Question

Name 3 causes of infant mortality. For each cause, suggest 2 or more public health measures aimed at reducing that risk. Discuss the barriers for achieving health equity for each cause.

Answer 1

1) Causes of Infant Mortality
Birth defects.
Preterm birth and low birth weight.
Maternal pregnancy complications.
Sudden infant death syndrome.
Injuries

2) Birth defects :-
The impact of birth defects in developing countries can be reduced through a series of interventions and eventually a comprehensive program that encompasses prevention, education about reproductive health, diagnosis, treatment, and rehabilitation. Several interventions presented in this chapter involve prevention of common birth defects and have been found to be affordable in even the poorest settings. These high priority interventions can be expanded as other health problems are resolved, as birth defects become a public health priority, and as additional resources become available. The health care provided to children and adults with birth defects should always be equitable with the care provided for other health conditions. In low-resource settings this may be very limited, but as the level of health care improves, the ability to diagnose and treat birth defects can be expanded and the quality of medical support for rehabilitation programs can be improved. Once health care has reduced infant mortality due to other causes, screening for genetic defects becomes cost effective and can further reduce the impact of birth defects. Although the number and severity of birth defects pose a challenge to countries with limited health resources, the process of reducing the impact of birth defects can be undertaken in three stages:

1.Introduction of low cost preventive interventions.

2.Provision of improved treatment for children and adults with birth defects.

3. Introduction of screening to identify genetic birth defects that can be prevented or treated.
Developing countries have a wide range of priorities, capacities, and resources for health care services. Successful implementation of each intervention requires that it be matched to the local setting. At each stage of development, health care services also need national leadership and coordination, surveillance to provide a sound evidence base for setting public health priorities, and monitoring of interventions to ensure their clinical and cost effectiveness.

PRETERM BIRTH & LOW BIRTH WEIGHT CONTROL

Preterm birth (PTB) is one of the major health-care challenges of our time. Being born too early is associated with major risks to the child with potential for serious consequences in terms of life-long disability and health-care costs. Discovering how to prevent PTB needs to be one of our greatest priorities. Recent advances have provided hope that a percentage of cases known to be related to risk factors may be amenable to prevention; but the majority of cases remain of unknown cause, and there is little chance of prevention. Applying the principle of precision public health may offer opportunities previously unavailable. Presented in this article are ideas that may improve our abilities in the fields of studying the effects of migration and of populations in transition, public health programs, tobacco control, routine measurement of length of the cervix in mid-pregnancy by ultrasound imaging, prevention of non-medically indicated late PTB, identification of pregnant women for whom treatment of vaginal infection may be of benefit, and screening by genetics and other “omics.” Opening new research in these fields, and viewing these clinical problems through a prism of precision public health, may produce benefits that will affect the lives of large numbers of people.
Preterm birth is defined as birth before 37 and after 20 completed weeks of gestation. There are many potential pathways to this complication of pregnancy. At all gestational ages, and especially the very early ages, inflammation in the pregnant uterus, either due to infectious or non-infectious causes, is commonly associated with preterm deliveries. For cases where the age is closer to term, a major concern is medical intervention which at times may not be medically indicated. In other cases, the delivery may be expedited to prevent stillbirth or maternal morbidity, such as for preeclampsia, fetal growth restriction, or diabetes. In half of all cases of PTB, labor commences spontaneously for no known reason or the membranes rupture unexpectedly leading later to the birth. These various phenotypes are diverse and poorly classified, reflecting our incomplete understanding of their various causal pathways and mechanisms.The impetus to discover strategies by which PTB rates may be lowered has been driven at least in part by advances in neonatal care resulting in more babies surviving at lower gestational ages at birth, but often at high cost in human and financial terms. Starting in the 1960s, much attention was given to developing and refining tocolytic drugs, which are therapeutic agents aiming to inhibit uterine contractions and hence prevent early birth. These drugs may have some usefulness in delaying PTB by hours or a few days, but do not extend pregnancies to gestational ages that will lower the rate of PTB.

3) 1.BIRTH DEFECT:-
People with disabilities are being left out of everyday activities like playing with their children at a community playground. Consequently, this lack of access has created an unrecognized population that faces many barriers to health promotion opportunities. These barriers are widely recognized as contributors to health disparities in people with disabilities.
Barriers are created by factors in the environment, such as lack of transportation, inaccessible facilities and community architecture. Barriers also exist within a programmatic space, which entail policies, procedures, and lack of training and professional competence. Additionally, attitudes and beliefs can lead to discrimination and implicit bias. These barriers contribute to health inequities because they can affect access to healthcare, participation in community and social activities, education, and employment. But through inclusive public health practice, this can be a possible mission, and we can address these health inequities faced by people with disabilities to create inclusive, healthy communities that benefit society as a whole.

2. LOW BIRTH WEIGHT :-

Baby with low birth weight may be at increased risk for complications. The baby's tiny body is not as strong and he or she may have a harder time eating, gaining weight, and fighting infection. Because they have so little body fat, low birth weight babies often have difficulty staying warm in normal temperatures.