Low infant mortality among Palestine refugees despite the odds

Riccardo, Flavia; Khader, Ali; Sabatinelli, Guido

doi:10.2471/blt.10.082743

Cited by 11 publications

(16 citation statements)

References 10 publications

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“…To ensure comparability with previous data, the preceding-birth technique was used. [ 10 – 12 ] Multiparous mothers who attended UNRWA health centres with their most recently-born child for registration and immunization were interviewed and asked if their preceding child was alive or dead. The preceding-birth technique is derived from the original Brass-Macrae method [ 13 ] and was modified by asking the age at death, categorized as early-neonatal (≤7 days), late-neonatal (8-≤28 days), and post-neonatal (>28 days-1 year).…”

Section: Methodology and Methodsmentioning

confidence: 99%

“…The following assumptions and requirements were used to calculate the sample size by the Epi-info StatCalc program for population surveys: based on 2008 data, the estimated infant mortality rate in Gaza was 20.2. [ 10 ] A 95% confidence interval of ± 5 deaths per 1000 live births was desired. The estimated sample size needed was 3130 mothers, and was stratified in proportion to the number of registered newborn infants per year at each health centre.…”

Section: Methodology and Methodsmentioning

confidence: 99%

“…These surveys have recorded a decline from 127 per 1000 in 1960, to 82 per thousand in 1967, to 33 per thousand in 1995, to 20.2 per thousand in 2008. [ 8 , 10 , 11 ] Regular estimation of infant mortality among UNRWA’s beneficiaries is important for monitoring the Agency’s progress towards achieving MDG4. As a follow-up to previous UNRWA estimates we have extended the series by conducting a survey in 2013 to estimate infant mortality in 2011.…”

Section: Introductionmentioning

confidence: 99%

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Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

et al. 2015

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BackgroundThe United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008.MethodsWe used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality.FindingsInfant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98–24.85), consanguinity (2.41, 1.35–4.30) and high-risk pregnancies (3.09, 1.46–6.53).ConclusionFor the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed.

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Section: Methodology and Methodsmentioning

confidence: 99%

Section: Methodology and Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

et al. 2015

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“…The Palestinian refugee population is one of the oldest and largest populations of refugees in the world. 1 In 1948, with the creation of the state of Israel, more than 700,000 Palestinians fled their homes. Four generations later, Palestinian refugees remain displaced.…”

Section: Introductionmentioning

confidence: 99%

Access to Safe Water and Personal Hygiene Practices in the Kulandia Refugee Camp (Jerusalem)

Issa

McHenry

Issa

et al. 2015

Infectious Disease Reports

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Diarrheal illness, frequently associated with fecal-oral transmission, is one of the leading causes of death worldwide. It is commonly preventable through the implementation of safe water practices. This experiment concerns how to best implement safe water practices in a quasi-permanent refugee camp setting with limited ability for structural changes. Specifically, we explore how health promotion activities that help identify target groups for hygiene interventions can play a role in disease prevention. An anonymous survey was conducted at the United Nations Relief and Works Agency Health Clinic in the Kulandia refugee camp to assess the safe water and personal hygiene practices. Demographic and social characteristics, accessible water and personal hygiene characteristics, and gastrointestinal (GI) burden for individuals and their households were assessed. A total of 96 individuals were enrolled; 62 females and 34 males. Approximately 58% of the sample had soap available and washed hands before and after eating and when preparing food. Piped water was the main source of drinking water (62%), while 31% of our sample utilized tanker-trucks. 93% of participants had access to toilet facilities, with 86% of these facilities being private households. 55% practice extra water hygiene measures on their household drinking water source. 51.3% considered vendor cleanliness when they were buying food. 51% had received formal health education. 68.8% had been taught by their parents, but only 55.2% were teaching their children and 15.6% had consistent access to a health professional for hygiene inquiries. Individual variables and hygiene practices associated with lower rates of diarrheal illnesses included having water piped into the home, proper hand washing, adequate soap availability, proper consideration of vendor cleanliness, higher income, levels of education, health hygiene education, and having access to healthcare professions to discuss hygiene related matters. This is the first study to assess the water and personal hygiene practices at the Kulandia refugee ramp. This study demonstrates that hygiene education and better practices are closely associated with the rate at which individuals and households suffer from diarrheal illnesses within the Kulandia refugee camp. There are significant hygiene deficits in the camp, which likely result from a lack of formal hygiene education and a lack of awareness concerning the connection between diarrheal illness and hygiene. With respect to practices, our results elucidate several areas where basic, communal programming – including lessons on appropriate hand washing and food preparation – will likely improve hygiene practices and decrease overall GI burden.

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“…To ensure comparability with previous data, the preceding-birth technique was used [ 2 – 4 , 9 ] to estimate infant mortality (the probability of dying between birth and the first birthday) per 1000 live births. Mothers were interviewed and asked if their preceding child was alive or dead.…”

Section: Methodsmentioning

confidence: 99%

Stalled decline in infant mortality among Palestine refugees in the Gaza Strip since 2006

et al. 2018

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BackgroundThe United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates (IMR) among Palestine refugees in the Gaza Strip (Gaza). These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2006. Thereafter, a survey revealed an IMR of 22.4 in 2011. Alerted by these findings, a follow up survey was conducted in 2015 to further assess the trend of IMR.MethodsWe used the same preceding-birth technique as in previous surveys to estimate IMR and neonatal mortality rate (NMR) per 1000 live births. All multiparous mothers who came to the 22 UNRWA health centers to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the previous IMR of 22.4 and we interviewed 3126 mothers from September to November 2015.FindingsThe third survey estimated mortality rates in 2013. The IMR was 22.7 (95% CI 17.2–28.1) per 1000 live births. IMR did not decline since the estimated IMR of 20.2 (15.3–25.1) per 1000 live births in 2006 and 22.4 (16.4–28.3) per 1000 live births in 2011. NMR was 16.1 (11.6–20.7) per 1000 live births, which was not statistically significantly different from 2006 (12.1 (8.7–16.4)), and was lower than in 2011 (20.3 (15.3–26.2)).ConclusionThe estimated mortality rate in infants of Palestine refugees in Gaza has not declined since 2006. The stagnation of infant mortality rates indicates that further efforts are needed to investigate causes for this stagnation and ways of addressing the potentially preventable causes among Palestine refugee children in Gaza.

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Low infant mortality among Palestine refugees despite the odds

Cited by 11 publications

References 10 publications

Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

Access to Safe Water and Personal Hygiene Practices in the Kulandia Refugee Camp (Jerusalem)

Stalled decline in infant mortality among Palestine refugees in the Gaza Strip since 2006

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