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By Institute of Medicine, Board on Global Health, Committee on Improving Birth Outcomes, Adetokunbo O. Lucas, Barbara J. Stoll, Judith R. Bale

Start results have better dramatically world wide long ago forty years. but there's nonetheless a wide hole among the results in constructing and built international locations. This ebook addresses the stairs had to lessen that hole. It stories the to be had records of low start weight, prematurity, and delivery defects; stories present wisdom and practices of a fit being pregnant, identifies budget friendly possibilities for bettering delivery results and assisting households with an youngster handicapped through beginning difficulties, and recommends precedence study, potential construction, and institutional and international efforts to minimize adversarial beginning results in constructing nations. The committee has dependent its research on info and knowledge from a number of constructing nations, and gives options which can help the March of Dimes, facilities for disorder regulate and Prevention, and NIH in tailoring their overseas application and forging new partnerships to minimize the mortality and morbidity linked to opposed beginning results.

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Based on data from the Demographic and Health Surveys from 1986 through 1998, approximately two-thirds of under-5 deaths in developing countries occurred to infants (less than 1 year old); among these infants, nearly twothirds were neonates (less than 1 month old); and among these neonates, nearly two-thirds were less than 1 week old (World Health Organization, 1996). These figures approximate recent estimates by WHO based on data from 1995, which indicate that neonatal mortality accounts for nearly 60 percent of infant mortality (Save the Children, 2001).

16 IMPROVING BIRTH OUTCOMES Recommendation 6. To determine the true burden of disease associated with adverse birth outcomes and measure the effectiveness of interventions to address these problems, basic epidemiological and surveillance data must be collected, analyzed, interpreted, and acted upon. Each country should, as resources permit, incrementally develop complete national demographic data and ongoing surveillance of maternal, neonatal, and fetal mortality and morbidity (Chapter 5). Health care services can be improved continuously over time by recognizing priorities that need to be addressed, identifying interventions that address them, implementing the interventions, assessing their effectiveness, and tuning them to be more effective.

A cross-national analysis of status indicators, such as women’s level of education relative to men, age at first marriage, and contraceptive prevalence, showed that all of these factors are in large measure associated with maternal mortality, even after controlling for wealth and economic growth (Shen and Williamson, 1999). Where women’s socioeconomic status is low, maternal mortality tends to be higher, and fewer provisions are made for obstetric emergencies (Shen and Williamson, 1999; The Prevention of Maternal Mortality Network, 1992).

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