Impact of maternal and child health strategy on child survival in a rural community of Pondicherry
- PMID: 9492416
Impact of maternal and child health strategy on child survival in a rural community of Pondicherry
Abstract
Objective: To determine the impact of Maternal and Child Health (MCH) services on child survival in a socio-economically backward rural community.
Setting: Twelve villages in Pondicherry with a population of 16,803.
Design: Prospective study.
Subjects: A birth cohort of 356 live births (LB) born between January 1st and December 31st 1988.
Methods: The live births were followed-up from birth to five years age (1988-1993). The health care received by this cohort and the antenatal services received by the cohort mothers was reviewed. Outcome measures related to child survival were determined and their changing trend since 1967 was examined.
Results: Fifty-four per cent of the cohort children were from families below the poverty line. Antenatal registration and tetanus immunization coverage of the mothers of the cohort was 100%. Immunization coverage of the cohort children was more than 98% for BCG, DPT (three doses) and OPV (three doses) and 82% for measles. The infant mortality rate had reduced from 201/1000 LB in 1967 to 64/1000 LB (95% CI 58.9-68.1) in 1989. The child death rate decreased from 29.4/1000 children 1-4 years of age (1970) to 18/1000 (95% CI 13.9-22.1) in 1992. There were no deaths due to neonatal tetanus or measles. Neonatal mortality (35/1000 LB; 95% CI 29.9-40.1) was higher than the post-neonatal mortality (29/1000 LB; 95% CI 24.1-33.9). Fifty eight per cent of the neonatal deaths were due to non-infective causes like prematurity, birth asphyxia, birth injuries and congenital anomalies. Eighty per cent of post neonatal deaths were due to infections. Overall, the child survival index was high (91.27%; 95% CI 88.14-94.26). This was inspite of the low socio-economic background of the children's families.
Conclusions: Good MCH services can substantially improve child survival inspite of prevailing low socio-economic situations. Inputs for neonatal care need to be strengthened to further enhance child survival.
PIP: A cohort of 356 live births (LBs) in 12 villages in Pondicherry during 1988 was followed from birth to age 5 years to determine the impact of maternal and child health (MCH) services upon child survival in a low income, rural community. 54% of the children were from families living in poverty. All mothers of the cohort were registered antenatally and immunized against tetanus, and more than 98% of the children had been immunized with BCG, DPT (3 doses), and OPV (3 doses). 82% of the children were immunized against measles. The infant mortality rate declined from 201/1000 LBs in 1967 to 64/1000 in 1989, while the child death rate decreased from 29.4/1000 children aged 1-4 years in 1970 to 18/1000 in 1992. No death occurred due to neonatal tetanus or measles. Levels of neonatal and post-neonatal mortality were 35/1000 LBs and 29/1000, respectively. 58% of the neonatal deaths were due to non-infective causes such as prematurity, birth asphyxia, birth injuries, and congenital anomalies, while 80% of post-neonatal deaths were due to infections. The child survival index was 91.27%. These findings demonstrate how the provision of good MCH services can improve child survival in low income populations.
Comment in
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Impact of maternal and child health strategy on child survival.Indian Pediatr. 1998 Feb;35(2):188-90. Indian Pediatr. 1998. PMID: 9707869 No abstract available.
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