Infant mortality in a deprived area of Papua New Guinea: priorities for antenatal services and health education
- Author:
P. Garner
;
P. Heywood
;
M. Baea
;
D. Lai
;
T. Smith
- Publication Type:Journal Article
- From:
Papua New Guinea medical journal
1996;39(1):6-11
- CountryPapua New Guinea
- Language:English
-
Abstract:
This cross-sectional study of women was conducted in a deprived area of Papua New Guinea with an estimated infant mortality rate of 133/1000 live births. Mortality patterns derived from birth histories showed that neonatal deaths contribute proportionally more to infant mortality than postneonatal deaths, emphasizing the need for better care at delivery. To examine possible mechanisms for intervention, pregnant women were interviewed to determine patterns of antenatal clinic use, antimalarial drugs and micronutrient supplements given, and how much the women smoked. The results showed that the health system was failing to implement current routine supplementation and prophylaxis regimens, and that there was a need to revise national guidelines. A large proportion of pregnant women smoked during pregnancy, and this behaviour could be a target for future public health campaigns and health worker promotion advice to women.
PIP: A cross-sectional study conducted in 20 randomly selected villages in the impoverished Wosera Subdistrict, East Sepik Province, Papua New Guinea, in 1989 assessed infant mortality, antenatal attendance, and smoking during pregnancy in 1008 women. 60% of respondents had never attended school. The total fertility rate was 5.7/woman. The infant mortality rate was 133/1000 live births. Of the 3074 births reported by respondents, 52 were stillbirths (rate, 17/1000 births). The perinatal mortality rate was 80/1000, the neonatal mortality rate 88/1000, and the postneonatal mortality rate 45/1000. The finding that neonatal deaths contributed proportionately more to infant mortality than postneonatal deaths indicates a need for better care at delivery. Bacterial sepsis related to umbilical infection was common. Of the 109 women pregnant at the time of the survey, only 33 (30%) had been seen at the antenatal clinic. Few of these women were complying with chloroquine treatment (given every 6 weeks). 69% of pregnant women were current smokers of locally cultivated sun-dried tobacco and 68% chewed betel nut during pregnancy. Overall, these findings indicate a need for major changes, including improved implementation of routine supplementation and prophylaxis regimens during pregnancy, health education around the dangers of smoking during pregnancy, improved attendance at antenatal care, and attention to the major causes of infant mortality.
