Prematurity and low birth weight have the highest influence on the survival of an infant, according to a study carried out in Samdrupjongkhar.
The study found that premature newborns and those with low birth weight were respectively 5.9 times and 4.1 times more likely to die. Newborns whose mother received better antenatal and post-natal care services were more likely to survive.
Senior nutritionist with Samdrupjongkhar hospital, Hari Prasad Pokhrel, during a presentation at the fourth International conference on medical and health sciences earlier this month, said that infant mortality was an important indicator of health and well-being of the population.
He said that Samdrupjongkhar reported an increasing trend in infant mortality rates in the recent years. To identify the determinants of infant mortality in the dzongkhag, a population-based case-control study was conducted in May this year.
Case refers to the infant who died during the period in Samdrupjongkhar. Control, he said refers to living, born during the same period living closest to homes where infant mortality occurred.
Case group comprised of 79 mothers who lost their infants between January 2015 to April this year. About 158 mothers with living children born during the same period and living closest to a home where infant mortality occurred were recruited as controls.
Only those mothers who were recorded as the resident of Samdrupjongkhar in at least one of the annual household surveys conducted from 2014 were included for the story.
The data collection was done through personal interview and by reviewing MCH (maternal and child health) handbooks and MCH registers.
The study found that 26.6 percent of the infants died at home, 25.3 percent died at the general hospital, and 22.8 percent died in an ambulance.
This trend, he said, suggested delayed health service seeking behaviour in the community.
In terms of age, he said nearly two-third of the deaths occurred during the post-natal period, which was an uncommon finding reported in the literature. Over half of these post-natal deaths occurred either at home or in an ambulance.
This too, he said, indicated delayed health service seeking behaviour.
About 65.8 percent of the infants died when they were more than 28 days old; 19 percent died within 24 hours of the birth.
About 8.9 percent died when they were one to seven days old and 6.3 percent died when they were more than seven days but less than 28 days old.
Of 79 infant deaths, the reason for the 34 was unknown. This, he said was because the majority of the deaths occurred at home or in an ambulance.
The study recommends implementing a multi-stakeholder approach to strengthen antenatal and post-natal care services in the districts.
“Further study is required to understand the causes of the highest proportion of deaths during the post-neonatal period,” he said.