BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

350 Patternaof Mortalityin Childhood
14 years of age, the periods in which
mortality can be reduced drastically by
known methods. These populations are at
the greatest risk of disease and death and
must be provided with at least the minimumn
health facilities and services.
Fourteenth. The availability of piped
water supplies varied markedly in the Latin
American areas. In four areas 90 per cent
or more of families in which neonatal deaths
occurred had piped water inside the house
or available from a communal facility,
while in five (two cities and three rural
areas) less than one-fourth had water service
available. For the 13 Latin American
cities combined, 69.4 per cent of such fainilies
had piped water (37.1 per cent inside
house) but in the eight other areas only
28.8 per cent had that service (15.0 per cent
inside house). These findings in families
of infants (lying in the neonatal period,
which are probably quite similar to those in
the general populations of the same areas,
can be considered in relation to the new
goals set by the Special Meeting of Min-
isters of Health of the Americas for the
daey, tof thovie water7 s wit1 ­
namely, to provide water services with house
connections for 80 per cent of the urban
population and water for 50 per cent of the
rural population. It can be seen that attainment
of these goals poses a great challenge.
Of the families of infants who died in the
postneonatal period, lower percentages were
in cities
supplied with piped water (60.2
and 21.6 in the eight other areas), findings
which indicated that environmental conditions
as measured by this parameter were
much less favorable than in families in
which neonatal deaths occurred. A negative
correlation was established between postneonatal
death rates and the percentages
of homes with piped water among families
of infants dying in the postneonatal period.
The inverse relation was even clearer when
death rates were correlated with percentages
of homes with piped water inside the house.
Provision of water supplies (and sanito
much higher tary facilities)
proportions
of families in many urban and rural areas
is essential if major reductions in mortality
are to be achieved.
Fifteenth. Coordinated, community-centered
research has clearly been demonstrated
to be a sound method of uncovering
health problems and providing data needed
for the establishment of effective programs.
The Ministers of Health of the Andean
Region (Colombia, Ministry of Public
Health, 1971) expressed their recommendation
on this point as follows (in translation) :
If we really desire to invest resources effectively,
we need to measure and evaluate the
known problems and to uncover those that remain
hidden or whose magnitude is unknown.
Operational research acquires the utmost importance,
both for assessing the coverage and
productivity of existing systems and for laying
the bases for new designs and methods of work.
To achieve this end, it is important that our
countries not remain in isolation but combine
their efforts for the conduct of joint research
programs such as the "investigation of mortality
in children under 5 years of age," just completed
by the Pan American Health Organization in
cooperation with various countries-among them
Bolivia, Chile, and Colombia, members of the
(Andean) group.
The overall significance of this research
project, therefore, is its value for the establishment
of a new policy, by the Organization
and other international agencies, to
support and conduct, in cooperation with
the countries, community-centered research
as an essential part of health programs.