A comparative analysis of infant mortality in major Ohio cities: significance of socio-biological factors

"Using linked birth and infant death records for Ohio for the 1984-87 birth cohorts, this paper examines differentials in neonatal, postneonatal, and infant mortality rates in four major Ohio cities....It was found that, compared to Toledo, Cleveland had 51% higher risk of infant death, Cincinnati had 45% higher risk, [and] Columbus had 13% higher risk of infant death. Although in each of these cities, black infants had significantly higher risk of death than white infants, controlling for race alone reduced but did not eliminate the infant mortality differentials among the cities. The results of the hazards analyses reveal that maternal education, marital status, maternal age, birth order, prenatal care, gestational age, and birth weight had a profound net impact on the risk of infant death and that, even after controlling for these and other maternal and infant characteristics, significant city differentials persisted in infant mortality."

Promoting family planning for better health: policy and programme implications

Renewed emphasis is being given to the role of family planning health care programs. This review of the lessons learned during the past decade provides guidance to policy makers and program managers on ways to improve maternal, infant, and child health through family planning and related health and development activities. It covers policies and laws, accessibility to services, acceptability and quality of services, provision for the special needs of high-risk groups, the use of communications programs, the importance of improving the status of women and the quality of life, and the resources needed to implement such a program globally. Practical steps for integrating family planning fully into maternal and child health care are described.

Technologies -- appropriate and inappropriate

People often think that "technology" means "machines". But according to WHO a technology is an association of methods, procedures, techniques, and equipment which, together with the people using them, can contribute to solving a health problem. An appropriate technology is one that is scientifically sound, adapted to local needs, acceptable to those who use it or for whom it is used, and that can be maintained and utilized with resources that the community can afford. Many different technologies have contributed enormously to reducing maternal and perinatal mortality and morbidity. Yet, very often, not enough attention is paid to the economic, human, and infrastructure implications of the technology or to the implications of introducing it into a new setting. This issue of Safe Motherhood looks at some of the technologies currently widely available in maternal and neonatal health care and asks two simple questions. Has this technology been evaluated in different settings? And at which level of the health care system can this technology be used appropriately?