Q15: INFANT AND UNDER 5 MORTALITY

Define infant and under 5 mortality rates

a) What is the current Zimbabwe infant and under 5 mortality rates?

b) What strategies would you advocate for to help reduce under 5s mortality?

Definitions
Infant mortality rate (IMR) is defined as the probability of dying between birth and exactly 1 year of age,
expressed per 1000 live births

Under 5 mortality rate (U5MR) is defined as the probability of dying between birth and exactly 5 years of
age, expressed per 1000 live births

ES
a) Zimbabwe statistic
2015 2018

IMR 50/1000 34/1000

U5MR 61/1000
BI
50/1000
BA
b) Strategies to reduce U5MR
Preconceptual
OF

1. Family planning and birth spacing counselling for young girls and women
2. Adolescent and women nutrition
3. Education
4. HIV and STI prevention and treatment
PR

5. Preconceptual folate supplementation

6. Deworming for anaemia prevention

Pregnancy

1. 4 visit focused ANC

2. Folate and Iron supplementation
3. Tetanus toxoid
4. Intermittent presumptive treatment (IPT) and insecticide treated nets for malaria
prevention
5. Prevention and management of STIs
6. PMTCT
7. Detection and treatment of asymptomatic and symptomatic bacteriuria
8. Counselling and preparation for newborn care, breastfeeding, birth and emergency
preparedness
Intrapartum

1. Antibiotics for premature rupture of membranes

2. Antenatal steroids for preterm deliveries
3. Emergency Obstetric care
4. Skilled obstetric care and immediate newborn care (hygiene, warmth, breastfeeding)
and resuscitation

Newborn and Postnatal Care

1. Hospital care of newborn and childhood illnesses including HIV

2. Extra care for preterm babies inc kangaroo mother care and iron supplementation
3. Emergency care of sick newborns

ES
4. PMTCT for HIV
5. Newborn temperature management
6. Promotion of healthy behaviours
7.
8.
BI
Early detection of and referral for illnesses
Newborn care counselling inc hygiene and warmth at home
BA
Child health care

1. Immunisations
2. Nutrition inc vit A supplementation, growth monitoring and deworming
3. Care of HIV infected children including cotrimoxazole prophylaxis
OF

4. First level assessment and care of childhood illnesses (IMNCI)

5. Exclusive BF for the 1st 6months of life
6. BF from 6 to 23 months
7. Appropriate complimentary feeding
PR

8. PMTCT and replacement (in able parents) for babies of HIV infected moms
9. Counselling to seek appropriate complimentary feeding
10. Danger sign recognition (fever, poor feeding, fast breathing, convulsions, jaundice etc)
11. ORS, Zinc, Antibiotics for dysentery
12. Antibiotics, Zinc , oxygen for respiratory infections
13. Counselling about indoor pollution
14. Insecticide treated nets for children

Intersectoral interventions

1. Improved living conditions including clean water, sanitation and hygienic practices
2. Nutrition for children, women and girls