BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...
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BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ... BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

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Chapter XV. Medical Attention 297 Flo. 148. Percentage of Mothers of Deceased require admission to hospital for special Infants Receiving Prenatal Care, by Stage of Pregnancy at the First Visit, in 25 Areas of 15 Projects. care. PER CENT New knowledge has led to few practical 20 o 60, ao ,0 improvements in prenatal care during the siunac , last trimester (WHO, 1965). Abnormal con- WV, nW., uSA JUN, ditions l present in early stages of pregnancy acquire compounded severity as gestation SANmAn PJ) (COYN progresses and this is often the reason for STAM ,, late first consultations. Under these cirt cumstances the result is often early ternina- SAMJU RURAL I0T0 '_____,_ tion of pregnancy or the birth of a low U.PILCO ' i weight infant CHU in poor physical condition. OU CRA1 COMAS _ Fetal hypoxia frequently occurs in the last FRANCA TA ...... months of complicated pregnancies (with ."____ placental insufficiency) and is a precursor cUT, of postnatal morbidity and mortality. 01AC0 RUAL~ u11 The numbers and percentages of mothers asA.vW 100 0100(1 of deceased infants who received Irenatal care for the first time during the second FIST TRIMESTER t=IAT1S and third trimesters of )regnancy are shown in Table 174 and Figure 148. As for mothers of El Salvador received no prenatal care at who received prenatal attention at any all. It is obvious, therefore, that there are period during pregnancy, the percentages areas in which timely action to ensure sue- varied greatly anmong the areas of the 15 cessful pregnancy is not possible for large projects. In nine areas more than 80 per numbers of women because of the inad- cent of the pregnant women received )reequacy of prenatal care services during the natal care; at the other extreme, there were early months of pregnancy. The lack of five areas in which less than half received these basic services is particularly serious such care. These data reflect the need to for groups of women at greater risk, such as increase the coverage of these inmportant those in areas distant from urban facilities, health services. During the intermediate stage of preg- Data on the number of prenatal care nancy (second trimester) certain maternal visits reported for mothers of deceased inand fetal disorders predominate, such as fants are presented in Table 175 and Figure fetal pathology from infections (syphilis, 149 for 23 areas of 14 projects (such data toxoplasmosis, and other infectious dis- were not obtained in the California project). eases) which can interfere with normal ie- In only four areas, (Sherbrooke, San Juan velopment ot the central nervous system; city, San Juan suburban, and Ribeirilo PrCto premature separation of placenta or unsatis- city) had as high as 20 per cent of mothers factory development of placental function; attended prenatal clinics seven or more and appearance of new maternal disorders times. In those areas where only small persuch as early toxemia, or exacerlation of centages of mothers had received any )repre-existing conditions. Even under condi- natal attention, the proplortions who had tions of adequate control, some women may made four or more visits were low, and

298 Patternsof -Mord ity in Childhood TADBL 175. Visits for Prenatal Care Reported for Mothers of Deceased Infants in 23 Areas of 14 Projects. Number of mothers, Percentageb Area 7 or Un- 7or Total None 1-3 4-6 more known Total None 1-3 4-6 more Total ........................ 21,146 7,282 5,196 4,923 2,431 1,315 100.0 34.4 27.2 25.7 12.7 ARGENTINA Chaco Province 693 209 167 162 52 103 100.0 30.2 30.6 29.7 9.5 Resistencla ............... Rural departments ......... 621 331 138 63 12 77 100.0 53.3 30.3 13.8 2.6 San Juan Province San Juan (city) ............ 244 28 70 63 73 10 100.1 11.5 30.1 27.1 31.4 Suburban departments ..... 6t 106 196 150 138 28 100.0 17.2 33.5 25.7 23.6 Rural departments ......... 839 188 339 165 113 34 100.0 22.4 42.6 20.8 14.2 BOLIVIA la Pae .................. 1,013 863 216 225 194 115 100.0 53.5 15.8 16.5 14.2 4 - - 100.0 83.1 12.4 4.5 ­ Viacha ................... 89 74 11 BRAZIL Recife ...................... 2,264 965 674 453 108 64 100.0 42.6 31.3 21.1 5.0 Ribeirao Preto Ribeirlo Preto (city) ....... 355 67 112 85 60 25 100.0 18.9 34.5 26.2 20.4 Franca................... 207 88 81 62 52 14 100.0 29.6 29.2 22.4 18.8 Communities ............. 176 45 68 31 20 12 100.0 25.6 42.5 19.4 12.5 Sio Paulo .................. 3,108 782 782 990 400 154 100.0 25.2 20.9 34.1 13.8 CANADA Sherbrooke ................. 275 9 33 112 101 20 100.0 3.3 13.0 44.0 39.7 CHILE Santiago .................. 1,436 244 289 532 250 121 100.0 17.0 22.4 41.2 19A Comunas .................. 167 43 39 54 26 5 100.0 25.7 24.4 33.7 16.2 COLOMBIA Call ........................ 706 345 133 177 102 39 100.0 43.3 18.3 24.4 14.0 Cartagena .................. 545 159 181 104 53 48 100.0 29.2 37.9 21.8 11.1 Medellin .................... 643 126 142 243 79 53 99.9 19.6 24.6 42.1 13.7 EL SALVADOR San Salvador .............. 1,941 1,044 325 352 142 78 100.0 53.8 18.3 19.9 8.0 Rural munifrpiot .......... 605 401 111 60 15 18 100.0 66.3 20.1 10.9 2.7 JAMAICA Metropolitan Kingston ..... 1,200 307 437 304 154 88 100.0 23.8 37.2 25.9 13.1 St. Andrew, rural .......... 104 20 45 31 7 1 100.0 19.2 43.8 30.2 6.8 MEXICO Monterrey .................. 2,427 838 606 501 274 208 100.0 34.5 28.7 23.8 13.0 C In families in %hich home interviews were conducted and information was provided. bIt was assumed that mothers for whom the number of visits was unknown were distributed In the same way as those for whom one or more visits were specified. especially low in rural areas: in Chaco The two rural areas with the lowest pro­ Province, 16.4 per cent in the rural departments compared with 39.2 per cent in the care-namely, Viacha (16.9 per cent) and portions of mothers receiving any prenatal city of Resistencia; in Bolivia, 4.5 per cent rural municipios of El Salvador (33.7 per in Viacha and 30.7 per cent in La Paz; and cent)-had very high infant death rates in El Salvador, 13.6 per cent in the rural (123.5 and 120.0 per 1,000 live births, re­ municipios and 27.9 per cent in the city of spectively); and conversely, areas in which San Salvador. In Recife as well, only a nearly all mothers received prenatal care small percentage (26.1) of mothers had had low death rates. Ta'lle 176 gives these made at least four visits, percentages in descending order, along with

298 <strong>Patterns</strong><strong>of</strong> -Mord ity in Childhood<br />

TADBL 175. Visits for Prenatal Care Reported for Mothers <strong>of</strong> Deceased Infants in 23 Areas <strong>of</strong> 14 Projects.<br />

Number <strong>of</strong> mothers,<br />

Percentageb<br />

Area 7 or Un- 7or<br />

Total None 1-3 4-6 more known Total None 1-3 4-6 more<br />

Total ........................ 21,146 7,282 5,196 4,923 2,431 1,315 100.0 34.4 <br />

27.2 25.7 12.7<br />

ARGENTINA<br />

Chaco Province<br />

693 209 167 162 52 103 100.0 30.2 30.6 29.7 9.5<br />

Resistencla ............... <br />

Rural departments ......... 621 331 138 63 12 77 100.0 53.3 30.3 13.8 2.6<br />

San Juan Province<br />

San Juan (city) ............ 244 28 70 63 73 10 100.1 11.5 30.1 27.1 31.4<br />

Suburban departments ..... 6t 106 196 150 138 28 100.0 17.2 33.5 25.7 23.6<br />

Rural departments ......... 839 188 339 165 113 34 100.0 22.4 42.6 20.8 14.2<br />

BOLIVIA<br />

la Pae .................. 1,013 863 216 225 194 115 100.0 53.5 15.8 16.5 14.2<br />

4 - - 100.0 83.1 12.4 4.5 ­<br />

Viacha ................... 89 74 11<br />

BRAZIL<br />

Recife ...................... 2,264 965 674 453 108 64 100.0 42.6 31.3 21.1 5.0<br />

Ribeirao Preto<br />

Ribeirlo Preto (city) ....... 355 67 112 85 60 25 100.0 18.9 34.5 26.2 20.4<br />

Franca................... 207 88 81 62 52 14 100.0 29.6 29.2 22.4 18.8<br />

Communities ............. 176 45 68 31 20 12 100.0 25.6 42.5 19.4 12.5<br />

Sio Paulo .................. 3,108 782 782 990 400 154 100.0 25.2 20.9 34.1 13.8<br />

CANADA<br />

Sherbrooke ................. 275 9 33 112 101 20 100.0 3.3 13.0 44.0 39.7<br />

CHILE<br />

Santiago .................. 1,436 244 289 532 250 121 100.0 17.0 22.4 41.2 19A<br />

Comunas .................. 167 43 39 54 26 5 100.0 25.7 24.4 33.7 16.2<br />

COLOMBIA<br />

Call ........................ 706 345 133 177 102 39 100.0 43.3 18.3 24.4 14.0<br />

Cartagena .................. 545 159 181 104 53 48 100.0 29.2 37.9 21.8 11.1<br />

Medellin .................... 643 126 142 243 79 53 99.9 19.6 24.6 42.1 13.7<br />

EL SALVADOR<br />

San Salvador .............. 1,941 1,044 325 352 142 78 100.0 53.8 18.3 19.9 8.0<br />

Rural munifrpiot .......... 605 401 111 60 15 18 100.0 66.3 20.1 10.9 2.7<br />

JAMAICA<br />

Metropolitan Kingston ..... 1,200 307 437 304 154 88 100.0 23.8 37.2 25.9 13.1<br />

St. Andrew, rural .......... 104 20 45 31 7 1 100.0 19.2 43.8 30.2 6.8<br />

MEXICO<br />

Monterrey .................. 2,427 838 606 501 274 208 100.0 34.5 28.7 23.8 13.0<br />

C In families in %hich home interviews were conducted and information was provided.<br />

bIt was assumed that mothers for whom the number <strong>of</strong> visits was unknown were distributed In the same way as those for<br />

whom one or more visits were specified.<br />

especially low in rural areas: in Chaco The two rural areas with the lowest pro­<br />

Province, 16.4 per cent in the rural departments<br />

compared with 39.2 per cent in the care-namely, Viacha (16.9 per cent) and<br />

portions <strong>of</strong> mothers receiving any prenatal<br />

city <strong>of</strong> Resistencia; in Bolivia, 4.5 per cent rural municipios <strong>of</strong> El Salvador (33.7 per<br />

in Viacha and 30.7 per cent in La Paz; and cent)-had very high infant death rates<br />

in El Salvador, 13.6 per cent in the rural (123.5 and 120.0 per 1,000 live births, re­<br />

municipios and 27.9 per cent in the city <strong>of</strong> spectively); and conversely, areas in which<br />

San Salvador. In Recife as well, only a nearly all mothers received prenatal care<br />

small percentage (26.1) <strong>of</strong> mothers had had low death rates. Ta'lle 176 gives these<br />

made at least four visits,<br />

percentages in descending order, along with

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