Infant Mortality

Infant Mortality

Infant Mortality

Trends, causes, and responses in a changing

world

Trends, causes, and responses in a changing

world

Megan BrownChildren’s Defense Fund Minnesota

Megan BrownChildren’s Defense Fund Minnesota

“Children who get a healthy start in life are more likely to reach their full potential, with benefits for themselves, their families and society as a whole.”

-State of the World’s MothersSave the Children, 2007

“Children who get a healthy start in life are more likely to reach their full potential, with benefits for themselves, their families and society as a whole.”


Infant MortalityInfant Mortality

Every day, 28,000 children under 5 die

10 million children annually

40% of those are newborns in their first month

2 million die on the day they are born

Every day, 28,000 children under 5 die

10 million children annually

40% of those are newborns in their first month

2 million die on the day they are born

“Using existing tools and knowledge, we could save more than 6 million of the 10 million children who die

every year from easily preventable or treatable

causes.”

“Using existing tools and knowledge, we could save more than 6 million of the 10 million children who die

every year from easily preventable or treatable

causes.”

Infant MortalityInfant Mortality• Trends

– Historical– Geographical

• Less Developed Countries– Causes– Responses

• More Developed Countries: U.S.– Causes– Responses

• Trends– Historical– Geographical

• Less Developed Countries– Causes– Responses

• More Developed Countries: U.S.– Causes– Responses

Historical TrendsHistorical Trends

• Prior to 1900, infant mortality rates of two and three hundred per 1,000 births

• Fluctuated sharply– Weather– Harvest– War– Epidemic disease

• Anthropologists have found groups that do not name children until they have survived a year.

• Prior to 1900, infant mortality rates of two and three hundred per 1,000 births

• Fluctuated sharply– Weather– Harvest– War– Epidemic disease

• Anthropologists have found groups that do not name children until they have survived a year.

Historical TrendsHistorical Trends

• 1900 – Industrial Revolution• New attitudes, behaviors and

advancements brought shift in infant mortality rates

• Geographic, economic disparities persist

• 1900 – Industrial Revolution• New attitudes, behaviors and

advancements brought shift in infant mortality rates

• Geographic, economic disparities persist

Infant Mortality Rates, 1900Infant Mortality Rates, 1900




Global Regional VariationGlobal Regional Variation1960s 1970s 1980s 1990s

Absolute Change

Percent Change

East Asia & Pacific 94 65 48 39 -55 -58.6

Europe & Central Asia n.a. n.a. 35 26 n.a. n.a.

Latin America & Caribbean 95 73 52 35 -60 -62.9

Middle East & North Africa 153 117 76 54 -100 -64.9

South Asia 151 132 106 81 -70 -46.2

Sub-Saharan Africa 151 126 107 96 -55 -36.3

High Income 26 16 10 7 -19 -73.7

• Nine of the 10 countries with the highest IMR are in Sub-Saharan Africa– Afghanistan is the tenth

• IMR sky-rocketing in the Middle East – Iraq: 1990 (50); 2005 (125)

• Nine of the 10 countries with the highest IMR are in Sub-Saharan Africa– Afghanistan is the tenth

• IMR sky-rocketing in the Middle East – Iraq: 1990 (50); 2005 (125)

Global Infant MortalityGlobal Infant Mortality

• 198 in 1960; 83 in 2001• Significant disparity between Less

Developed Countries (LDC) and More Developed Countries (MDC)– LDC (91); MDC (8)– 10X higher for LDC than MDC– 17X higher for Least Developed

Countries than MDC– Reductions overall, but more for MDC

• 198 in 1960; 83 in 2001• Significant disparity between Less

Developed Countries (LDC) and More Developed Countries (MDC)– LDC (91); MDC (8)– 10X higher for LDC than MDC– 17X higher for Least Developed

Countries than MDC– Reductions overall, but more for MDC

Per Capita Income and Infant Mortality

Per Capita Income and Infant Mortality

Two Sides of Infant MortalityTwo Sides of Infant Mortality

Less/Least Developed Countries v. More Developed Countries

Our responses depend on the causes, and the causes depend on the nation…

Less/Least Developed Countries v. More Developed Countries

Our responses depend on the causes, and the causes depend on the nation…

Infant Mortality in Less Developed Countries

Infant Mortality in Less Developed Countries

ViolenceViolence• Due to armed conflicts

over the past decade, – two million children were

killed,– six million were seriously

injured or permanently disabled,

– 12 million were left homeless,

– millions more orphaned.

• Refugee camps– disrupt home life– affect nutritional intake– expose children to infections

• Due to armed conflicts over the past decade, – two million children were

killed,– six million were seriously

injured or permanently disabled,

– 12 million were left homeless,

– millions more orphaned.

• Refugee camps– disrupt home life– affect nutritional intake– expose children to infections

PovertyPoverty

• Children born in the developing world have a 4 in 10 chance of living in extreme poverty.

• In 1998 over half a billion children lived on less than $1 a day.

• Children born in the developing world have a 4 in 10 chance of living in extreme poverty.

• In 1998 over half a billion children lived on less than $1 a day.

Total world population living off less than US$1 per dayby region 1981-2001

East Asia

Eastern Europe & Central Asia

Latin America and Caribbean

Middle East and N. Africa

South Asia

Sub-Saharan Africa

0

200

400

600

800

1000

1200

1400

1600

1981 1984 1987 1990 1993 1996 1999 2001

Tota

l popula

tion (

m)

Source: Economic and Social Research Council

Family SizeFamily Size• Children in larger families receive smaller

share of family resources.– More likely to be malnourished.

• Girls are often given fewer family resources, including medical care and food, than boys.

• Children in larger families receive smaller share of family resources.– More likely to be malnourished.

• Girls are often given fewer family resources, including medical care and food, than boys.

Mother’s Educational LevelMother’s Educational Level

• Adult female literacy rate – In countries where the adult female literacy rate

is higher, the IMR is consistently lower. • Mozambique: female literacy rate (23 percent), IMR

(130) • Tanzania: female literacy rate (57 percent), IMR (92)

• Delayed marriage and first birth – Babies born to women in their 20s and 30s have

a lower risk than those born to women younger than 20.

• Family planning and smaller families – Reproductive health care for themselves– Take better care of their children’s health needs.

• Adult female literacy rate – In countries where the adult female literacy rate

is higher, the IMR is consistently lower. • Mozambique: female literacy rate (23 percent), IMR

(130) • Tanzania: female literacy rate (57 percent), IMR (92)

• Delayed marriage and first birth – Babies born to women in their 20s and 30s have

a lower risk than those born to women younger than 20.

• Family planning and smaller families – Reproductive health care for themselves– Take better care of their children’s health needs.

HIV/AIDSHIV/AIDS• Increasing impact on children of all ages

– 4.3 million children under age 15 had died of AIDS (12/03)

– In 2000, 1.4 million children under 15 years of age were living with HIV/AIDS, up from 830,000 in 1996.

• One million live in sub-Saharan Africa• 1,600 children infected each day. • Mother-to-child transmission of HIV during pregnancy, birth,

or breastfeeding accounts for more than 90 percent of all infections in children.

– One-third of infants born to HIV-infected mothers become infected.

• Children orphaned by AIDS– More than 13 million children lost either their mother

or both parents by the end of 1999. • Ninety percent in sub-Saharan Africa

– Likely to be malnourished

• Increasing impact on children of all ages– 4.3 million children under age 15 had died of AIDS

(12/03) – In 2000, 1.4 million children under 15 years of age

were living with HIV/AIDS, up from 830,000 in 1996. • One million live in sub-Saharan Africa• 1,600 children infected each day. • Mother-to-child transmission of HIV during pregnancy, birth,

or breastfeeding accounts for more than 90 percent of all infections in children.

– One-third of infants born to HIV-infected mothers become infected.

• Children orphaned by AIDS– More than 13 million children lost either their mother

or both parents by the end of 1999. • Ninety percent in sub-Saharan Africa

– Likely to be malnourished

Illness & DiseaseIllness & Disease

• 70% caused by preventable, treatable diseases– Respiratory infections– Diarrhea– Malaria– Measles

• The physical environment is responsible for one-fourth of all preventable disease– Water supply– Sanitation– Urban versus rural resources

• 70% caused by preventable, treatable diseases– Respiratory infections– Diarrhea– Malaria– Measles

• The physical environment is responsible for one-fourth of all preventable disease– Water supply– Sanitation– Urban versus rural resources

Physical EnvironmentPhysical Environment• Safe drinking water and sanitation

– Over one billion people lacked access to safe drinking water in 2000

– Inadequate sanitation, unsafe drinking water, air pollution and crowdingmalnutrition, diarrhea and acute respiratory

infections

• Urban versus rural resources– Urban residents have greater access to

medical surveys and educational campaigns• Large-scale campaigns have constituted the most

recent child health initiatives• In Bolivia the child mortality rate in rural areas in

1998 was 134, versus 72 in urban areas.

• Safe drinking water and sanitation– Over one billion people lacked access to safe

drinking water in 2000– Inadequate sanitation, unsafe drinking water,

air pollution and crowdingmalnutrition, diarrhea and acute respiratory

infections

• Urban versus rural resources– Urban residents have greater access to

medical surveys and educational campaigns• Large-scale campaigns have constituted the most

recent child health initiatives• In Bolivia the child mortality rate in rural areas in

1998 was 134, versus 72 in urban areas.

ResponsesResponses

• Ensure the well-being of mothers• Invest in basic, low-cost solutions to

save children’s lives• Expand the availability of health care• Increase the use of basic, lifesaving

services • Increase government support for

proven solutions

• Ensure the well-being of mothers• Invest in basic, low-cost solutions to

save children’s lives• Expand the availability of health care• Increase the use of basic, lifesaving

services • Increase government support for

proven solutions-State of the World’s Mothers, Save the Children, 2007

Ensure the well-being of mothers

Ensure the well-being of mothers

• Nutrition– Stronger mothers– Fewer birth

complications– Healthier babies

• Skilled care during childbirth

• Family planning

• Nutrition– Stronger mothers– Fewer birth

complications– Healthier babies

• Skilled care during childbirth

• Family planning

Family PlanningFamily Planning

• Could prevent one in four of the deaths in children under five by helping women to space births at least two years apart. – Can also improve the

survival of the next sibling.

• Helps women to have children during their healthiest reproductive years

• Enables couples to have their desired number of children

• Could prevent one in four of the deaths in children under five by helping women to space births at least two years apart. – Can also improve the

survival of the next sibling.

• Helps women to have children during their healthiest reproductive years

• Enables couples to have their desired number of children

The United States, through the U.S. Agency for International Development (USAID), provides voluntary family planning and reproductive health services in over 60 developing countries. According to USAID, 50 million couples in the developing world use family planning directly as a result of its efforts.

Invest in basic, low-cost solutions

Invest in basic, low-cost solutions

• Antibiotics– Newborn sepsis– Pneumonia

• Insecticide-treated mosquito nets• Oral rehydration therapy• Breastfeeding

• Antibiotics– Newborn sepsis– Pneumonia

• Insecticide-treated mosquito nets• Oral rehydration therapy• Breastfeeding

“Recent analysis has shown that nearly 3 million of…newborn deaths could be prevented annually by improving access to basic, cost-effective interventions that are not yet reaching those who need them most.”


Oral rehydration Therapy (ORT)Oral rehydration Therapy (ORT)

• Low-cost, low-technology method to control diarrhea

• Prepackaged mixture of salts and sugars combined with water – Replaces fluid and

salts lost through diarrhea

• Throughout the 1990s, it was used in 80 percent of all episodes.

• Low-cost, low-technology method to control diarrhea

• Prepackaged mixture of salts and sugars combined with water – Replaces fluid and

salts lost through diarrhea

• Throughout the 1990s, it was used in 80 percent of all episodes.

Increased BreastfeedingIncreased Breastfeeding• One of the most cost-effective interventions

– Saves the lives of six million infants every year

• One of the most cost-effective interventions – Saves the lives of six million infants every year

Increased BreastfeedingIncreased Breastfeeding

• If a child is breastfed for six months, she is significantly less likely to contract or die from diarrhea and acute respiratory infections.

• Beyond 6 months, breastfed alongside age-appropriate feeding – Almost one-fifth of all child deaths– Save an additional two million children

each year

• If a child is breastfed for six months, she is significantly less likely to contract or die from diarrhea and acute respiratory infections.

• Beyond 6 months, breastfed alongside age-appropriate feeding – Almost one-fifth of all child deaths– Save an additional two million children

each year

Expand the availability of health care

Expand the availability of health care

• Trained health workers– Urban and rural

• Basic newborn care– Home visits

• Mass media, public education campaigns– Promote healthy behaviors– Raise awareness

• Trained health workers– Urban and rural

• Basic newborn care– Home visits

• Mass media, public education campaigns– Promote healthy behaviors– Raise awareness

Increase use of basic, lifesaving services

Increase use of basic, lifesaving services

• Community case management linked to local health facilities

• Community education and mobilization

Encourage family members to use lifesaving, home-based

practices to care for their infant.

• Community case management linked to local health facilities

• Community education and mobilization

Encourage family members to use lifesaving, home-based

practices to care for their infant.

Increase government support for proven solutions

Increase government support for proven solutions

• Basic education• HIV/AIDS awareness• Family planning

– Funding– Policies

• Basic education• HIV/AIDS awareness• Family planning

– Funding– Policies

U.S. Cuts in International Family Planning

U.S. Cuts in International Family Planning

• Funding– Level- funded since 2001– President Bush’s 2007 budget: 18 percent

reduction• $357 million, well below the 2006 level of $440 million

– Highest levels in 1995 ($541 million)• With inflation, 30 percent reduction• Funding should be $865 million

• "Mexico City Policy" / “Global gag rule”– Denies USAID funds to overseas clinics that

perform abortions, provide abortion counseling and referral, or lobby to make abortion legal.

– Clinics have closed or cut staff and services, including HIV screening, voluntary counseling and education.

– USAID has stopped shipment of condoms to 16 countries because the sole recipients – local family planning organizations – have refused to sign on to the gag rule.

• Funding– Level- funded since 2001– President Bush’s 2007 budget: 18 percent

reduction• $357 million, well below the 2006 level of $440 million

– Highest levels in 1995 ($541 million)• With inflation, 30 percent reduction• Funding should be $865 million

• "Mexico City Policy" / “Global gag rule”– Denies USAID funds to overseas clinics that

perform abortions, provide abortion counseling and referral, or lobby to make abortion legal.

– Clinics have closed or cut staff and services, including HIV screening, voluntary counseling and education.

– USAID has stopped shipment of condoms to 16 countries because the sole recipients – local family planning organizations – have refused to sign on to the gag rule.

More Developed CountriesMore Developed Countries

IMR and the Industrial Revolution

IMR and the Industrial Revolution

• Rates have been steadily decreasing

• Major decline in 20th century

• Attributed to– Cleanliness– Sewage systems– Central heating– Clean drinking water– More food– Cheaper clothing– Use of hospitals– Antibiotics and

vaccines

Infant Mortality in the U.S.Infant Mortality in the U.S.

• 2004– 27,936 infant deaths– More than all child/teen

deaths combined (25,325)

– 42nd in the world (2005)• 36th (2002)• 28th (1998)

• 2004– 27,936 infant deaths– More than all child/teen

deaths combined (25,325)

– 42nd in the world (2005)• 36th (2002)• 28th (1998)

1 Singapore 2.3

2 Sweden 2.76

3 Japan 2.80

4 Hong Kong 2.94

5 Iceland 3.27

6 France 3.41

7 Finland 3.52

8 Norway 3.64

9 Malta 3.82

10 Czech Rep. 3.86

11 Andorra 4.03

12 Germany 4.08

23 Canada 4.63

29 U.K. 5.01

42 U.S. 6.37

The U.S. spends more on health care than any other

country, but our infant survival rate is lower than

that of most other industrialized nations.

The U.S. spends more on health care than any other

country, but our infant survival rate is lower than

that of most other industrialized nations.

The United States has the second worst

newborn mortality rate

in the developed

world.

U.S. Infant Mortality Rates, 2004

U.S. Infant Mortality Rates, 2004

Racial Disparities: U.S.Racial Disparities: U.S.Infant Deaths, by Race

48%

29%

19%

4%

Non-Hispanic White

Non-Hispanic Black

Hispanic

Other

Births, by Race

56%

14%

23%

7%

2004 Rates• Non-Hispanic white: 5.7• Non-Hispanic black: 13.8• Hispanic: 5.6• American Indian: 8.9• Asian/Pacific Islander: 3.6

2004 Rates• Non-Hispanic white: 5.7• Non-Hispanic black: 13.8• Hispanic: 5.6• American Indian: 8.9• Asian/Pacific Islander: 3.6

At any age, and at any income, education or socioeconomic level, an African American mother is twice as likely to lose her infant than a white woman.

Causes: U.S.Causes: U.S.Primary Causes of Infant Deaths, 2004

Congenital malformations, deformations and chromosomal abnormalities 20.1%

Disorders related to short gestation and low birth weight, not elsewhere classified 16.6%

Sudden Infant Death Syndrome (SIDS) 8.0%

Newborn affected by maternal complications of pregnancy 6.1%

Accidents (unintentional injuries) 3.8%

Newborn affected by complications of placenta, cord and membranes 3.7%

Respiratory distress of newborn 3.1%

Bacterial sepsis of newborn 3.0%

Neonatal hemorrhage 2.2%

Diseases of the circulatory system 2.1%

All other causes 31.2%

Each year, well over half of infant deaths from all causes involve LBW

babies.

Each year, well over half of infant deaths from all causes involve LBW

babies.

Low Birth Weight Babies, 2004

Low Birth Weight Babies, 2004

Contributing FactorsContributing Factors

• Health of Baby– LBW– Birth Defects– Disease/Illness

• Health of Mother– High-risk pregnancy– Poor nutrition– Obesity

• Poverty• Health Insurance

– Reduced access to care– Lack of insurance

• Health of Baby– LBW– Birth Defects– Disease/Illness

• Health of Mother– High-risk pregnancy– Poor nutrition– Obesity

• Poverty• Health Insurance

– Reduced access to care– Lack of insurance

ResponsesResponses

• Address Disparities in Infant Mortality• Provide Pre-Pregnancy Education and

Counseling• Ensure Timely Prenatal Care for All Women• Expand Access to Medical Care for Infants

in the First Month of Life (Neonatal)• Expand Access to Well-baby Care and

Parenting Education• Expand Programs for the Prevention of

Child Abuse and Neglect-Annie E. Casey Foundation

• Address Disparities in Infant Mortality• Provide Pre-Pregnancy Education and

Counseling• Ensure Timely Prenatal Care for All Women• Expand Access to Medical Care for Infants

in the First Month of Life (Neonatal)• Expand Access to Well-baby Care and

Parenting Education• Expand Programs for the Prevention of

Child Abuse and Neglect-Annie E. Casey Foundation

Address DisparitiesAddress Disparities

• Support research on the medical, socioeconomic and behavior factors that affect infant mortality, esp. low birth weight – African American and Puerto Rican

babies most severely affected– Medical advances increase survival– Incidences of LBW are the same

• Support research on the medical, socioeconomic and behavior factors that affect infant mortality, esp. low birth weight – African American and Puerto Rican

babies most severely affected– Medical advances increase survival– Incidences of LBW are the same

The cost of a premature baby's hospital care can reach over a quarter-of-a-million

dollars. A full-term healthy newborn costs a few thousand dollars.

Address DisparitiesAddress Disparities

– African American mothers only 40% as likely to breastfeed as other mothers

• Accounts for higher rates of infant mortality

– Campaign– Research

• Improve education• Workplace policies

– African American mothers only 40% as likely to breastfeed as other mothers

• Accounts for higher rates of infant mortality

– Campaign– Research

• Improve education• Workplace policies

• Promote breastfeeding, with an emphasis on African American mothers• Promote breastfeeding, with an emphasis on African American mothers

Pre-Pregnancy Counseling and Education

Pre-Pregnancy Counseling and Education

• Health education and preconception counseling– Expectant mothers – Unplanned pregnancies

• Education about positive and negative behaviors that impact health of baby

• Effective monitoring and treatment of chronic diseases– Hypertension, diabetes, renal disease, urogenital

infactions– Addresses disparities (African American women)

• Health education and preconception counseling– Expectant mothers – Unplanned pregnancies

• Education about positive and negative behaviors that impact health of baby

• Effective monitoring and treatment of chronic diseases– Hypertension, diabetes, renal disease, urogenital

infactions– Addresses disparities (African American women)

Prenatal CarePrenatal Care

• Infant mortality is 50 percent higher for children born into families in poverty

• Decreased access to prenatal care– Low-income women– Segregated rural and urban

areas– Racial/ethnic minorities

• First trimester

• Infant mortality is 50 percent higher for children born into families in poverty

• Decreased access to prenatal care– Low-income women– Segregated rural and urban

areas– Racial/ethnic minorities

• First trimester

Prenatal CarePrenatal Care• Address barriers to prenatal care

– Medically underserved areas

– Regular source of care (Outpatient, ER)

– Culturally competent providers

• Ensure that all eligible individuals receive Medicaid and SCHIP services– Covering All Families

(www.coveringallfamilies.org)

• Address barriers to prenatal care– Medically underserved

areas– Regular source of care

(Outpatient, ER)– Culturally competent

providers• Ensure that all eligible individuals

receive Medicaid and SCHIP services– Covering All Families

(www.coveringallfamilies.org)

Infant Mortality in the 1990sInfant Mortality in the 1990s

Infant Medical CareInfant Medical Care• Expand access to neonatal intensive care• Timely, appropriate treatment for congenital

anomalies– Birth defects cause 1 in 4 deaths

• 1 in 3 are heart defects

– Improvements in surgical treatment

• Reduce the incidence of respiratory distress syndrome– Preterm babies (less than 3 1/3 lbs, earlier than 32

wks)• 40,000 develop it each year; 1,400 die

– Surfactant treatment– Reduce LBW incidence

• Expand access to neonatal intensive care• Timely, appropriate treatment for congenital

anomalies– Birth defects cause 1 in 4 deaths

• 1 in 3 are heart defects

– Improvements in surgical treatment

• Reduce the incidence of respiratory distress syndrome– Preterm babies (less than 3 1/3 lbs, earlier than 32

wks)• 40,000 develop it each year; 1,400 die

– Surfactant treatment– Reduce LBW incidence

Well-baby Care and Parenting Education

Well-baby Care and Parenting Education

• SIDS public education campaign– “Back to Sleep” campaign– Target communities

• American Indian 2X higher than whites• African American also higher than whites

• Well-baby and sick-baby care– Early detection and treatment of

influenza and pneumonia– Access through SCHIP or Medicaid

• SIDS public education campaign– “Back to Sleep” campaign– Target communities

• American Indian 2X higher than whites• African American also higher than whites

• Well-baby and sick-baby care– Early detection and treatment of

influenza and pneumonia– Access through SCHIP or Medicaid

Accessing Health InsuranceAccessing Health Insurance• Covering All Families• SCHIP Reauthorization

– Bush - $5 million• Kick off 1 to 2 million currently covered

kids

– Senate - $35 million• Cover 3 to 4 million uninsured kids

• Covering All Families• SCHIP Reauthorization

– Bush - $5 million• Kick off 1 to 2 million currently covered

kids

– Senate - $35 million• Cover 3 to 4 million uninsured kids

“In 2004, Gov. Haley Barbour came to office promising not to raise taxes and to cut Medicaid. Face-to-face meetings were required for annual re-enrollment in Medicaid and CHIP, the children’s health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.

As a result, the number of non-elderly people, mainly children, covered by the Medicaid and CHIP programs declined by 54,000 in the 2005 and 2006 fiscal years.

According to the Mississippi Health Advocacy Program in Jackson, some eligible pregnant women were deterred by the new procedures from enrolling. “

-Erik EckholmNew York Times

Accessing Health InsuranceAccessing Health Insurance

• Legislation– Children’s Health Security Act

• Cover 80,000 uninsured in MN, option for all kids

– All Healthy Children Act• Cover 9 million uninsured kids, option for all

kids

• Legislation– Children’s Health Security Act

• Cover 80,000 uninsured in MN, option for all kids

– All Healthy Children Act• Cover 9 million uninsured kids, option for all

kids“The CHSA…[would] change the way we provide health care coverage for children to a system analogous to public education – all children would have access to health care coverage just as all children are guaranteed a public education.”

-Carole SpecktorCDF-MN

Expand Programs for the Prevention of Child Abuse and Neglect

Expand Programs for the Prevention of Child Abuse and Neglect

• SIDS decreasing, deaths from abuse increasing– 1% to 5% of SIDS cases as infanticide

• Provide services to parents at risk for child abuse and neglect– Emergency services for distraught parents– Education for teen parents and single mothers on

babies’ needs and vulnerabilities

• Legal alternatives to desperate parents– Abandonment– Laws that allow parents to avoid prosecution for

child abandonment by leaving their babies in safe places such as hospital emergency rooms

• SIDS decreasing, deaths from abuse increasing– 1% to 5% of SIDS cases as infanticide

• Provide services to parents at risk for child abuse and neglect– Emergency services for distraught parents– Education for teen parents and single mothers on

babies’ needs and vulnerabilities

• Legal alternatives to desperate parents– Abandonment– Laws that allow parents to avoid prosecution for

child abandonment by leaving their babies in safe places such as hospital emergency rooms

SummarySummary• 10 million children under 5

die annually, 40% are newborns

• IMR decreasing through time– Geographic, economic

disparities persist• Less developed countries

– Easily preventable causes– Health care, education, family

planning• More developed countries

(U.S.)– Worst outcomes for MDC– Racial/ethnic disparities– Low birth weight, maternal

health

• 10 million children under 5 die annually, 40% are newborns

• IMR decreasing through time– Geographic, economic

disparities persist• Less developed countries

– Easily preventable causes– Health care, education, family

planning• More developed countries

(U.S.)– Worst outcomes for MDC– Racial/ethnic disparities– Low birth weight, maternal

health

Bottom line: This is a solvable problem!

Bottom line: This is a solvable problem!

`

“We should expect

more and we should do better,

and we need to look at every

aspect that we can

influence, that we can

control, that could

help improve the chance that a baby who is born can

live.”

Thank you for coming…

Documents

Infant Mortality