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CHILD & FAMILY HEALTH Infant Mortality Module 1 of 2 Grace E. Foege Holmes, MD

CHILD & FAMILY HEALTH Infant Mortality Module 1 of 2 Grace E. Foege Holmes, MD. Learning Objectives:. Performance Objectives:. Dr. Grace Holmes reads to grandson, Quentin. Copyright  1994, Christopher Wee. Mount Kilimanjaro. GEFH. Dr. Grace Holmes with patient in Malaysia, 1959.

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CHILD & FAMILY HEALTH Infant Mortality Module 1 of 2 Grace E. Foege Holmes, MD

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  1. CHILD & FAMILY HEALTHInfant MortalityModule 1 of 2Grace E. Foege Holmes, MD

  2. Learning Objectives:

  3. Performance Objectives:

  4. Dr. Grace Holmes reads to grandson, Quentin

  5. Copyright  1994, Christopher Wee Mount Kilimanjaro

  6. GEFH Dr. Grace Holmes with patient in Malaysia, 1959

  7. Mother with NewbornChild SurvivalWorld Development

  8. DIRECT Causes of Infant Death Immediate • Immaturity • Birth injury • Genetic disease • Congenital anomaly Chronic • Malnutrition • Infection

  9. INDIRECTCauses of Infant Death • Social • Economic • Environmental Indirect causes are non-medical conditions that make infants more vulnerable to Direct causes.

  10. GEFH Crowding among gypsies in Greece, 1959

  11. GEFH Child begging in Karachi, Pakistan, 1959

  12. Coffee trees in Tanzania, East Africa, 1972 GEFH Fishermen in Penang, Malaysia, 1959 GEFH

  13. Motherwashingbaby... Knowledge of basic sanitation is extremely important.

  14. Historical Perspective on IMR

  15. Europe–19th CenturyIMRs fluctuated with wars, famines, epidemics, and social turmoil of the Industrial Revolution.In 1870, one Bavarian city had an infant mortality rate of 449.

  16. Countries with High IMR • Death is usually due to: • Chronic DIRECTmedical causes (malnutrition; infection) • INDIRECT causes (social/economic/environmental)

  17. A rising IMR indicates that something is wrong with the country’s developmental process.

  18. Remember that poor countries may have a low IMR. Likewise, rich countries may have a high IMR.

  19. As general welfare of a society improves, the IMR declines. Add specific medical programs to reduce it even further.

  20. Barefoot DoctorsinChina

  21. Declining Deaths–China 200 Infant mortality rate (IMR) China 200 150 139 National Average IMR/1000 Live Births 100 71 Rural 50 32 25 13 22 13 0 1949 ‘54 ‘57 ‘63 ‘75 ‘82 Preliberation Child Survival–World Development

  22. Rockefeller Foundation Study

  23. A quick look at the decline in IMR in the United States over 100+ years

  24. 175 Infant Mortality Rate1851 to 1974 in US 150 125 100 75 50 25 1895 1920 1955 1985 1865 1910 1940 1970 1880

  25. Problems with Measurement of IMR • Different criteria used in different countries • Variation of data collection • Estimates and unreliable data

  26. Which is basically what Florence Nightingale said in 1893: “The life duration of babies is the most delicate test of health conditions.”

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