Card N23.

1. Infant and child health as a component.

1. Determinants of infant and child health
Lifestyle- Diet, living condition, culture and
tradition, education
Genetics
Environmental factors
Health
care
services-immunization,
food
fortification
2. Perinatal and neonatal mortality:
calculate and leading causes

ways

to

Perinatal mortality (PNM), also perinatal death, refers to the death of a

fetus or neonate and is the basis to calculate the perinatal mortality rate.
WHO s definition "Deaths occurring during late pregnancy (at 22
completed weeks gestation and over), during childbirth and up to seven
completed days of life" is not universally accepted. The perinatal mortality is
the sum of the fetal mortality and the neonatal mortality. The PNMR refers
to the number of perinatal deaths per 1,000 total births. It is usually reported
on an annual basis. It is a major marker to assess the quality of health care
delivery. Comparisons between different rates may be hampered by varying
definitions, registration bias, and differences in the underlying risks of the
populations.
Early neonatal mortality refers to a death of a life-born baby within the
first seven days of life, while late neonatal mortality covers the time after 7
days until before 29 days. The sum of these two represents the neonatal
mortality. Some definitions of the PNM include only the early neonatal
mortality. Neonatal mortality is affected by the quality of in-hospital care for
the neonate..
3. Infant
mortality:
leading
comparisms between countries

causes,

make

Infant mortality is the death of infants in the first year of life. The leading
causes of infant mortality are dehydration and disease.

Major causes of infant mortality in more developed countries include

congenital malformation, infection and SIDS. The most common cause of
infant mortality of all children around the world has traditionally been
dehydration from diarrhea. Because of the success of spreading information
about Oral Rehydration Solution (a mixture of salts, sugar and water) to
mothers around the world, the rate of children dying from dehydration has
been decreasing and has become the second most common cause in the late
1990s. Currently the most common cause is pneumonia.
Infanticide, abuse, abandonment, and neglect may also contribute to infant
mortality.
Infant mortality rate (IMR) is the number of newborns dying under a year
of age divided by the number of live births during the year. The infant
mortality rate is also called the infant death rate.
The infant mortality rate is reported as number of live newborns dying under
a year of age per one thousand live births, so that IMRs from different
countries can be compared.
Countries and regions with the highest and lowest infant mortality rates
(2005 est. CIA Factbook) are shown below.

Rank

Country \ region

Infant mortality rate

(deaths/1,000 live births)

Angola

187.49

Afghanistan

163.07

Sierra Leone

162.55

Liberia

161.99

Mozambique

130.79

184

United States of America 6.50

223

Japan

224

Hong Kong, SAR, PRC 2.96

225

Sweden

2.77

226

Singapore

2.29

3.26

4. Ways to reduce infant deaths, under 5-mortality

and improve child health
-Routine child immunizations,
-nutrition,
-prenatal care,
-safe motherhood
-Treatment of diseases
-Hospital admissions
-Frequent checkups
-Public education
5. Explain how
expectancy

infant

mortality

influences

life

Life expectancy is an indication of how long a person can

expect to live on average given prevailing mortality rates. It
is a good measure of population health. Low infant mortality
rates and an ageing population are both indicative of longer
life expectancywith an increases in mortality had a retarding
effect on life expectancy

2. Association and causation.

1. Explain the term association and its difference
from causation
-An association is said to exist between 2 variables when a change in one
variable parallels or coincides with a change in another.
-an association comes from two variables that are related. Association does
not imply causation.
-the relationship between association and causality is that association does
not imply a direct causal connection between the associated variables. If,
however, association is nonrandom (i.e., not due purely to chance), then it
implies that some causal mechanism is operative. Often, the nature of the
causal mechanism underlying an association is the joint influence of one or
more common causes operating on the variables in question.
2. Spurious association and reasons for it
- A non-causal association is inferred when the association
is due to chance, based on numerator analysis or
ecological correlation, or due to bias.
-Associations involving a third variable that jointly causes the association
between the two original variables, is often termed "spurious
association."
-Spurious association can be of 3 types
Due to selection bias
Due to information or measurement bias
Due to confounding bias
3. Explain the evidence for causality in infections
diseases
-No idea
4. Explain the evidence for causality in chronic noncommunicable diseases
-No idea
5. Difficulties in etiological investigations of noncommunicable diseases
-No idea