Articles: mortality.
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Multicenter Study Comparative Study
Maternal weight, height and risk of poor pregnancy outcome in Ahmedabad, India.
This paper explores the relationships between maternal weight, height and poor pregnancy outcome using a data set from a case-control study of low birth weight (LBW) and perinatal mortality in Ahmedabad, India. Maternal height and weights were compared between mothers of 611 perinatal deaths, 644 preterm-LBW, and 1465 normal birth weight controls as well as 617 small-for-gestational age (SGA) and 1851 appropriate-for-gestational-age (AGA) births. Weight and height were much lower in this population compared to western standards. ⋯ After adjusting for confounders, maternal weight remained significantly associated with poor pregnancy outcomes, whereas height was only weakly associated. Attributable risk estimates show that low weight is a much more important contributor to poor outcome than low height. Improvement in maternal nutritional status could lead to substantial improvement in birth outcome in this population.
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From January 1992 to December 1993, a total of 361 births and 243 deaths were recorded by village reporters in five villages in Muheza District, north eastern Tanzania. Among those aged less than one year 48 deaths were recorded, giving an infant mortality rate of 133 per 1000 live births (95% CI 97.9-168.0). ⋯ From analysis of these, 30 of the deaths were tentatively attributed to malaria. The results are discussed in relation to other studies in East and West Africa and to the prospects for reducing mortality by use of insecticide impregnated bednets.
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About a century after Koch's discovery of the TB bacilli the tuberculosis epidemic which had appeared to be under control was again recognized as a major global health threat. The decline in the epidemic in this century had been largely through the improved living standards and, eventually, the availability and use of effective antibiotics. While tuberculosis gradually disappeared from the health agenda in the western world it remained a big killer throughout the century and in 1992 an estimated 2.7 million TB deaths occurred; 30 million will die from TB during the 1990s if current trends are not reversed. ⋯ The control of the epidemic can only be through a concerted action to reinstate TB as priority among health concerns, reflected in national and international resources. A coalition of public and private supporters must be mobilized to support the effort to fight the disease. Governments, non-governmental organizations, the business community, refugee organizations, medical institutions, and other UN agencies are invited to join with WHO in this effort.
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A community-based survey on maternal mortality was carried out in the Ejisu health district of Ghana in January and February 1990 to identify all women who died in pregnancy, delivery or the puerperium from January 1985 to December 1989, determine their characteristics, the presumptive causes of death and related factors. Forty-four women who died in pregnancy, delivery or the puerperium were identified over the stated period. 59% were aged between 20 and 34 years. Eighty-two percent were married and sixty-six percent had at least primary education. ⋯ Thirty-four percent of the women who died did not attend any antenatal clinic. The actual number of deaths may be underestimated due to the sampling method used and the difficulties encountered in linking survey data with hospital records. Based on the survey findings and other related PMM research, plans have been developed to reduce maternal mortality in the district as outline in the conclusion.
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The Safe Motherhood Initiative has successfully stimulated much interest in reducing maternal mortality. To accelerate programme implementation, this paper reviews lessons learned from the experience of industrial countries and from demonstration projects in developing countries, and proposes intervention strategies of policy dialogue, improved services and behavioural change. A typological approach with three hypothetical settings from resource poor to resource rich environments is used to address the variability in health behaviours and infrastructure encountered when programming for safe motherhood.