BIBLIOGRAPHIC INPUT SHEET TEMPORARY Patterns of mortality ...

ChapterI1. Collection and Quality of Basic Data
35
sufficient consideration of the quality of the
basic data. The leveling off of the infant
death rate in the United States at a higher
level than in several European countries
has been a matter of great concern to health
authorities. Basic to comparability is the
acceptance of the WHO definition of a live
birth and a fetal death. As long as products
born alive are termed "abortions" or still-
births there will not be comparability. Until
thorough investigations arc made of procedures
in hospitals as well as of deliveries
at home, and until standard definitions are
followed, comparability will remain in
doubt. This leads to another point on which
operational research is urgently reecded,
that is, the distribution of live births by
birth weight (see Chapter III).
BIRTH
The original proposal called for the current
collection of data on all births among
residents of the project areas. This proved
difficult. In one project where birth regisknown
to be incomplete, the
tration was
nurses made daily visits to maternity services
in order to complete individual cards
on live births, and they also obtained inforination
on home deliveries from midwives.
Early counts for that project showed that
only 5 per cent of the births were known to
have occurred at home, while counts from
the sample of households indicated a higher
frequency of home deliveries. As a result,
new approaches and intensive efforts were
instituted which increased the percentage,
though it remained lower than that found
in the sample. In several projects the birth
files were the source of the number of births
used for calcuiation of birth rates and for
the denominators for calculation of infant
mortality in this report. In several projects
a combination of files of hospital births and
estimates of births occurring at home was
used. In Colombia baptisms have traditionally
been used as the source of data on
births, but records of baptism are often
filed late and some infants are not baptized;
thus estimates of live births had to be made
by other means.
RATES
TABLL 4. Estimated Annual Birth Rates for
Two Years, of the Investigation in 24 Areas of 15
Projects.
Birtha
Area per 1.000
population
ARGENTINA
Chaco Province ............... 33.7
Resistencia ................. 32.3
Rural departments .......... 35.7
San Juan Province ............ 30.4
San Juan (city) ............. 26.0
Suburban departments ....... 30.3
Rural departments .......... 34.0
BOLIVIA
1a 11az .................... 34.1
Viacha . . . . . . . . . . . . . . . . . . . . . 41.2
BRAZIL
Recife ....................... 41.6
Ribeirio Prto
Ribeir.io Prito (city) ........ 25.6
Franca .................... . 30.0
Communities ............... 28.5
Si-o Paulo.................... 24.8
CANADA
Sherbrooke................... 15.2
CHILE
Santiago ................... 26.0
Comunas................... 27.4
COLOMBIA
Cali ......................... 31.1
Cartagena .................... 32.5
Medellin ..................... 31.0
EL SALVAI)OR
San Salvador ............... 39.7
Rural inunicipios ............ 43.8
JAMAICA
Kingston-St. Andrew.......... 38.0
MEXICO
Monterrey .................. 39.8
UNITED STATES
San Francisco .............. 15.8
California, suburban ......... 10.5
* Exrept for California project (one year).