Do Mothers with Lower Socioeconomic Status Contribute to the Rate of All-Cause Child Mortality in Kazakhstan?

Factors associated with maternal mortality in Kazakhstan: a pre- and during-pandemic comparison

Introduction

The maternal mortality indicator serves as a crucial reflection of a nation's overall healthcare, economic, and social standing. It is necessary to identify the variations in its impacts across diverse populations, especially those at higher risk, to effectively reduce maternal mortality and enhance maternal health. The global healthcare landscape has been significantly reshaped by the COVID-19 pandemic, pressing disparities and stalling progress toward achieving Sustainable Development Goals, particularly in maternal mortality reduction.

Methods

This study investigates the determinants of maternal mortality in Kazakhstan from 2019 to 2020 and maternal mortality trends in 17 regions from 2000 to 2020, employing data extracted from national statistical reports. Stepwise linear regression analysis is utilized to explore trends in maternal mortality ratios in relation to socioeconomic factors and healthcare service indicators.

Results

The national maternal mortality ratio in Kazakhstan nearly tripled from 13.7 in 2019 to 36.5 per 100,000 live births in 2020. A remarkable decrease was observed from 2000 until around 2015 with rates spiked by 2020. Significant factors associated with maternal mortality include antenatal care coverage and the number of primary healthcare units. Additionally, socioeconomic factors such as secondary education enrollment and cases of domestic violence against women emerged as predictors of MMR. Moreover, the impact of the pandemic was evident in the shift of coefficients for certain predictors, such as antenatal care coverage in our case. In 2020, predictors of MMR continued to include secondary education enrollment and reported cases of domestic violence.

Conclusion

Despite Kazakhstan's efforts and commitment toward achieving Sustainable Development Goals, particularly in maternal mortality reduction, the impact of the COVID-19 pandemic poses alarming challenges. Addressing these challenges and strengthening efforts to mitigate maternal mortality remains imperative for advancing maternal health outcomes in Kazakhstan.

Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria

BACKGROUND

The current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity. However, case-specific fatality which defines the risk of dying from these and other neonatal morbidities is rarely emphasized. Determination of case-specific fatality rates (CSFR) may inform a change in our current approach to neonatal care interventions which may eventually bring about the much-needed reduction in our neonatal mortality rate. Our aim was to determine the case-specific fatality rates for the common causes of mortality among hospitalized neonates at the National Hospital Abuja (NHA).

METHODS

Relevant demographic and clinical data on all neonates admitted into the NICU at the NHA over a period of 13 months (January 2017 to February 2018) were extracted from the Neonatal Registry database and analyzed using appropriate statistical methods with the SPSS version 20 software. The case-specific fatality rates were computed for the predominant morbidities in addition to determination of the neonatal mortality rates and associated risk factors.

RESULTS AND CONCLUSION

A total of 730 neonates were admitted, out of which 391 (53.6%) were females, 396 (54.5%) were inborn and 396 (54.2%) were term. The three most prevalent morbidities were prematurity 272(37.2%), neonatal Jaundice 208(28.4%) and perinatal asphyxia 91(12.5%) while the most common causes of mortality were prematurity 47/113(41.6%), congenital malformations 27/113(23.9%) and perinatal asphyxia 26/113(23%). Congenital malformations had the highest case-specific fatality 27/83(32.5%) followed by Perinatal Asphyxia 26/91(28.6%) and prematurity 47/272(20.7%). The mortality pattern differed between inborn and out born babies. Implications of these case-specific fatality rates for targeted interventions are discussed.

Forecasting Maternal Complications Based on the Impact of Gross National Income Using Various Models for Rwanda

Introduction

Preferably maternal mortalities are predominant in low- and middle-income countries (LMICs). In some African countries, including Rwanda, programs related to health-care delivery to reduce significantly severe complications including mortalities are established. Unfortunately, historical and forecasted maternal mortality reduction and the influence of gross national income (GNI) were not accessed. This study is aimed to forecast the three years of maternal mortalities (MMs) based on the influence of gross national income (GNI) in Rwanda.

Methods

The period involved is from January 2009 to April 2018. Data analyzed were obtained from the Central Hospital of the University of Kigali (CHUK) and mined data from the WHO database. Time series approach (Box-Jenkins and exponential smoothing) and linear regression models were applied. Besides, IBM-SPSS and Eviews were used in the analysis.

Results

The results revealed that MMs were not statistically different in several years, and there was a significant correlation between MMs and GNI (-0.610, P value 0.012 < 0.05). A double exponential smoothing model (DESM) was fitted for the best forecast and ARIMA (0,1,0) and linear regression models for a quick forecast.

Conclusion

There was a slight effect of GNI in maternal mortality reduction, which leads to the steady decrease of the forecasted maternal mortality up to May 2021. The Government of Rwanda should intensively strengthen the health-care system, save the children programs, and support pregnant women by using GNI for reducing MMs at an advanced level.

Determinants of Subjective Health, Happiness, and Life Satisfaction among Young Adults (18-24 Years) in Guyana

Abstract. Persistent urban-rural disparity in subjective health and quality of life is a growing concern for healthcare systems across the world. In general, urban population performs better on most health indicators compared with their rural counterparts. However, research evidence on the urban-rural disparity on perceived health, happiness, and quality of life among the young adult population is scarce in South American countries like Guyana. Therefore, in the present study we aimed to investigate whether subjective health, happiness, and quality of life differ according to place of residence among the young adult population in Guyana.