Study On Death Of Children Under5Years Old From2000～2011in Zibo City

ObjectiveTo study the prevalence status, tendency, leading causes of death and analyze the health service utilization before children death based on the death surveillance data of children under5years old in Zibo city from2000to2011. This study aims to provide scientific evidences for drawing up intervention strategies of mortality to reduce child mortality under5years old in Zibo city.MethodsThe death surveillance data of children under5years old in Zibo city from2000to2011was collected and analyzed. The prevalence status, tendency, leading causes of death were described using the indicators of neonatal mortality rate (NMR), infant mortality rate (IMR), under five mortality rate (U5MR), cause-specific mortality, distribution of death places and so on. The treatment accepted before death also was analyzed. Some indicators of the children death were divided by sex and region, compared by χ2test to search the characteristic of the child mortality in Zibo city.Results1. The study shows that the NMR, IMR, U5MR of Zibo City from2000to2011was respectively4.50%o,6.06%o and7.18‰. Among these children died under5years old,62.76%were neonates,84.46%were infants and15.54%were children aged1to4years old. Neonatal deaths account for the highest proportion of the children died under5years old, followed by the deaths of the infant (except newborns), mortality in children aged1to4years old was the lowest.78.15%of the neonatal deaths occurred within seven days after born. The NMR, IMR, U5MR of urban areas was obviously higher than that in rural areas. Whether in urban or rural areas, the NMR, IMR, U5MR of male children was obviously higher than that in female children.2. Even with some fluctuations, the NMR, IMR, U5MR of Zibo City from2000to2011showed an overall downward trend. The NMR, IMR, U5MR of female and male children was also showed an overall downward trend. The NMR, IMR, U5MR of urban and rural areas was showed an overall downward trend too, and we can see the difference of NMR, IMR, U5MR between urban and rural areas become smaller and smaller.3. The top five causes of death of newborns in2011were preterm and low birth weight, neonate asphyxia, congenital heart disease, accidental suffocation and pneumonia. The top five causes of death of infants and children under5years old in2011were preterm and low birth weight, congenital heart disease, neonate asphyxia, accidental suffocation and pneumonia. The analysis of leading causes of death in this study based on the top five causes of death in2011, the result show that mortality rate of preterm and low birth weight, neonate asphyxia, congenital heart disease and pneumonia from2000to2011showed an obviously downward trend, the mortality rate of accidental suffocation was low and didn’t show obviously downward trend.4. For all average,78.84%of children under5years old obtained treatment in hospital,11.60%in clinic before death with9.37%did not obtain treatment. The proportion of obtain treatment in hospital of urban area was higher than that in rural area, however the proportion of obtain treatment in clinical of rural area was higher than that in urban area, the proportion of did not obtain treatment of urban area was closer to that in rural area. For all average,68.97%of children under5years old died in hospital, the proportion of died in hospital of urban area were higher than that in rural area, however the proportion of died in family of rural area was higher than that in urban area. The ultimate diagnoses before death were main rely on province (city), county (region) level health institutes, the proportion of diagnose in province (city) level health institutes showed an overall upward trend, however the proportion of diagnose in county (region) level health institutes showed an overall downward trend. There was a big difference between urban and rural areas, the ultimate diagnoses before death in urban area was main rely on province (city) level health institutes, however the ultimate diagnoses before death in rural area was main rely on county (region) level health institutes. About10%of the children in rural area diagnose in village clinics, obviously higher than urban area.ConclusionsThere were overall downward trends respectively in NMR, IMR, U5MR in general from2000to2011in Zibo city. Preterm and low birth weight, congenital heart disease, neonate asphyxia, accidental suffocation and pneumonia were the top five causes of death of children under5years old in2011. We should perfect the three-stage network of maternal and child hygiene, strengthen the health care management in child birth period, improve the obstetric technical level, propagate scientific knowledge and health education to reduce the mortality of infant, especially the newborns, because it is the key to reduce the mortality of children under five years old.