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New York, New York, United Nations, 1992. viii, 400 p. (ST/ESA/SER.A/128)Available child mortality data are provided since the 1960s for 82 developing countries, arranged alphabetically, with a population of >1 million. The scope and methodology of the data, the main findings, a guide to the notation and layout of the database, and country specific profiles are included. Available data are included from many different sources without adjustment; graphs are provided. There is a brief discussion of the nature of child mortality and the methods used to measure it such as the crude death rate, age specific death rates, the infant mortality rate, <5 mortality, mortality 1-5 years, and model life tables for age specific child mortality. There is also discussion of the various data sources and estimation methods: vital registration data, prospective surveys, household surveys, prospective sample surveys, surveillance systems, retrospective questions in censuses and surveys, questions on recent household deaths by age, Brass method questions to whom on aggregate number of children born or dead, questions on women's most recent birth and survival, and maternity histories. Commentary is provided on the common index approach and the intersurvey change approach to evaluation of child mortality estimates. There is not 1 best method for measuring mortality. Countries with the most complete reporting of vital registration data are Hong Kong, Israel, Mauritius, Puerto Rico, and Singapore. Countries with incomplete data which does not provide a good measure of child mortality are Egypt, El Salvador, Guatemala, Jamaica, and Trinidad and Tobago. Brass estimates which agree with vital registration data include the following countries: Costa Rica, Cuba, Kuwait, and Peninsular Malaysia. Indirect estimates which confirm vital registration data pertain to Chile and Uruguay. Brass questions provide satisfactory results in Costa Rica, Cuba, Egypt, El Salvador, Guatemala, Jamaica, Sri Lanka, and Trinidad and Tobago. Underestimates are expected for Argentina and Egypt. Indirect methods applied to census data provide good estimates for 23 countries, indirect methods applied to survey data yields good estimates for 21 countries, and direct calculations from maternity histories provide good estimates for 20 countries. 17 countries have poor results from maternity histories alone. Child mortality may have fallen by >50% in developing countries between 1960-85.
Journal of Tropical Pediatrics. 1983 Aug; 29(4):217-9.The World Health Organization (WHO) launched the Expanded Program of Immunization (EPI) in 1974 based on the belief that most countries already had some elements of national immunization activities which could be successfully expanded if the program became a national priority with a commitment from the government to provide managerial manpower and funds. The federal government of Nigeria quickly adopted the policy of WHO on EPI and urged the state governments to set up administrative arrangements for planning and implementation of EPI. The program started off in Oyo State of Nigeria after a pilot study conducted at Ikire in Irewole Local Government area in 1975. The stated objectives of the programs were: to provide immunization service to at least 85% of the target population e.g. children under 4 years; and to integrate immunization programs into routine activities of all static primary health centers in the state. This study focuses on administration of the immunization program in the Oranmiyan Local Government area of Oyo State, within the structure of the local government health system and the field health administration of the state government. This study shows that the stated objectives of the EPI are not likely to be achieved in the near future because of low coverage of the eligible population, due to inadequate community involvement in the planning and implementation of the program; 2) poor communication between different government departments; and 3) inadequate publicity. The effect of improvement in health status because of immunization programs, has been very difficult to demonstrate in Nigeria because a lack of accurate data on birth, morbidity, and mortality patterns of the population. Other socioeconomic and health factors of significance in the battle against infectious diseases include environmental sanitation, adequate and safe water supply, housing and nutrition. Nevertheless, immunization programs constitute one of the most economical and effective approaches to the prevention of communicable diseases and can produce dramatic effects in the battle to lower infant and childhood mortaltiy rates in the developing countries if they are well implemented.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1982; 35(1):2-10.The goal of health for all by the year 2000 was first stated at the 1977 World Health Assembly and global strategy was launched at the 32nd World Health Assembly in 1979. This article focuses on life expectancy at birth as the most widely used indicator of the health status of populations and also the health status indicators most closely correlated with socioeconomic development. Developing countries have set a target of life expectancy of 60 years; at present 86% of these countries are exposed to mortality conditions which leave life expectancy at age 50. Among 80 countries with GNP per capita of more than $500 61 have life expectancy over 60 years and of the 35 with a life expectancy of 70 or more 28 have GNP over $2500. The largest concentration of countries below the target level is in Asia. Discovering the leading causes of death is crucial in raising life expectancy; in developed countries they are cardiovascular disease, malignant neoplasms, and accidents, accounting for 70% of all deaths. In developing countries there is variation with regard to level of modernization of the cause of death structure but in at least 1/2 the 3 latter causes are also predominant with diarrheal disease and infectious and parasitic conditions related to malnutrition the main causes in the other 1/2. When assessing the health care needs of developing countries the difference between countries regarding their ability to reduce mortality from the traditional diseases must be considered before deciding on use of resources.