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UNIVERSITY OF PRISHTINA

FACULTY OF MEDICINE

INFANT MORTALITY AND DEATHS IN REPUBLIC OF

KOSOVA DURING 2005-2010

Student: Floran SahitiICBMS-ALBANIA 3rd of May 2013

INTRODUCTION

Infant mortality is a key indicator of the health of a population and Kosova unfortunately has a high level

In the European region,Finland has the lowest level of infant mortality and Kyrgyzstan has the highest level

Infant mortality in Kosova in 2000 is estimated to be 29 deaths per 1.000 live births. At that time this mortality rate was the highest among all countries in the region.

Main direct causes of infant deaths at the global level are: congenital anomalies, asphyxia, trauma at birth, infantile infections, disorders caused by complications during pregnancy

Other causes that contribute indirectly are : economic and social circumstances, smoking, age and weight of the mother, mother’s level of education, high level of births and quality of health care.

Infant mortality and infant deaths are used as an indicator of public health, quality of health services, distribution of goods and general living standards in a society

In Kosova Health Strategy for 2005-2012 it is stated that the main purpose is to reduce infant mortality –number of infant deaths.

Survey and researches pro/against correlation between maternal education and infant deaths.

The aim

The aim of this retrospective paper is evaluation and analysis of infant deaths/mortality, presentation of the main causes and the impact of maternal education level in infant mortality during 2005-2010 in Kosova.

Materials and methods The data used are taken from the annual

official publications of KSA for the period 2005-2010.

Data is taken for the infant deaths by the age of infants (three intervals), gender, mother’s age, mother’s education level where for the reason of study, maternal education will be divided in two big target groups.

Descriptive tabulations data are presented and interpreted. The data derived were tested p=0.05. The trend of the phenomena is also analyzed.

Infant mortality is defined as the number of infant deaths (1 year or younger) per 1000 live births in a geographic region or institution in a period of time

Perinatal death is the death of a child born alive, that occurs within six days of postnatal life (168 hours).

Neonatal death is the death of a child born alive that occurs after 7-27 days of postnatal life (over 168 hours, but before 28 days of life after birth).

Post-neonatal death is the death of a child born alive that occurs after 27 days birth (but before age 1 year of life after birth).

Maternal education level: for study and simplification issues are taken only two target groups for review with respect to education of mothers, and they are:

a) The group of mothers with these levels of education : not attending school at all, primary school not completed, primary school completed .

b)The group of mothers with : high school completed and other higher levels.

Comparing with the other European data’s of infantil mortality , Kosova is located between the states with highest level of infant deaths

In Kosova Health Strategy for 2005-2012 it is stated that the main purpose is to reduce infant mortality –number of infant deaths.

Results

For the period 2005-2010 in Kosova have happened 206907 live births

Infant deaths in the Republic of Kosova in the period 1 January 2005 to 31 December 2010 are in a total of 2030 cases (this includes dead babies up to 365 days of age

Infant deaths according to age during 2005-2010

1275, 63%

263, 13%492, 24%

Infantil

Neonatal

Post-neonatal

In all the above mentioned subdivisions is noticed a trend of male domination approximately by 10% for infant deaths.

20% of the total deaths occurred in the first 24 hours of birth or a total of 407 cases for this time interval. That is approximately 68 deaths in a year in this vital interval .

0

50

100

150

200

250

2005 2006 2007 2008 2009 2010

Infant deaths according to gender for the period 2005-2010

Male Female

9981032

2030

635640

1275

150113263 213279

492

0

500

1000

1500

2000

2500

Perinatal Neonatal Post-neonatal

Total Age of infant deaths

Infant deaths acc. to maternal education level for the period 2005-2010

1.Not attending school at all, primaryschool not completed, primary schoolcompleted

2.High school completed and higherlevels

Total

Infant deaths according to mother's age 2005-2010

0% 4%

22%

34%

21%

12%

4% 1% 2%

<14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Unknown

Discussion The average within six years is 338.3 infant

deaths per year. Also we understand that the phenomena of infant deaths tends to decrease from year to year to 11.15 occasions.

Although the number of infant deaths in Kosovo has declined in recent years, the country still tops the list of European countries in infant mortality. - The rate is still higher than it should be with 17.1 deaths in 1000 births - a huge decrease from 2000, when the number of deaths was 29 per 1,000 births

Infant mortality phenomenon should be viewed broadly, not just through health and healthcare services. General welfare of children and families in Kosovo, environment, housing, and nutrition, overall level of education and health education, economic conditions such as poverty and unemployment, all contribute to infant mortality

A lack of professionalism and financing in the health care system

According to the WHO, 68% of the deaths result from complications during pregnancy. About 36% of these deaths are caused by trauma during delivery (more specifically As far as health reasons go that effect infant mortality, they are fetal immaturity (32%), complications in pregnancy (29%), congenital anomalies (6%), infections (2%), and others (31%),.

According to the UN Population Division from 2005 to 2010, infant deaths in Turkey were 24.02 per 1,000 births; in Albania 18.28; in Macedonia 14.72; in Serbia 11.77; in Croatia 6.06; and Montenegro with 8.70

Causes for this level of mortality are many, but poor prenatal care, lack of preventive health services and community healing that should be offered within family medicine, poor hygiene in hospitals, individual and collective responsibility, are causes that continually must be addressed

The strategy has to do with child health and adolescent reproductive health by establishing a provision for basic healthcare for every newborn, management of babies born prematurely, and with low body weight; establishing a monitoring and evaluation system of care for mother and the newborn, and others

Reducing infant mortality is a long and laborious process, but in comparison with European countries, of whose family we pretend to be a part of, there's no room for complacency

We still remain at this time with countries with unacceptable levels of [infant death] indicators.

Mortality remains high, but improvements were observed. Kosova is far from the level Finland, Austria, and Switzerland, which have the lowest infant mortality in Europe, but close to the numbers in Macedonia, yet better than Turkey, Armenia, Kazakhstan, Georgia and Kyrgyzstan that have a higher infant mortality from Kosova.

Maternal education level Education of a potential women to become a

mother, is an indicator that affects her status and often relates with her incomes and occupation and it is used as socioeconomic factor

It is important to look at possible mechanisms influencing variables directly or indirectly related to the level of maternal education and their impact on infant deaths/mortality

There is no significant difference in infant deaths and maternal level of education of the two levels of education.

But how maternal education could affect children's health and mortality ? 1. Mother’s-education increases acquisition and

use of health knowledge’s

2. Mother’s-education helps to increase the use of health services

3. Education of the mother - may increase the financial resources of the family through work which indirectly affects the health of family members.

4. Education of the mother-affects in preferences for family size and their health.

Conclusions We conclude that the total infant deaths during the

period 2005-2010, include a total of 2030 cases where perinatal deaths take the biggest part of it -1266 cases or 62.8%./ Neonatal deaths include 12.95% of cases or 263. and finally post-neonatal deaths with 24,23% or 492 cases. Men are approximately 10% more affected

Infant mortality phenomenon should be viewed broadly, not just through health and healthcare services. General welfare of children and families in Kosovo, environment, housing, and nutrition, overall level of education and health education, economic conditions such as poverty and unemployment, all contribute to infant mortality

Although the number of infant deaths in Kosovo has declined in recent years, the country still tops the list of European countries in infant mortality. - The rate is still higher than it should be with 17.1 deaths in 1000 births - a huge decrease from 2000, when the number of deaths was 29 per 1,000 births.

A lack of professionalism and financing in the health care system and other factors such as poverty and education continues to contribute to Kosovo's high infant mortality rate, as well as the deaths of many mothers during childbirth. It is proven that there is no significant difference between two levels described of mother education in infant mortality

Relationship between maternal educational level and infant deaths and mortality during 2005-2010 is examined, in terms of two target groups –

a) The group of mothers with these levels of education : not attending school at all, primary school not completed, primary school completed

b)The group of mothers with : high school completed and other higher levels.

And regarding to that there is no significant difference between these two levels of education in infant mortality/deaths.

It is believed that this downward trend of reducing the rate of infantil deaths in Kosova has occurred due to many factors, among which are: Improving antenatal care, care during labor increased and improved quality of care for newborns, birth performing under adequate medical care and improved medical technology that is used in diagnostic procedures and during birth

Thank you for attention!