Evaluation On The Impact Of Health â…§ Project On Infant Death

ObjectiveThe overall objective is to evaluate the impact of healthⅧproject on infant death. The specific objective are to analyze the trend of infant mortality rate in overall project counties,to compare the difference of infant death and times trend among the three type project counties,and explore the influencing factors of infant mortality rate.Materials and Methods1.Source of materials:In this study,we mainly use the three sources of data,which are monitoring data of project counties,underreporting data by household survey and collected infant death certificates and demographic data of project counties.2.Methods:Descriptive statistical methods were used to analyze the trend of infant mortality rate and characteristics of infant death in project counties.Besides,in this study,we applied the multi-level model to explore the influencing factors of infant mortality rate of project counties.Results1.Underreporting rate of infant death dropped a little during the period of project, from 27.8%in the early stage to 25.4%at the end of the project.2.Infant mortality rate in project counties dropped remarkably,and showed a more rapid decreasing than that of national countryside's average level.At the end of the project,the infant mortality rate in project counties was only 2.4%0 higher than national countryside's average level3.Among all reported deaths,proportion of neonatal deaths was increasing,and the DFID trial counties and MCH intervention counties had the higher increase amplitude.4.In project counties,proportion of male infant deaths was always larger than female infant deaths.The male infant mortality death was approximately the same with the female,both of which dropped from 39‰of early stage of project to 21‰of the end of project.5.Proportion of infant death occurred at home was decreasing.From the view of gender,both the proportions of male and female infant death occurred at hospital was increasing,but the male part showed the higher increase amplitude.6.During the project,more and more infant would seek treatment before death either in clinics or hospitals.Proportion of infant death that had not treatment seeking before death of DFID trial counties and MCH intervention counties was decreasing,but increasing in common project counties.7.At the early stage of project,one fifth of infants did not do any diagnosis before death.In comparison,73%of infant got the diagnosis before death at the county level or above medical facilities.Proportion of infants that did not do any diagnosis before death in common project counties show a decreasing trend,but the lower amplitude than that of the other two types of counties.8.Proportion of diagnosing cause of infant death by clinical methods was increasing steadily,and DFID trial counties and MCH intervention counties showed the higher increase amplitude.9.Proportion and mortality rate of infectious diseases was decreasing gradually. Proportion and mortality rate of congenital abnormal diseases was increasing. Neonatal asphyxia became the first cause of infant deaths.Acatalepsy diseases occupied the 4^th place during the period of the project.10.The results of multi-level analysis demonstrated that the influencing factors of infant mortality rate in project were year,systemic management of pregnant women,immunization coverage rate of four vaccines,crude birth rate.Besides, type of intervention and net income per capita of the farmers did not show the statistical correlation with the infant mortality rate.Conclusions1.The gap of infant mortality rate between project counties and national countryside's average level was reduced,which demonstrated that implementation of healthⅧproject efficiently promote the health of infant and accelerates the decreasing of infant mortality rate.2.In the project areas,the utilization of maternal and child care was rising,with the higher proportion of neonatal deaths and lower threats of infectious diseases. Infant death profile of project areas is changing towards that of developed areas, and among the three types of interventions,DFID trial counties and MCH intervention counties displayed the more rapid transition. 3.In project areas,the decreasing of infant mortality rate is mainly because the implementation of project greatly improves the utilization of maternal and child care,and income has little impact on the infant mortality rate.