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Nabarralde | Nabarra Papers
Infant
Mortality Rate Drops in the Basque
Territories
Mila Parot
Infant mortality
rate of children under one year of age in Navarre dropped from
12.7-14.7 nearly twenty years ago to 6.4 in 1998, the Institute
of Public Health of Navarre reported for a study conducted by
the Basque statistics institute Eustat in the Spanish state.
Similar numbers for Baskongadak (Araba, Bizkaia and Gipuzkoa)
were obtained from the Eustat study.
The Basque
region under French jurisdiction, which is not included in the
Eustat report, has the lowest infant mortality rate among the
Basque territories, nearly under 4.
According to
the Eustat report, most infant deaths reported in 1998 were
of children under 28 days of life. Neonatal mortality is a component
of the infant mortality rate that comprises the number of deaths
reported of children under 28 days of life. It is divided into
two subgroups: Early Neonatal Mortality (ENM), corresponding
to deaths of children under 7 days of life, and Late Neonatal
Mortality (LNM), including deaths of children between 7 and
27 days of life.
Reduction in
neonatal mortality, especially early neonatal mortality, requires
a great deal of effort and resources. Causes of death within
this age group are closely related to prenatal maternal care,
labor, and delivery; adequate medical care for the newborn infant
in the delivery room; gestational age; low birth weight; anoxia;
congenital anomalies; and neonatology services.
At present,
with a worldwide reduction of mortality as a result of implementation
of the World Health Organization Programmes for the Control
of Diarrhoeal Diseases and Acute Respiratory Infections, as
well as the implementation of an Expanded Programme of Immunization,
postneonatal mortality has been markedly reduced, resulting
in a decline of the infant mortality rate. Consequently, neonatal
mortality arises as the most important component for reducing
infant mortality.
Notwithstanding
the statistics on the Basque territories indicating lower infant
mortality, the number of deaths linked to medical malpractice
continue on the rise, according to the government's public health
department.
All twenty
cases of medical malpractice reported in Baskongadak in 1998
were either closed or the defendants were acquitted, the health
department added.
International
comparisons of infant mortality are compromised by a lack of
standardization with regard to birth registration practices.
Studies have documented wide variation in the rate at which
extremely small babies at the borderline of viability (e.g.,
< 500 g) are registered in different countries. As a potential
solution, the World Health Organization has recommended that
international comparisons of infant mortality be restricted
to live births in which the newborn weighs 1000 g or more. Such
a restriction would eliminate a substantial proportion of neonatal
deaths from the infant mortality counts of most industrialized
countries, however.
This and other
challenges inherent in birth- weight-specific comparisons mean
that international infant mortality rankings will continue to
be based on crude rates and will favour industrialized countries,
which tend not to register extremely small live births.
August
30, 2000
Mila
Parot is a law student and environmental activist. She lives
in Miarritze.
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