• Child Health Nursing Research
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• 제26권4호
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• pp.463-469
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• 2020

Reduction of the under-5 mortality rate is a target of the Sustainable Development Goals. Therefore, this study aimed to estimate under-5 child mortality rates in 52 low-migration countries using population data. The study utilized population data from the US Census Bureau from 1990 to 2015. The method involved first estimating mortality rates for countries with negligible net migration and then applying these rates to countries with matching mortality profiles, where it is reasonable to assume that migration is negligible for children under the age of 5 years. The highest child mortality was concentrated in the African region, followed by Asia and the Western region. However, steady progress in child mortality trends was concentrated in low-income countries. This simple method demonstrated that child mortality has significantly improved in high-income countries, followed by middle- and low-income countries. To reduce the under-5 mortality rates even further in these 52 countries, there is a need to accelerate equitable plans and policies related to child health to promote children's longevity and survival.

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.336-342
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• 2014

Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

• 한국인구학
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• 제23권2호
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• pp.143-166
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• 2000

이 연구는 상이한 성선호의 문화적 전통을 지닌 인종집단들을 대상으로 하여 의료수준과 유아사망력의 관계를 파악하기 위한 것이다 이를 위해 1990년 중국인구센서스 중에서 연변자치 주에 거주하는 조선족과 한족 그리고 서쌍판납자치주의 한족과 다이족의 원자료를 활용하였다. 이 논문은 성선호, 사회경제적 수준, 의료수준과 유아의 성별 차별사망력의 관계를 설명하기 위한 새로운 모형을 제시하고 있다. 의료인력이 널리 가용한 지역사회에서는 유아사망력의 수준이 성선호에 의하여 영향받을 가능성이 낮다. 그러나 지역사회의 의료수준이 낮으면, 특정한 성을 선호하는 경향이 강한 인종집단의 구성원들은 선호하는 성의 자녀들의 생존을 위하여 모든 노력을 기울이게 될 것이다. 이에 반해서 부모들이 선호하지 않는 성의 자녀생존을 위한 행위들은 이에 수 반되는 비용이나 여러 가지 조건들에 의하여 영향을 받게될 것이다. 따라서 선호하는 성의 유아사망력의 수준은 선호하지 않는 성의 그것에 비해 월등히 낮을 가능성이 크다. 그러나 사회경제적 발전과정에서 의료수준이 향상되고 이에 수반되는 비용이 낮아지면, 선호하지 않는 성의 유아사망력은 급격히 감소하고 성별 사망력의 차이는 줄어드는 경향을 보이게 된다. 이 연구에서 강한 남아선호관을 지닌 조선족 및 한족과, 반대로 여아를 선호하는 경향이 강한 다이족의 유아사망력을 분석한 결과는 이러한 명제들을 뒷받침 해준다.

• Journal of Preventive Medicine and Public Health
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• 제39권6호
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• pp.469-476
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• 2006

Objectives : To investigate the effect of parents' social class on infant and child mortality rates among the birth cohort, for the period of transition to and from the Koran economic crisis 1995-2004. Methods : All births reported to between 1995 and 2004 (n=5,711,337) were analyzed using a Cox regression model, to study the role of the social determinants of parents in infant and child mortality. The results were adjusted for the parents' age, education and occupation, together with mother's obstetrical history. Results. The crude death rate among those under 10 was 3.71 per 1000 births (21,217 deaths among 5,711,337 births) between 1995 and 2004. The birth cohorts from lower educated parents less than elementary school showed higher mortality rates compared with those from higher educated parents over university level (HR:3.0 (95%CI:2.8-3.7) for father and HR:3.4 (95%CI:3.3-4.5) for mother). The mother's education level showed a stronger relationship with mortality among the birth cohort than that of the fathers. The gaps in infant mortality rates by parents' social class, and educational level became wider from 1995 to 2004. In particular, the breadth of the existing gap between higher and lower parents' social class groups has dramatically widened since the economic crisis of 1998. Discussions : This study shows that social differences exist in infant and child mortality rates. Also, the gap for the infant mortality due to social class has become wider since the economic crisis of 1998.

• Child Health Nursing Research
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• 제15권1호
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• pp.81-87
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• 2009

In recent years, reductions in infant mortality have mainly been accomplished by improving the survival of premature and low birth weight infants, however premature infants still remain at great risk. The purpose of this study was to review the maternal child health service related to premature infants and to provide a future direction for improving maternal child health (MCH) in Korea. We reviewed two MCH services which are directly related to premature infants: 1) a registry and financial support program for families with a premature infant, and 2) financial support to build neonatal intensive care units in rural public hospitals. Suggestions are made for the development of a national vital signs record system to identify high risk infants and to monitor the trends in infant mortality due to prematurity. Prevention efforts and preconception care for childbearing women is also an important strategy to reduce the rate of preterm births. Finally, we need consider long-term follow-up plans for premature infants for a successful transit to the special education system. Developing MCH policy related to premature infants that decreases the occurrence of premature may decrease infant mortality, and also improve maternal and child health services.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.49-69
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• 2018

Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

• Neonatal Medicine
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• 제28권3호
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• pp.99-107
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• 2021

Purpose: Studies have been conducted on the prevalence and infant mortality rate of congenital anomalies; however, studies on child mortality are rare. Therefore, we evaluated the characteristics of deaths associated with congenital anomalies among children born in Korea who died within 5 years of age. Methods: Birth-to-death cohort linked data of children under the age of 5 years from 2010 to 2013, and statistical data on the cause of death by age from 1999 to 2019, both provided by the Korea National Statistical Office's Microdata Integrated Service, were retrospectively investigated. We investigated the trends and characteristics of mortality associated with congenital anomalies. Results: Among 1,858,945 children, 6,510 children who died were under 5 years of age, and among them, 1,229 deaths were associated with congenital anomalies, while 5,281 deaths were due to other causes. Deaths associated with congenital anomalies accounted for 18.9% of all deaths. When comparing congenital anomalies by systems, anomalies of the cardiovascular system (52.6%) were the most common. The mortality rate associated with congenital anomalies and those of other causes showed similar declining trends in 21 years. Conclusion: The mortality rate of congenital anomalies during the first 5 years of life did not increase differently from the prevalence of congenital anomalies but rather decreased. Deaths associated with congenital anomalies accounted for 20.5% of all infant deaths and 12.1% of child deaths, since the major causes of death in infants and children are slightly different, continuous and careful monitoring is required.

• 보건행정학회지
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• 제10권2호
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• pp.120-130
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• 2000

Studies on the relation between socio-economic factors and metermal and child health have found that poverty, lack of edcation, inappropriate health serives are affecting to maternal and child health. The Gender Related Development Index (GDI) focuses on equality between men and women as well as on the average achiement of all people taken together, using same cariables as the Human Development Index (HDI) which are life expectancy, literacy rate, and per capita GDP. This research is to inverstigate whether HDI and GDI are useful determinants for maternal infant mortality. Using 146 UN member countries date, we condented multiple regression analysis for maternal and infant mortality with three models which are Model(individual variables-literacy rate, per capita GDP), Model(HDI) and Model(GDI). The results showed that HDI and GDI are powerful determinants of both maternal and infant mortality, respectively HDI($\beta$=-1.18, t=3.3; $\beta$=1.04, t=5.1) GDI($\beta$=-1.44, t=3.9; $\beta$=1.28, t=6.5) The higher power in model with GDI for both maternal and infant mortalities represented that GDI was more powerful determinant of maternal and infant mortality, than HDI respectively HDI($R^2$=0.824, $R^2$=0.842), GDI($R^2$=0.834, $R^2$=0.865). In conclusion, the maternal and infant mortalities are explained by GDI than HDI and may be lower in the societies where there are less discimination between men and women.

• Clinical and Experimental Pediatrics
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• 제59권12호
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• pp.490-493
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• 2016

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1194-1199
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• 2009

Child abuse is defined by a recent act or failure to act that results in death, serious physical or emotional harm, sexual abuse or exploitation, or imminent risk of serious harm; involved a child; and is carried out by a parent or caregiver. This report provides guidance in the clinical approach to the evaluation of suspected physical abuse in children, and role of pediatrician. The medical assessment is outlined with obtaining a medical history, physical examination, and diagnostic testing. A minor form of child abuse which only involves skin injury is most frequently seen by a pediatrician. This kind of child abuse can be followed by more severe forms of child abuse, which have high mortality rates and cause serious physical and mental sequelae to the survivor. Therefore, a pediatrician's role in an early detection and prevention of child abuse is very important.