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  • Title: Neonatal mortality in Meerut district.
    Author: Garg SK, Mishra VN, Singh JV, Bhatnagar M, Chopra H, Singh RB.
    Journal: Indian J Med Sci; 1993 Sep; 47(9):222-5. PubMed ID: 8112786.
    Abstract:
    A study of neonatal mortality in Meerut district revealed an infant mortality rate of 50.1 per 1000 live births. Neonatal mortality accounted for 37.8% of infant mortality with a neonatal mortality rate of 19.0 per 1000 live births. 90.5% of these neonates were delivered at home largely by untrained personnel (57.2%). Only 28.6% of these neonates were treated by qualified doctors and only 30.9% of their mothers were fully immunized against tetanus. At least 2/3rd of neonatal mortality was due to exogenous factors with tetanus neonatorum and septicaemia being the principal causes of mortality each accounting for a mortality rate of 4.7 per 1000 live births. A household survey of neonatal mortality was conducted during 1991 in Meerut District, about 70 km from Delhi in Uttar Pradesh, India. The sample included 2211 infants from 30 clusters, which included 111 deaths in the first year of life for data collected during November 12-19, 1991. The estimate of infant mortality rate was 50.1/1000 live births. There were 42 neonatal deaths--a neonatal rate of 19.0/1000 live births. 90.5% of neonates were home deliveries. 45.3% were delivered by an untrained birth attendant and 30.9% were delivered by a trained birth attendant. 11.9% were delivered by a family member. 42.8% of neonates who died did not receive treatment for an illness before their death. 11.9% of neonates, who died but received some treatment, were treated in hospitals. 66.7% of mothers had knowledge about prenatal immunization against tetanus, but only 30.9% received complete immunization, and 23.8% had one dose of tetanus toxoid vaccine. The most common causes of death were attributed to septicemia and neonatal tetanus infections (21.4% of neonatal deaths). Other causes of neonatal death were infantile diarrhea (11.9%), prematurity (9.5%), congenital anomalies (9.5%), pneumonia (7.2%), and birth asphyxia, meningitis, burn injury, and Rh incompatibility (2.4% each). This study in 1991 shows that neonatal mortality declined over the prior 10 years. However, outreach of qualified medical staff into this rural community was still limited. Knowledge of some health practices, such as immunization, was evident, but the service component was inadequate. This study confirms that exogenous factors contributed to at least 66% of neonatal deaths. These deaths could have been averted with proper and timely maternal and child health care services.
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