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  1. 1

    Using 30-cluster survey to assess neonatal and perinatal mortality [letter]

    Aras R; Velhal G; Pai N; Naik V

    WORLD HEALTH FORUM. 1991; 12(4):449-50.

    Staff at the Shivajinagar Urban Health Centre in Deonar (population 250,000) near Bombay, India conducted a cluster survey in 30 sectors of the slum using the WHO methodology for evaluating immunization coverage to measure neonatal and perinatal mortality among births that occurred between November 1986-April 1988. They gathered information on 54 births for the case group and 9 controls from each cluster. 1610 live births and 19 stillbirths occurred in the study period. There were 27.6 perinatal deaths for every 1000 total births (standard error=1.108). Neonatal deaths equalled 28.6/1000 live births (standard error-1.126). Confidence intervals for perinatal mortality rate and neonatal mortality rate were 25.39-29.82 and 26.35-30.85 and significant (p<.05). 26.4% of births occurred at home. Untrained women attended 84.6% of these deliveries. The remaining births occurred at the municipal general hospital or at a municipal maternity home. 60% of the fetal deaths were females. 77% of the 26 early neonatal deaths were males, but the male female ratio of deaths after 7 days was the same. The leading causes of neonatal mortality were prematurity and low birth weight. Other causes included congenital malformations and neonatal tetanus. Obstructed labor resulted in fetal death in 40% of stillbirths. The researchers at the Shivajinagar Urban Health Centre in Deonar, India concluded that the 30-cluster survey technique was effective in measuring perinatal and neonatal mortality in a community with >50,000 people in a developing country.
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  2. 2

    Tackling Africa's slums.

    Egunjobi L

    WORLD HEALTH. 1991 Mar-Apr; 14-5.

    Less developed countries are undergoing rapid, unplanned, and uncontrolled urbanization at the expense of their populations' health. Physical expansion of cities has outpaced the abilities of city planners and management and has contributed to the spread of tuberculosis, pneumonia, influenza, threadworm, cholera, dysentery, and other diarrheal diseases. Overcrowding, lack of access roads, dangerous roads, drinking water scarcity, frequently collapsing buildings, uncollected garbage, lack of sewers, inadequate air space, and houses littered with human feces are common conditions contributing to high mortality rates especially among children. In this context, the World Health Organization's Environmental Health in Rural and Urban Development Program, which is designed to promote awareness about the association between health and planning, is noted. Guidelines for change are also a component of the program, and are encouraged for adoption by planners of less developed countries, especially Africa. Urban rehabilitation and upgrading are recommended in the guidelines while maintaining central focus upon promoting the population's health. While examples of rampant urbanization are drawn primarily from Nigeria, ancient Greek and Roman societies as well as the UK are mentioned in the context of urban planning with a view to health.
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