Displaying publications 41 - 60 of 144 in total

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  1. Induction of labour from 39 weeks in low-risk multiparas with ripe cervixes: A randomised controlled trial
    Tan PC, Othman A, Win ST, Hong JGS, Elias N, Omar SZ
    Aust N Z J Obstet Gynaecol, 2021 Jun 05.
    PMID: 34089525 DOI: 10.1111/ajo.13377
    BACKGROUND: Induction of labour (IOL) in low-risk nulliparas at 39 weeks reduces caesarean delivery. Multiparas with ripe cervixes typically have vaginal delivery within eight hours. Delivery at night and weekend are associated with higher maternal and neonatal mortality.

    AIMS: To evaluate IOL in full-term multiparas with ripe cervixes to achieve delivery at normal working hours and improve maternal satisfaction.

    METHODS: A randomised trial was performed in a tertiary hospital in Malaysia. Low-risk multiparas with ripe cervixes (Bishop score ≥6) were recruited at 38+4 -40+0  weeks, then randomised to planned labour induction at 39+0  weeks or expectant care. Primary outcomes were delivery during 'normal working hours' 09:00-17:00 hours, Monday-Friday and patient satisfaction by visual numerical rating scale.

    RESULTS: For IOL (n = 80) vs expectant care (n = 80) arms respectively, primary outcomes of delivery at normal working hours was 27/80 (34%) vs 29/78 (37%), relative risk (RR) 0.9, 95% CI 0.5-1.7, P = 0.41, patient satisfaction was 8.0 ± 1.8 vs 7.8 ± 1.6, P = 0.41; presentation for spontaneous labour or rupture of membranes were 27/80 (34%) vs 70/79 (89%), RR 0.4, 95% CI 0.3-0.5, P 

    Matched MeSH terms: Infant Mortality
  2. Fulltext Trend of stillbirths and neonatal deaths in University Kebangsaan Malaysia Medical Centre (UKMMC) from 2004-2010
    Haslina Hassan, Rosnah Sutan, Nursazila Asikin Mohd Azmi, Shuhaila Ahmad, Rohana Jaafar
    Int J Public Health Res, 2013;3(1):241-248.
    MyJurnal
    The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children's health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
    Matched MeSH terms: Infant Mortality
  3. Survival and Associated Risk Factors for Mortality Among Infants with Critical Congenital Heart Disease in a Developing Country
    Mat Bah MN, Sapian MH, Jamil MT, Alias A, Zahari N
    Pediatr Cardiol, 2018 Oct;39(7):1389-1396.
    PMID: 29756159 DOI: 10.1007/s00246-018-1908-6
    Critical congenital heart disease (CCHD) is associated with significant morbidity and mortality. However, data on survival of CCHD and the risk factors associated with its mortality are limited. This study examined CCHD survival and the risk factors for CCHD mortality. Using a retrospective cohort study of infants born with CCHD from 2006 to 2015, survival over 10 years was estimated using Kaplan-Meier analysis, and the risk factors for mortality were analyzed using multivariate Cox proportional hazards regression. A total of 491 CCHD cases were included in the study, with an overall mortality rate of 34.8% (95% confidence interval [CI] 30.6-39.2). The intervention/surgical mortality rate was 9.8% ≤ 30 days and 11.5% > 30 days after surgery, and 17% died before surgery or intervention. The median age at death was 2.7 months [first quartile: 1 month, third quartile: 7.3 months]. The CCHD survival rate was 90.4% (95% CI 89-91.8%) at 1 month, 69.3% (95% CI 67.2-71.4%) at 1 year, 63.4% (95% CI 61.1-65.7%) at 5 years, and 61.4% (95% CI 58.9-63.9%) at 10 years. Weight of infants with CCHD.
    Matched MeSH terms: Infant Mortality
  4. Fulltext Factors associated psychological well-being of mothers with low birth weight (LBW) infants who are admitted at neonatal intensive care units (NICU)
    Rusnani Ab Latif
    The Malaysian Journal of Nursing, 2018;9(3):39-45.
    MyJurnal
    Psychological well-being is relatively complex notions with a variety of components that may contribute to it. Individuals differ in their overall levels of psychological health and well-being. Mother with low birth weight (LBW) babies required hospitalization especially in the Neonatal Intensive Care Unit (NICU) more exposed to the experience of anxious symptoms. Therefore, it would become a stressful event that might cause psychological distress or even emotional crisis in mother's when their infants were LBW especially premature. Health promotion is very important to prevent this problem. Health promotion efforts aimed at improving infant health status must do so by improving women's health. Improving women's health before, during, and after pregnancy is the key to reduce the human and economic costs associated with infant mortality and morbidity. To improve both women's and infants' health, efforts should include an emphasis on preventive health care services, family-oriented work site options, changes in social norms, and individual behavior modification. Therefore, it is important for health care professionals in NICU to be able to assess the factors associated psychological well-being of mother's with LBWinfant.
    Matched MeSH terms: Infant Mortality
  5. Common diseases of children as seen in the general hospital, Singapore
    Williams CD
    Journal of the Malaya Branch of the British Medical Association, 1938;2:113-23.
    Matched MeSH terms: Infant Mortality
  6. Fulltext Clinical nutrition in East Asia and the Pacific
    Darnton-Hill I, Cavalli-Sforza LT, Volmanen PV
    Asia Pac J Clin Nutr, 1992 Mar;1(1):27-36.
    PMID: 24323002
    Identifying the nutrition problems of Asia and the Pacific is made difficult by the enormous geographic, socioeconomic and cultural diversity that exists in these areas. With increasing longevity and reduced infant mortality, the more chronic diseases are becoming increasingly important. For almost 90% of the countries that keep such data in the Western Pacific Region of WHO, at least three of the five leading causes of death are noncommunicable diseases. Nevertheless undernutrition is still the most important nutritional problem in the Region. Even though there have been some encouraging declines in the proportion of malnourished under 5-year-olds, increasing populations have meant the actual numbers have not declined. Vitamin A deficiency, iodine deficiency disorders and iron deficiency anaemia remain major public health problems in many countries. There is evidence that vitamin A deficiency is appearing in countries in which it has not previously been a problem. New challenges are occurring, such as childhood obesity, the susceptibility of undernourished populations to the human immunodeficiency virus and the increase in noncommunicable diseases. The three arms of clinical nutrition: therapeutic, research and public health will need to work closely to meet the considerable and continuing threat posed by the nutrition-related diseases.
    Matched MeSH terms: Infant Mortality
  7. A population-based study of birth defects in Malaysia
    Thong MK, Ho JJ, Khatijah NN
    Ann Hum Biol, 2005 Mar-Apr;32(2):180-7.
    PMID: 16096215 DOI: 10.1080/03014460500075332
    Birth defects are one of the leading causes of paediatric disability and mortality in developed and developing countries. Data on birth defects from population-based studies originating from developing countries are lacking. One of the objectives of this study was to determine the epidemiology of major birth defects in births during the perinatal period in Kinta district, Perak, Malaysia over a 14-month period, using a population-based birth defect register. There were 253 babies with major birth defects in 17,720 births, giving an incidence of 14.3/1000 births, a birth prevalence of 1 in 70. There were 80 babies with multiple birth defects and 173 with isolated birth defects. The exact syndromic diagnosis of the babies with multiple birth defects could not be identified in 18 (22.5%) babies. The main organ systems involved in the isolated birth defects were cardiovascular (13.8%), cleft lip and palate (11.9%), clubfeet (9.1%), central nervous system (CNS) (including neural tube defects) (7.9%), musculoskeletal (5.5%) and gastrointestinal systems (4.7%), and hydrops fetalis (4.3%). The babies with major birth defects were associated with lower birth weights, premature deliveries, higher Caesarean section rates, prolonged hospitalization and increased specialist care. Among the cohort of babies with major birth defects, the mortality rate was 25.2% during the perinatal period. Mothers with affected babies were associated with advanced maternal age, birth defects themselves or their relatives but not in their other offspring, and significantly higher rates of previous abortions. The consanguinity rate of 2.4% was twice that of the control population. It is concluded that a birth defects register is needed to monitor these developments and future interventional trials are needed to reduce birth defects in Malaysia.
    Matched MeSH terms: Infant Mortality
  8. Socio-economic and environmental factors influenced the United Nations healthcare sustainable agenda: evidence from a panel of selected Asian and African countries
    Saleem H, Jiandong W, Aldakhil AM, Nassani AA, Abro MMQ, Zaman K, et al.
    Environ Sci Pollut Res Int, 2019 May;26(14):14435-14460.
    PMID: 30868457 DOI: 10.1007/s11356-019-04692-3
    The objective of the study is to evaluate socio-economic and environmental factors that influenced the United Nations healthcare sustainable agenda in a panel of 21 Asian and African countries. The results show that changes in price level (0.0062, p infant mortality rate, (iv) from foreign direct investment (FDI) inflows to PM2.5 emissions, (v) from trade openness to greenhouse gas (GHG) emissions, and (vi) from mortality indicators to per capita income, while there is a feedback relationship between health expenditures and per capita income across countries. The variance decomposition analysis shows that (i) under-5 mortality rate will increase out-of-pocket health expenditures, (ii) unemployment rate will increase mortality indicators, and (iii) health expenditures will increase economic well-being in a panel of selected countries, for the next 10 years.
    Matched MeSH terms: Infant Mortality
  9. Fulltext Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality
    Mariapun J, Hairi NN, Ng CW
    PLoS One, 2016;11(6):e0158685.
    PMID: 27362581 DOI: 10.1371/journal.pone.0158685
    INTRODUCTION: Socioeconomic inequalities in health represent unfairness in the health distribution of a population. Efforts to produce information on mortality distributions in many low and middle income countries (LMICs) are mostly hampered by lack of data disaggregated by socioeconomic groups. In this paper we describe how mortality statistics obtained from multiple data sources were combined to provide an evaluation of the socioeconomic distribution of mortality in Malaysia, a LMIC located in the Asia Pacific region.

    METHODS: This study has an ecological design. As a measure of socioeconomic status, we used principal component analysis to construct a socioeconomic index using census data. Districts were ranked according to the standardised median index of households and assigned to each individual in the 5-year mortality data. The mortality indicators of interest were potential years of life lost (PYLL), standardised mortality ratio (SMR), infant mortality rate (IMR) and under-5 mortality rate (U5MR). Both socioeconomic status and mortality outcomes were used compute the concentration index which provided the summary measure of the magnitude of inequality.

    RESULTS: Socially disadvantaged districts were found to have worse mortality outcomes compared to more advantaged districts. The values of the concentration index for the overall population of the Peninsula are C = -0.1334 (95% CI: -0.1605 to -0.1063) for the PYLL, C = -0.0685 (95% CI: -0.0928 to -0.0441) for the SMR, C = -0.0997 (95% CI: -0.1343 to -0.0652) for the IMR and C = -0.1207 (95% CI: -0.1523 to -0.0891) for the U5MR. Mortality outcomes within ethnic groups were also found to be less favourable among the poor.

    CONCLUSION: The findings of this study suggest that socioeconomic inequalities disfavouring the poor exist in Malaysia.

    Matched MeSH terms: Infant Mortality
  10. Fulltext Impact of increasing capacity for generating and using research on maternal and perinatal health practices in South East Asia (SEA-ORCHID Project)
    SEA-ORCHID Study Group, Lumbiganon P, McDonald SJ, Laopaiboon M, Turner T, Green S, et al.
    PLoS One, 2011;6(9):e23994.
    PMID: 21915274 DOI: 10.1371/journal.pone.0023994
    BACKGROUND: Maternal and neonatal mortality and morbidity remain unacceptably high in many low and middle income countries. SEA-ORCHID was a five year international collaborative project in South East Asia which aimed to determine whether health care and health outcomes for mothers and babies could be improved by developing capacity for research generation, synthesis and use.

    METHODS: Nine hospitals in Indonesia, Malaysia, the Philippines and Thailand participated in SEA-ORCHID. These hospitals were supported by researchers from three Australian centres. Health care practices and outcomes were assessed for 1000 women at each hospital both before and after the intervention. The capacity development intervention was tailored to the needs and context of each hospital and delivered over an 18 month period. Main outcomes included adherence to forms of care likely to be beneficial and avoidance of forms of care likely to be ineffective or harmful.

    RESULTS: We observed substantial variation in clinical practice change between sites. The capacity development intervention had a positive impact on some care practices across all countries, including increased family support during labour and decreased perineal shaving before birth, but in some areas there was no significant change in practice and a few beneficial practices were followed less often.

    CONCLUSION: The results of SEA-ORCHID demonstrate that investing in developing capacity for research use, synthesis and generation can lead to improvements in maternal and neonatal health practice and highlight the difficulty of implementing evidence-based practice change.

    Matched MeSH terms: Infant Mortality
  11. Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana
    Gupta ML, Aborigo RA, Adongo PB, Rominski S, Hodgson A, Engmann CM, et al.
    Glob Public Health, 2015 Oct;10(9):1078-91.
    PMID: 25635475 DOI: 10.1080/17441692.2014.1002413
    Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.
    Matched MeSH terms: Infant Mortality/trends
  12. Fulltext Does cultural practice affects neonatal survival- a case control study among low birth weight babies in Aceh Province, Indonesia
    Sutan R, Berkat S
    BMC Pregnancy Childbirth, 2014;14:342.
    PMID: 25269390 DOI: 10.1186/1471-2393-14-342
    BACKGROUND: Cultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low birth weight babies in Aceh Province Indonesia.
    METHODS: Unmatched case control study was conducted using data from year 2010 to 2012 in 8 selected districts of Aceh Province Indonesia. A total of 500 samples were obtained. There were 250 of the samples died in neonatal period (case group) and 250 who were alive (control group). There were 26 variables studied and were grouped into 4 factors: neonatal factor, maternal factor, maternal and child health services and neonatal care practices. The data was analysed using bivariate logistic regression and multivariate logistic regression.
    RESULTS: There were 13 out of 26 variables found as determinant factors of neonatal mortality among low birth weight babies in Aceh Province. The predictors found in this study were: boy (aOR1.80, 95% CI: 1.09-2.96), moderate low birth weight (aOR17.84, 95% CI: 6.20-51.35), preterm (aOR1.84, 95% CI: 1.07- 3.17), presence of maternal illnesses (aOR1.87, 95% CI: 1.06-3.30), too short or too long birth interval (aOR1.80, 95% CI: 1.20-2.91), inappropriate antenatal care (aOR2.29, 95% CI: 1.34-3.91), inappropriate neonatal visit (aOR7.04, 95% CI: 3.67-13.49), not practicing kangaroo mother care (aOR15.32, 95% CI: 2.85-82.56), not using warm bottle padding (aOR20.70, 95% CI: 6.32-67.80), not practicing 'didaring' (aOR4.33, 95% CI: 1.83-10.19), late initiation of breastfeeding (aOR2.03, 95% CI: 1.09-3.80), discard colostrums (aOR3.53, 95% CI: 1.93-6.43) and not practicing exclusive breastfeeding (aOR5.58, 95% CI: 2.89-10.77).
    CONCLUSIONS: Cultural practices are strongly seen among Acehnese. Inappropriate antenatal care and neonatal care, late initiation of breastfeeding, discarding colostrums and not practicing exclusive breastfeeding were related to cultural practices. Improving knowledge heat preservation to prevent hypothermia using Kangaroo mother care, warm bottle padding and 'didaring' were proven methods to reduce neonatal mortality. Strengthening of health services in screening for high risk cases and anticipate intervention tailored to cultural practices are important to decrease neonatal mortality among low birth weight.
    Matched MeSH terms: Infant Mortality*
  13. Admission hypothermia among VLBW infants in Malaysian NICUs
    Boo NY, Guat-Sim Cheah I, Malaysian National Neonatal Registry
    J Trop Pediatr, 2013 Dec;59(6):447-52.
    PMID: 23774951 DOI: 10.1093/tropej/fmt051
    This study aimed to determine the prevalence of admission hypothermia (AH) among very-low-birth-weight (≤1500 g) infants in 32 Malaysian neonatal intensive care units (NICUs). This was a retrospective analysis of prospectively collected data of all very-low-birth-weight infants admitted and a questionnaire survey of the practice of AH prevention. Of the 3768 (99.8%) infants with admission temperature recorded, 64.8% (n = 2440) were hypothermic: 40.3% (n = 983) mildly (36.0-36.4°C), 58.5% (n = 1428) moderately (32.0-35.9°C) and 1.2% (n = 29) severely (<32.0°C). Mean ambient temperature of these NICUs was 22.8°C (SD = 2.7, n = 28) in labour rooms and 20.1°C (SD = 1.6, n = 30) in operation theatres. None of the NICUs practised complete care bundle against AH at birth (i.e. use of pre-warmed radiant warmer and cling wrap, ambient temperature of at least 25°C and use of pre-warmed transport incubator). Care bundle against neonatal hypothermia should be actively promoted in Malaysian labour rooms and operation theatres.
    Matched MeSH terms: Infant Mortality*
  14. Risk factors associated with outcomes of very low birthweight infants in four Asian countries
    Wariki WM, Mori R, Boo NY, Cheah IG, Fujimura M, Lee J, et al.
    J Paediatr Child Health, 2013 Jan;49(1):E23-7.
    PMID: 23282105 DOI: 10.1111/jpc.12054
    The study aims to determine the risk factors associated with mortality and necrotising enterocolitis (NEC) among very low birthweight infants in 95 neonatal intensive care units in the Asian Network on Maternal and Newborn Health.
    Matched MeSH terms: Infant Mortality*
  15. Impact and Challenges of Early Continuous Positive Airway Pressure Therapy for Very Low Birth Weight Neonates in a Developing Country
    Boo NY, Cheah IG, Neoh SH, Chee SC, Malaysian National Neonatal Registry
    Neonatology, 2016;110(2):116-24.
    PMID: 27074004 DOI: 10.1159/000444316
    BACKGROUND: Early nasal continuous positive airway pressure (EnCPAP) therapy after birth for very low birth weight (VLBW; <1,500 g) neonates has been reported to be beneficial in developed countries. Its benefits in developing countries, such as Malaysia, are unknown.

    OBJECTIVES: This study aimed to determine EnCPAP rates in 36 neonatal intensive care units of the Malaysian National Neonatal Registry (MNNR) in 2013, to compare the outcomes of VLBW neonates with and without EnCPAP, and to determine whether the availability of CPAP facilities and unit policies played a significant role in EnCPAP rates.

    METHODS: First, a retrospective cohort study was conducted of VLBW neonates born in the hospitals participating in the study without major congenital abnormalities in the MNNR. This was followed by a questionnaire survey of these hospitals focussed on CPAP facilities and unit policies.

    RESULTS: Of the 2,823 neonates, 963 (34.1%) received EnCPAP. Amongst EnCPAP neonates significantly fewer deaths were recorded (10.9 vs. 21.7%; p < 0.001), less bronchopulmonary dysplasia was observed (BPD; 8.0 vs. 11.7%; p = 0.002) and fewer mechanical ventilation days were necessary (p < 0.001) than in non-EnCPAP neonates. Logistic regression analysis showed that EnCPAP was significantly associated with a lower mortality (adjusted OR 0.623; 95% CI 0.472, 0.824; p = 0.001) and BPD among survivors (adjusted OR 0.585; 95% CI 0.427, 0.802; p = 0.001). The median EnCPAP rate of the 36 hospitals was 28.4% (IQR 14.3-38.7). Hospitals with CPAP facilities in the delivery suites (p = 0.001) and during transport (p = 0.001) and a policy for EnCPAP (p = 0.036) had significantly higher EnCPAP rates.

    CONCLUSION: EnCPAP reduced mortality and BPD in Malaysian VLBW neonates. Resource-strapped developing countries should prioritise the use of this low-cost therapy.

    Matched MeSH terms: Infant Mortality/trends*
  16. The role of expressed breastmilk and continuous positive airway pressure as predictors of survival in extremely low birthweight infants
    Boo NY, Puah CH, Lye MS
    J Trop Pediatr, 2000 Feb;46(1):15-20.
    PMID: 10730035
    A case-control study was carried out on 152 extremely low birthweight (ELBW, < 1000 g) infants born consecutively in a large Malaysian maternity hospital during a 21-month period to determine the significant predictors associated with survival at discharge. Forty-nine (32.2 per cent) of these infants survived and 103 (67.8 per cent) died. The survivors weighed significantly heavier (mean = 888 g, SD = 99) than infants who died (mean = 763 g, SD = 131; p < 0.0001). They were also of higher gestational age (mean = 28.7 weeks, SD = 2.2) than those who died (mean = 26.7 weeks, SD = 2.5; p < 0.0001). Logistic regression analysis showed that, after controlling for various confounders, only three factors were significantly associated with the survival of these infants. These were: (1) increasing birthweight of the infants (with every gram increase in birthweight, adjusted odds ratio of survival was: 1.009; 95 per cent CI 1.004, 1.015; p = 0.0006); (2) given nasal continuous positive airway pressure for treatment of respiratory distress syndrome (adjusted odds ratio of survival: 4.2; 95 per cent CI 1.2, 14.0; p = 0.02); and (3) given expressed breastmilk (adjusted odds ratio of survival: 57.5; 95 per cent CI: 7, 474; p = 0.0002). Maternal illness, intrapartum problems, ethnicity, gestational age, use of antenatal steroid, modes of delivery, Apgar scores, congenital anomalies, respiratory distress syndrome, persistent ductus arteriosus, septicemia, necrotising enterocolitis, chronic lung disease, oxygen therapy, intermittent positive pressure ventilation, surfactant therapy, and blood transfusion were not significant factors associated with increased survival.
    Matched MeSH terms: Infant Mortality/trends*
  17. Women's autonomy and child survival: a comparison of Muslims and non-Muslims in four Asian countries
    Ghuman SJ
    Demography, 2003 Aug;40(3):419-36.
    PMID: 12962056 DOI: 10.1353/dem.2003.0021
    In this article, I evaluate the hypothesis that higher infant and child mortality among Muslim populations is related to the lower autonomy of Muslim women using data from 15 pairs of Muslim and non-Muslim communities in India, Malaysia, the Philippines, and Thailand. Women's autonomy in various spheres is not consistently lower in Muslim than in non-Muslim settings. Both across and within communities, the association between women's autonomy and mortality is weak, and measures of autonomy or socioeconomic status are generally of limited import for understanding the Muslim disadvantage in children's survival.
    Matched MeSH terms: Infant Mortality*
  18. Health inputs and child mortality: Malaysia
    Panis CW, Lillard LA
    J Health Econ, 1994 Dec;13(4):455-89.
    PMID: 10140534
    This paper is concerned with the relationship between child mortality and the use of health care. We develop a simultaneous model of fetal and postnatal mortality risks and input demand equations for prenatal medical care and institutional delivery. This model is applied to retrospective data from Peninsular Malaysia covering 1950-1988. The results show that prenatal medical care and institutional delivery have strong beneficial effects on child survival probabilities, and that these effects are substantially underestimated when adverse self-selection among users of health care is ignored. The effectiveness of prenatal health care in Malaysia improved until 1980, and then deteriorated. We find that the risk of infant and child mortality is not independent of fetal survival, but show that ignoring selective fetal survival introduces only mild biases in infant and child mortality estimation. Higher infant and child mortality rates among young mothers are partly explained by their lower likelihood of purchasing health care.
    Matched MeSH terms: Infant Mortality*
  19. Malaysian antenatal risk coding and the outcome of pregnancy
    Geefhuysen CJ, Isa AR, Hashim M, Barnes A
    J Obstet Gynaecol Res, 1998 Feb;24(1):13-20.
    PMID: 9564100
    Measure the effectiveness of the colour coding system in Malaysia for the prediction of risk in pregnancy.
    Matched MeSH terms: Infant Mortality*
  20. Socio-economic determinants of fertility in some countries of Asia
    Pathak KB, Murty PK
    Artha Vijnana, 1982 Jun;24(2):163-78.
    PMID: 12339046
    Matched MeSH terms: Infant Mortality*
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