DOCSLIB.ORG

Faculty Research Summaries Under 5 Mortality in Trinidad and Tobago

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Faculty Research Summaries Under 5 Mortality in Trinidad and Tobago Faculty Research Summaries Under 5 Mortality in Trinidad and Tobago Overview: Under-five mortality rate is defined as probability of dying between birth and exactly five years of age expressed per 1,000 live births (UNICEF, n.d.). It is a valuable tool in assessing the overall health care system of any country. Under-five mortality shows a country’s commitment to its vulnerable population and is associated with economic development. According to the World Health Organization (2013), there were 6.6 million children in the world who died before their fifth birthday in 2012. The risk of dying is highest during the first 28 days of a child’s life also called the neonatal period. Purpose: The study looked at under-five mortality rates in Trinidad and Tobago. It was a collaboration between UNICEF and the Ministry of Health (MOH) in an effort to improve vital statistics and the overall quality of perinatal health by evaluating current policies and practices. Trinidad and Tobago - is one of the wealthiest country in the Caribbean with a gross domestic product (GDP) of 23.3 billion (USD) (2012), yet their infant and child mortality rates are significantly higher than their counterparts. With an under-five mortality rate of 28 deaths per 1,000 live births in 2011, and 34 deaths per 1,000 live births in infant mortality in 2009. In comparison, Jamaica has a GDP of 14.8 billion (USD) and an under-five mortality rate of 18 per 1,000 live births, and Barbados has a GDP of 4.2 billion (USD) with an under- five mortality rate of 20. In addition, Trinidad and Tobago is disproportionately affected by deaths especially during the neonatal period through the first year. Of all child mortality deaths, 89 percent occur in the first year and of those 64 percent occur in the first 28 days. Methods: Determinant Frameworks (UNICEF) were used and classified under 4 categories: Enabling environment; Supply; Demand; and Quality. (This frame work is part of the Marginal Budgeting of Bottlenecks (MBB) methodology preferred by UNICEF). Qualitative and quantitative data were obtained. 589 cases were used from medical records and death certificates from 6 hospitals and 9 health facilities. 90 interview and focus groups were conducted from government staff, health care providers (private and public), and parents who have lost their children after hospital birth. Findings: · Perinatal deaths (infants who died in the first week of life) mostly died during birth. 50% died from prematurity, 19% from congenital anomalies, 9% from neonatal diseases, and 5% from birth asphyxia. · Neonatal deaths (deaths between 7-27 days) were from prematurity (58%), congenital anomalies (19%), and neonatal diseases (8%). · Deaths of infants between 2-11 months were related to congenital anomalies (31%), infections (15%), injuries (2%), and prematurity (23%). 24.5 % of the cases were missing diagnosis recorders. st th · For the 10% of children who died between their 1 -4 year of life, 32% were from congenital anomalies, 22% were due to infections, 17% were caused by cancer, and 10% were from injuries. 43% of the cases were missing causes of death in the recorders. · Of the 589 cases reviewed, 393 had data on birth weights. Of those 207 (53%) were very low birth weight (less than 1500 grams) and 75 were moderately low birth weight (less than 2500 grams). Qualitative Findings (examples): Enabling Environment: ¨ Social Norms: “We need to get training for young physicians and ways to keep them in the country.” ¨ Budget/Expenditure: “We are told we are using too many (paper towels) and may be stealing.” Supply: ¨ Availability of Equipment & Supplies: “Doctors spend a lot of time discussing who can use what monitor and who can’t because this baby needs it more than the other one. Some babies don’t get optimal care because there is not enough equipment.” ¨ Staffing: “The ratio of nurses to baby in NICU is 1:8. That’s way too many.” Demand: ¨ Social and Cultural Practices and Beliefs: “Poorer people may not come in for care; they may go to herbal types for medication” ¨ Financial Access: “Our population has social problems, like being able to feed and clothe children” Quality: ¨ Quality of Care: “We don’t have the capacity to handle ALL the social cases, we sometimes deliberately turn an eye, and it’s too long of a process.” Family Interviews: ¨ “Nurses need some kind of sympathy and grieving training. Three hours after my son died a nurse decided to me all the ways that it could have been my fault he died, and she ended with ‘just in case you want to blame the hospital’.” Recommendations: · Create an electronic country wide health information system. · Establish a national Maternal and Child Health Coalition to increase partnership and collaboration, and standardize care. · Increase patient and health care provider’s education through modern communication and social marketing. · Increase access and maintenance of equipment. More neonatal beds & a transferring system are needed. · A national human resources plan to fill the human resources gap including pediatric medical specialists. Summary: Child mortality is an important public health issue that needs immediate attention. As part of the Millennium Development Goal, child mortality needs to be reduced by two thirds between the years 1900 to 2015. It is essential to reduce child mortality rates and invest in the health of mothers and children as they play an important role in the overall health of the community. Reference: Nelson R. M., Kirby, R. S., Chee, V. A., & Kynes, R. E. (2013). Under 5 mortality in Trinidad and Tobago. Ministry of Health, Trinidad and Tobago and UNICEF UNICEF. (n.d.). Basic indicators. Retrieved from http://www.unicef.org/infobycountry/stats_popup1.html World Health Organization (WHO). (2013). Children: Reducing mortality. Retrieved fromhttp://www.who.int/mediacentre/factsheets/fs178/en/.
Load more

Recommended publications
  • Maternal Bereavement: the Heightened Mortality of Mothers After The
    Economics and Human Biology 11 (2013) 371–381 Contents lists available at SciVerse ScienceDirect Economics and Human Biology jo urnal homepage: http://www.elsevier.com/locate/ehb Maternal bereavement: The heightened mortality of mothers after the death of a child a, b,1 Javier Espinosa *, William N. Evans a Department of Economics, Rochester Institute of Technology, 92 Lomb Memorial Drive, Rochester, NY 14623, USA b Department of Economics, University of Notre Dame du Lac, 437 Flanner Hall, Notre Dame, IN 46556, USA A R T I C L E I N F O A B S T R A C T Using a 9-year follow-up of 69,224 mothers aged 20–50 from the National Longitudinal Article history: Received 4 August 2011 Mortality Survey, we investigate whether there is heightened mortality of mothers after Received in revised form 30 March 2012 the death of a child. Results from Cox proportional hazard models indicate that the death Accepted 15 June 2012 of a child produces a statistically significant hazard ratio of 2.3. There is suggestive Available online 23 June 2012 evidence that the heightened mortality is concentrated in the first two years after the death of a child. We find no difference in results based on mother’s education or marital Keywords: status, family size, the child’s cause of death or the gender of the child. Bereavement ß 2012 Elsevier B.V. All rights reserved. Mother mortality Child death Cox proportional hazard National Longitudinal Mortality Study 3 1. Introduction ‘‘spousal bereavement effect’’. Empirical results have also demonstrated negative relationships between bereave- 4 5 Inquiry into the health outcomes of bereavement has ment and measures of health for grandparents, parents, 6 7 been conducted over the past decades by researchers from children, and siblings, but there remains a paucity of a variety of disciplines, including psychology, epidemiol- research addressing the bereavement effect for non- ogy, economics, sociology, and other social and medical spousal relationships.
    [Show full text]
  • Child Labor and Human Trafficking: How Children in Burkina Faso and Ghana Lose Their Childhood
    Global Majority E-Journal, Vol. 6, No. 2 (December 2015), pp. 101-113 Child Labor and Human Trafficking: How Children in Burkina Faso and Ghana Lose Their Childhood Kaitie Kudlac Abstract This article examines the impact and effects of human trafficking, child labor, and the various forms of mortality and immunization in the West African countries of Burkina Faso and Ghana. While human trafficking and inadequate labor laws encompasses all ages and genders, the primary focus of this article is to examine child trafficking and child labor and the degree to which people sold into slavery or forced labor are below eighteen years of age in these West African countries. Through the use of a literature review and the analysis of data provided by the World Bank and other scholarly sources, this article provides a comparison and an analysis on the effects of children “losing their childhood” in the two countries and the impacts of children born and raised in these West African nations. The concluding remarks of this article introduces and analyzes some solutions. I. Introduction Many people say that poverty is multidimensional. While multidimensional is technically defined as affecting many areas of life, I believe it has another, more important meeting. Poverty is non- discriminatory. It affects everyone and some more than others. Through the root causes of poverty like lack of access to clean drinking water, improper sanitation, malnutrition, inadequate vaccinations and immunizations, and a high rate of child immortality, children in the countries of Burkina Faso and Ghana are forced to fight for their lives before they even reach their fifth birthday.
    [Show full text]
  • Child Deaths in MICHIGAN 2006
    Child Deaths IN MICHIGAN 2006 Michigan Child Death State Advisory Team S i x t h A n n u a l REPORT A Report on Reviews conducted in 2004 A report on the causes and trends of child deaths in Michigan based on findings from community-based Child Death Review Teams. With recomendations for policy and practice to prevent child deaths. The Michigan Department of Human Services Michigan Public Health Institute ACKNOWLEDGEMENTS We wish to acknowledge the dedication of the nearly twelve hundred volunteers from throughout Michigan who serve our state and the children of Michigan by serving on Child Death Review Teams. It is an act of courage to acknowledge that the death of a child is a community problem. Their willingness to step outside of their traditional professional roles, and examine all of the circumstances that lead to child deaths, and to seriously consider ways to prevent other deaths, has made this report possible. Many thanks to the local Child Death Review Team Coordinators, for volunteering their time to organize, facilitate and report on the findings of their reviews. Because of their commitment to the child death review process, this annual report is published. The Michigan Department of Community Health, Office of the State Registrar, Division for Vital Records and Health Statistics has been especially helpful in providing the child mortality data and in helping us to better understand and interpret the statistics on child deaths. The Michigan Department of Human Services provides the funding and oversight for the Child Death Review program, which is managed by contract with the Michigan Public Health Institute.
    [Show full text]
  • The 9Th SIDS International Conference Program and Abstracts
    Program and Abstracts The 9th SIDS The9th International Conference SIDS International June 1-4 2006 in YOKOHAMA Conference June 1-4 2006 in YOKOHAMA www.sids.gr.jp Co-sponsored by The Japan SIDS Research Society and SIDS Family Association Japan Meeting with the International Stillbirth Alliance (ISA) and the International Society for the Study and Prevention of Infant Deaths (ISPID) Program and Abstracts Secretariat PROTECTING LITTLE LIVES, PROVIDING A GUIDING LIGHT FOR FAMILIES General lnquiry : SIDS Family Association Japan 6-20-209 Udagawa-cho, Shibuya-ku, Tokyo 150-0042, Japan Phone/Fax : +81-3-5456-1661 Email : [email protected] Registration Secretariat : c/o Congress Corporation Kosai-kaikan Bldg., 5-1 Kojimachi, Chiyoda-ku, Tokyo 102-8481, Japan Phone : +81-3-5216-5551 Fax : +81-3-5216-5552 Email : [email protected] Federation of Pharmaceutical WAM Manufacturers' Associations of JAPAN The 9th SIDS International Conference Program and Abstracts Table of Contents Welcome .................................................................................................................................................. 1 Greeting from Her Imperial Highness Princess Takamado ................................ 2 Thanks to our Sponsors!.............................................................................................................. 3 Access Map ............................................................................................................................................ 5 Floor Plan ...............................................................................................................................................
    [Show full text]
  • The Decline in Child Mortality: a Reappraisal Omar B
    Theme Papers The decline in child mortality: a reappraisal Omar B. Ahmad,1 Alan D. Lopez,2 & Mie Inoue3 The present paper examines, describes and documents country-specific trends in under-five mortality rates (i.e., mortality among children under five years of age) in the 1990s. Our analysis updates previous studies by UNICEF, the World Bank and the United Nations. It identifies countries and WHO regions where sustained improvement has occurred and those where setbacks are evident. A consistent series of estimates of under-five mortality rate is provided and an indication is given of historical trends during the period 1950–2000 for both developed and developing countries. It is estimated that 10.5 million children aged 0–4 years died in 1999, about 2.2 million or 17.5% fewer than a decade earlier. On average about 15% of newborn children in Africa are expected to die before reaching their fifth birthday. The corresponding figures for many other parts of the developing world are in the range 3–8% and that for Europe is under 2%. During the 1990s the decline in child mortality decelerated in all the WHO regions except the Western Pacific but there is no widespread evidence of rising child mortality rates. At the country level there are exceptions in southern Africa where the prevalence of HIV is extremely high and in Asia where a few countries are beset by economic difficulties. The slowdown in the rate of decline is of particular concern in Africa and South-East Asia because it is occurring at relatively high levels of mortality, and in countries experiencing severe economic dislocation.
    [Show full text]
  • Africa Key Facts and Figures for Child Mortality
    Africa Key Facts and Figures for Child Mortality Newborn and Child Mortality Estimates Sub-Saharan Africa has the highest risk of death in the first month of life and is among the regions showing the least progress. However, Sub-Saharan Africa has seen a faster decline in its under-five mortality rate, with the annual rate of reduction doubling between 1990–2000 and 2000–2011. Sub-Saharan Africa, which accounts for 38 percent of global neonatal deaths, has the highest newborn death rate (34 deaths per 1,000 live births in 2011). Neonatal deaths there account for about a third of under-five deaths globally (1.1 million newborns die in the first month of life).Sub-Saharan Africa has reduced under-five mortality by 39% between 1990 and 2011. If current trends persist, 1 in 3 children in the world will be born in sub-Saharan Africa, and its under-five population will grow rapidly. The highest rates of child mortality are still in Sub-Saharan Africa—where 1 in 9 children dies before age five, more than 16 times the average for developed regions (1 in 152). Under-five mortality rate in Africa (per 1,000 live births) declined from 163 in 1990 to 100 in 2011. These rates are still insufficient to achieve Millennium Development Goal 4 by 2015. o In Eastern and Southern Africa the decline was from 162 in 1990 to 84 in 2011. o In West and Central Africa the decline was from 197 in 1990 to 132 in 2011. o Eastern and Southern Africa have reduced under-five deaths by 48% from 1990 to 2011.
    [Show full text]
  • World Mortality Report 2007
    ST/ESA/SER.A/289 Department of Economic and Social Affairs Population Division World Mortality Report 2007 United Nations New York, 2011 DESA The Department of Economic and Social Affairs of the United Nations Secretariat is a vital interface between global policies in the economic, social and environmental spheres and national action. The Department works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic, social and environmental data and information on which Member States of the United Nations draw to review common problems and take stock of policy options; (ii) it facilitates the negotiations of Member States in many intergovernmental bodies on joint courses of action to address ongoing or emerging global challenges; and (iii) it advises interested Governments on the ways and means of translating policy frameworks developed in United Nations conferences and summits into programmes at the country level and, through technical assistance, helps build national capacities. Note The designations employed in this report and the material presented in it do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Symbols of United Nations documents are composed of capital letters combined with figures. This publication has been issued without formal editing. Suggested citation: United Nations, Department
    [Show full text]
  • CI 3 Revised Results and Evidence Updated 28
    UNICEF Innocenti Research Centre Innocenti Working Paper CHILD MORTALITY AND INJURY IN ASIA: SURVEY RESULTS AND EVIDENCE Michael Linnan, Le Vu Anh, Pham Viet Cuong, Fazlur Rahman, Aminur Rahman, Shumona Shafinaz, Chitr Sitti-Amorn, Orapin Chaipayom, Venus Udomprasertgul, Maria Consorcia Lim- Quizon, Guang Zeng, Jing Rui-wei, Zhu Liping, Katrina Irvine and Thomas Dunn Special Series on Child Injury No. 3 IWP-2007-06 October 2007 Innocenti Working Papers UNICEF Innocenti Working Papers are intended to disseminate initial research contributions within the Centre’s programme of work, addressing social, economic and institutional aspects of the realization of the human rights of children. The findings, interpretations and conclusions expressed in this paper are entirely those of the author(s) and do not necessarily reflect the policies or the views of UNICEF. The Special Series on Child Injury is a joint initiative of UNICEF Programme Division, The Alliance for Safe Children, the UNICEF Regional Office for East Asia and the Pacific and the UNICEF Innocenti Research Centre. The present version of this paper (February 2008) reflects minor editorial adjustments to the original version. Extracts from this publication may be freely reproduced with due acknowledgement. © 2007 The United Nations Children’s Fund (UNICEF) ISSN: 1014-7837 Readers citing this document are asked to use the following form: Linnan, Michael, et al., ‘Child Mortality and Injury in Asia: Survey results and evidence’, Innocenti Working Paper 2007-06, Special Series on Child Injury No. 3. UNICEF Innocenti Research Centre, Florence, 2007. ii UNICEF INNOCENTI RESEARCH CENTRE The UNICEF Innocenti Research Centre in Florence, Italy, was established in 1988 to strengthen the research capability of the United Nations Children’s Fund and to support its advocacy for children worldwide.
    [Show full text]
  • Review of HRM, Vol. 4 No. 2, April 2016
    ISSN: 2249-4650 Review of HRM Vol. 4, No. 2 April 2016 Honorary Editor Swarn Kant Mishra, Footwear Design & Development Institute, Noida Editorial Advisory Board Anita Singh, Institute of Management Studies, Ghaziabad Govind Swaroop Pathak, Indian School of Mines, Dhanbad Juin Choudhury, Acharya School of Management Studies, Bangalore Richa Chaudhary, BML Munjal University, Gurgaon S C Das, Banaras Hindu University, Varanasi Sharmistha Banerjee, Calcutta University, Kolkata Yasmin Nehar, Siliguri Institute of Technology, Darjeeling Shailesh, Editorial Head & Publisher Review of HRM, Vol. 4, No. 2 April 2016 Review of HRM (RHRM) is a biannual peer-reviewed journal published in October and April and by Centre for People & Management, New Delhi. RHRM seeks to create a body of knowledge around the contemporary issues in Human Resource Management and Organizational Behaviour. It is likely to serve as an independent forum for the academia, industry, civil society and the State to carry forward a candid and objective discussion on contemporary HR issues having a bearing on economy, business, community, environment and above all –the quality of life of the people. Research papers, articles, commentaries, reflective essays, interviews, book reviews and annotated bibliographies are invited from academics, researchers and practicing managers for publication in the forthcoming issues of RHRM. Contributors are welcome to discuss ideas for developing their papers with the editor. Length of the research papers should be 3000-5000 words while those of articles/commentaries/colloquium/interviews/book reviews should be 1500-2000 words. Please follow APA style for referencing. For further details, please contact: [email protected] Copyright © Management Development Research Foundation, New Delhi All rights reserved.
    [Show full text]
  • Mortality Statistics 1911
    DEPARTMENT OF COMMERCE ,“ . BUREAU OF THE CENSUS E. DANA DURAND, DIRECTOR ... BULLETIN’ 2 . MORTALITY- STAT ST CS 911 .. GENERAL DEATH RATES s SPECIFIC AND STANDARDIZED DEATH RATES ~ INFANT AND CHILD MORTALITY * . CAUSES OF DEATH . ) WASHINGTON GOVERNMENT PRINTING OFFICE Bls I ,, CONTENTS. I?aga DEATHSA~CR~EDEA~ mTES. ..7.l2 Grofiof tiere@ation mea. .. J...... ------- . .- 7 Extent of there@tration meak1911. -. ..-- . ..-. -.. -.- . ..-. -.. -.- . ..-. -... --- . ..-. -..-..' ------- . 8 .Dea&s. bycolor mdage of decedent . ..-. 9 Deatirates oftiere@tration area.-.-.. -.-.. -... -.- . ------------------------------------------------- ------- . ..’ “9 Deitirates ofre#shati6n states. --------------------------------------------------------------------- . ------ . 10 Deatira&s oflqecities . ------- . ..----- . 11 Deatim&s of fore@ comties andcities . ------------------------------------------------- ------- . ,11 SPECIFICAND STANDAR&EDDEA’JiHRATES. ... ---- ------- . .. ---- .- . 12-22 SpecScdeati rates. ..+. 13 Stindm&ed (orcomected) deatirabs . ..-. ..- . ..-. ..- . ..-. -.-- . .- . 18 S@dm&ed deatirates, bycolor andnatitity. .-. -.. - . ..-. ----------------- . .. ---- . ----- . 20 I~AN~AND C- NORTmY ------------------------------------------------------ ------- --------- . 22-26 Impor@ce ofrepofig ~deatis ofitimts bomtive . ---------------- . ------ . 24 CAUSXSOFDEA~ . ... ..". ...1 . ..-. ... .. 26-34 Det~edand abtid~ed International &ts. ------- ------- . 26 ‘ T~hoidfever . ..~ . ..- 27 Measles. ... ..~ . ..- 28 Scmletfever . ..~ .
    [Show full text]
  • Explanatory Notes Child and Youth Mortality Trend Series to 2019
    Explanatory Notes Child and youth mortality trend series to 2019 United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) Member agencies: UNICEF, the WHO, the UN Population Division and the World Bank Group September 2020 United Nations Explanatory Notes 2 The United Nations Inter-agency Group for relevant to the estimation of child and Child Mortality Estimation (UN IGME), which youth mortality including data from includes members from UNICEF, the World vital registration systems, population Health Organization (WHO), the United Nations censuses, household surveys and sample Population Division, and the World Bank Group, registration systems. was established in 2004 to advance the work on 2. Assess data quality, recalculate data monitoring progress towards the achievement of inputs and make adjustments if needed child survival goals. by applying standard methods. 3. Fit a statistical model to these data In accordance with the decision by the Statistical to generate a smooth trend curve Commission and the United Nations Economic that averages over possibly disparate and Social Council resolution 2006/6, UN estimates from the different data sources IGME child mortality estimates are produced for a country. in consultation with countries. UNICEF and the 4. Extrapolate the model to a target year, in WHO engage in joint country consultation on this case 2019. Sustainable Development Goal (SDG) indicators 3.2.1 (all countries aiming to reduce under-five To increase the transparency of the estimation mortality to at least as low as 25 deaths per process, the UN IGME has developed a Child 1,000 live births) and 3.2.2 (all countries aiming to Mortality Estimation (CME) web portal (www.
    [Show full text]
  • The Unexpected Death of an Infant Or Child: Standards for Services to Families
    THE UNEXPECTED DEATH OF AN INFANT OR CHILD: STANDARDS FOR SERVICES TO FAMILIES Copyright © 2001 Association of SIDS and Infant Mortality Programs Reprinted 2002, 2004 Association of SIDS and Infant Mortality Programs c/o New York State Center for SID School of Social Welfare Stony Brook University Stony Brook, New York 11794 (631) 444 – 3690 The Association of SIDS and Infant Mortality Programs (ASIP) is an association of health and human service professionals committed to bereavement support and risk reduction activities. ASIP promotes programs of counseling, education, advocacy, and research to ensure a supportive community response for those affected by infant and child death and to reduce the risk of death for future children. Copyright © 2001 Association of SIDS and Infant Mortality Programs (ASIP). All Rights Reserved. This document or any component part thereof, may not be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, storage in an information retrieval system, or otherwise, without the prior written permission of ASIP. 2 ACKNOWLEDGEMENTS The Association of SIDS and Infant Mortality Programs (ASIP) wishes to thank all those who have assisted with the development of this revised and expanded document, The Unexpected Death of An Infant or Child: Standards for Services to Families. These standards reflect the collective wisdom, expertise, and compassion of many members of this organization. ASIP extends special appreciation to Sarah J.M. Shaefer R.N., Ph.D., Chair of the ASIP Family Services Committee and past ASIP president, who worked diligently on this project, to ASIP members, too numerous to mention, who volunteered their time and talent to develop these standards, and to the staff of the National Center for Cultural Competence of the Georgetown University Child Development Center, for their review and contribution.
    [Show full text]