BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

28: Patterhs ol Mortality in Childhood
to be. aware at all times of the distinction
and seek clinical evidence of condition of
the product of pregnancy at birth.
In Jamaica the problem in this regard
was uncovered during the planning phase,
when it was found that products of conception
under 2 pounds were considered
nonviable and all were recorded as fetal
deaths. The WHO definition was explained
by a consultant of PAHO at a seminar held
in 1968 in the large maternity hospital in
Kingston, and thus the distinction between
live birth and fetal death was introduced
in time for its acceptance and use by obin
that project.
stetricians and midwives
Ideally an educational program covering
these specific points should have been con­
ducted in all projects in a planning phase.
However, efforts were exerted to make the
data as complete and comparable as possible
in each project. In this chapter the
procedures for collection of data on all
deaths, the difficulties encountered, and the
solutions applied are explained.
COLLECTION OF DATA
In each project the principal collaborator
directed a team of medical interviewers,
public health nurses or social workers, and
others who assisted in the field work. (In
Slo Paulo health educators who had interviewed
women in a previous study of fertility
were used.) Each collaborator determined
his own needs in terms of personnel
for the conduct of the Investigation.
The 27-month schedule for field work
was divided as follows: one month of preparatory
work and trial interviewing; 24
months for collection of data on deaths
and sampling of households; and two
months for completion of the program. The
three types of data collected were: (1) information
on deaths under 5 years of age
among residents of the area for 24 consecutive
months, recorded on questionnaires;
(2) samples of households, using questionnaires
for data on families and on living
children under 5 years, with two to four
sampling units completed per month for the
same 24 consecutive months; and (3) cornplete
file of live births among area residents
for the same two years. The first category
of data required the major portion of the
staff's time and is the one that produced
most of the information for this report.
In 10 projects all deaths occurring under
5 years of age in the project areas were
investigated, and the corresponding ques­
tionnaires were completed. In the other
five projects, because of the size of the
areas and the large number of deaths, samples
were selected for investigation. In
Medellin one out of each three deaths was
selected and in Sfio Paulo 1 in 4.25, for the
24 months. In three projects the sampling
procedures were changed during the course
of the study: in Santiago the sample was
increased from 1 in 5 deaths in the first
eight months to 1 in 3 in the following 16
months; in Cali and Monterrey the number
of deaths proved too large for the staff to
handle, and thus the number investigated
was reduced in the second year. Table 1,
in Chapter I, lists the sampling ratios.
As soon as a death occurred and was
known to the project staff, a nurse or social
worker made a visit to the household concerned
to obtain data regarding housing