the proportionate decline in infant mortality. A persistent pattern of higher child mortality for females than for males is found suggesting preferential care and treatment of male offspring. The higher mortality risk is found for infants born to very young and very old mothers with short previous birth intervals of higher birth orders and where the previous infant had died. Among the socioeconomic characteristics the education of the mother and rural-urban residence are found to affect infant survival. In childhood among the demographic factors only birth interval shows a significant effect on mortality. The risk of child mortality decreases considerably with the increase in the birth interval. The analysis of the effect of breastfeeding on mortality although based on limited information clearly shows the beneficial effect of breastfeeding on the infants survival especially during the early months of life. For all countries the mortality rate for the non-breastfeeders is substantially higher than for the breastfeeders even when the effect of the other covariates is controlled.

ABSTRACTOne of the key objectives of the Millennium Development Goals (MDGs) was to improve the lives of infants and children, particularly the reduction of high infant and childhood mortality rates throughout the developing world. This paper examines the experiences of Malawi in tackling the problem of high infant and childhood mortality over recent decades, 1990–2010. We highlight the strategies that were used in Malawi which led to Malawi’s stellar performance in achieving the targets set by the MDGs with reference to infant and childhood mortality. The data for the analysis were obtained from Demographic and Health Surveys and from the various censuses the country has conducted. Regression analysis using district as the unit of observation reveals several important factors that have led to the commendable declines in infant mortality. Significant factors included immunisation of infants as well as increasing levels of female education and the availability of skilled birth attendants. What Malawi’s case demonstrates is that given a correct mix of strategies, even a poor country such as Malawi can meet some of the lofty targets set by the MDGs.

Pediatric Gastroenterology in Chile—A Personal Perspective

Structural racism, socio-economic marginalization, and infant mortality

Infant and Child Mortality in Industrialized Countries

Substantial declines in infant and under-5 mortality have taken place in recent years in many countries in Sub-Saharan Africa. Kenya's infant mortality rate has fallen by 7.6 percent per year, the fastest rate of decline among the 20 countries in the region for which recent Demographic and Health Survey data is available. Kenya's rate of postneonatal deaths per 1,000 live births fell by more than half over a five-year period, dropping from 47 to 22, as measured using data from the 2003 and 2008-09 Demographic and Health Surveys. Among the possible causes of the decline are various targeted new public health initiatives and improved access to water and sanitation. A Oaxaca-Blinder decomposition using Demographic and Health Survey data shows that the increased ownership of insecticide-treated bednets in endemic malaria zones explains 39 percent of the decline in postneonatal mortality and 58 percent of the decline in infant mortality. Changes in other observable candidate factors do not explain substantial portions of the decline. The portion of the decline not explained may be associated with generalized trends such as the overall improvement in living standards that has taken place with economic growth. The widespread ownership of insecticide-treated bednets in areas of Kenya where malaria is rare suggests that better targeting of insecticide-treated bednet provision programs could improve the cost-effectiveness of such programs.

A close examination of the literature suggests that the consistent relation between political and welfare state characteristics and infant mortality in the second half of the 20th century in wealthy countries may not be causal. The evolution of infant mortality since the late 19th century was studied in 17 wealthy countries classified according to political traditions, family policy model and period of infant mortality transition. The relation of public health expenditure and income inequality to infant mortality from 1980 to 2005 was also evaluated. The Social Democratic and Scandinavian countries, and those with the earliest transition in infant mortality, had the lowest infant mortality rates until the early 21st century, whereas the late democracies, the Southern European countries, and those in which the transition in infant mortality took place later, had the highest rates until the late 20th century. By the early 21st century, the differences in infant mortality were negligible. Three of the four Scandinavian countries were the first to achieve infant mortality transition, whereas the Southern European countries were the last. The relation between public health expenditure and infant mortality varied depending on the time period in which the analysis was made, and increased income inequality was associated with higher infant mortality. The relation between political and welfare state characteristics and infant mortality in previous studies probably reflects the historical moment in which the transition in infant mortality took place in each country. Methodological limitations do not allow inference of causality in the associations found between welfare state characteristics and infant mortality.

Background The infant mortality rate is defined as the number of infant deaths for every 1000 live births. In 2020, the infant mortality rate was 5.8% in the state of Florida, compared to 7.0% in 2000. Although infant mortality rates have declined in the state of Florida, disparities influencing these rates exist across varying Florida counties, with the widest differences being compared between the healthiest versus unhealthiest counties in Florida.Many factors can contribute to high infant mortality rates in certain counties, including income inequality, access to and quality of healthcare, race/ethnicity, obesity, and disadvantaged socioeconomic status (SES). Methods This study utilized data from Florida Health Charts on infant mortality rates in the state of Florida and the Pregnancy and Young Child Profiles in 10 counties to examine how certain risk factors impact infant mortality outcomes in the state of Florida. These 10 counties consistoffive healthiest andfive unhealthiest counties, as determined by the 2022 County Health Rankings data. T-tests were used to evaluate the relationship between county health status and several county health indicators. Results The average infant mortality rate from 2011 to 2020 differed significantly among healthy and unhealthy counties (p-value=0.0000). Median household income, individuals below the poverty level, and those aged zero to 17 years old were found to differ significantly by county health status (p-values 0.0000, 0.001, and 0.009, respectively). However, mothers having no high school education, births with first-trimester care, births with adequate care, and births with late or no prenatal care were not statistically significant. Conclusion Our study suggests that counties more likely to have fewer resources than other counties, such as those considered unhealthy, are more impacted by a higher infant mortality rate. The unhealthy counties in this study were found to have lower average median household income, higher rates of no high school education among mothers, and less prenatal care in comparison to healthy counties.

Limited data exist on population-level mortality outcomes related to extreme neonatal hyperbilirubinemia (EHB) and this study examines trends in annual infant mortality rate (IMR) attributed to hemolytic and perinatal jaundice among Germany, France, Italy, Portugal, Greece and Spain from 1990 to 2019. Data on annual incident cases and disability-adjusted life years were collected from the 2019 Global Burden of Disease study. Live birth cohort data were sourced from UN World Population Prospects. We quantified temporal trends, with relative percent changes. Average annual percent changes (AAPCs) were evaluated using the Joinpoint Regression Program. EHB-related infant mortality decreased from 21.4 (95%CI: 16.1, 27.1) in 1990 to 4.2 (95%CI: 1.9, 7.6) per million live births in 2019. Germany demonstrated lowest AAPC of -3.2% (95% CI: -3.8, -2.5), while Portugal had the highest AAPC of -8.6% (95% CI -11.9, -5.1) in reducing infant mortality due to EHB. There were distinct divergences in the trajectories of declining EHB mortality among the studied countries. This study highlights a significant decline in infant mortality due to extreme hyperbilirubinemia, emphasizing the need for national surveillance and tailored guidelines to prevent bilirubin induced neurological damage. This cross-sectional analysis revealed a marked decline in infant mortality rates attributed to extreme hyperbilirubinemia across the selected European countries. The rates of decline varied significantly between countries, demonstrating notable heterogeneity in mortality trends when stratified by age at death. Implementing data-driven surveillance systems can optimize the alignment of equitable healthcare services, strengthen accountability measures, and identify critical operational inefficiencies. In the European Union, country-specific hyperbilirubinemia guidelines should be reinforced to ensure effective screening and post-discharge follow-up protocols that are tailored to risk burden and available healthcare resources.