TAILIEUCHUNG - IMPACT OF MATERNAL AND CHILD HEALTH STRATEGY ON CHILD SURVIVAL IN A RURAL COMMUNITY OF PONDICHERRY

This system is financed through a mixture of public and private insurance and out-of-pocket payments by families, especially for mental, developmental, and oral health services that are not well covered by services are pro- vided within the traditional health care sector (doctors’ offices, hospitals, and clinics); however, some services such as mental health services take place outside the health care sector in schools and in child care and community centers, further fragmenting delivery pathways and complicating contend that the cur- rent system cannot achieve expected performance goals because it is powered by outdated logic, outmoded organization, and inadequate and misaligned finance strategies that were designed to be. | INDIAN PEDIATRICS VOLUME 34-SEPTEMBER 1997 IMPACT OF MATERNAL AND CHILD HEALTH STRATEGY ON CHILD SURVIVAL IN A RURAL COMMUNITY OF PONDICHERRY Debashis Dutt and . Srinivasa From the Department of Preventive and Social Medicine and Center for Disaster Preparedness and Training Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry 605 006. Reprint requests Dr. Debashis Dutt Assistant Professor Department of Community Medicine Kasturba Medical College Manipal Karnataka 576119. Manuscript received May 30 1996 Initial review completed July 15 1996 Revision accepted March 21 1997 Objective To determine the impact of Maternal and Child Health MCH services on child survival in a socio-economically backward rural community. Setting Twelve villages in Pondicherry with a population of16803. Design Prospective study. Subjects A birth cohort of 356 live births LB born between January 1st and December 31st 1988. Methods The live births were followed-up from birth to five years age 1988-1993 . The health care received by this cohort and the antenatal services received by the cohort mothers ivas reviezued. Outcome measures related to child survival were determined and their changing trend since 1967 was examined. Results Fifty-four per cent of the cohort children were from families below the poverty line. Antenatal registration and tetanus immunization coverage of the mothers of the cohort was 100 . Immunization coverage of the cohort children was more than 98 for BCG DPT three doses and OPV three doses and 82 for measles. The infant mortality rate had reduced from 201 1000 LB in 1967 to 64 1000 LB 95 in 1989. The child death rate decreased from 1000 children 1-4 years of age 1970 to 18 1000 95 in 1992. There were no deaths due to neonatal tetanus or measles. Neonatal mortality 35 1000 LB 95 CI was higher than the post-neonatal mortality 29 1000 LB 95 C I . Fifty eight per cent of the neonatal deaths .

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