Abstract
A comprehensive review of available sources of mortality data was undertaken to document the changes that have occurred in infant mortality in Nicaragua over the last three decades. It was found that a rapid fall in infant mortality commenced in the early 1970s and has continued steadily since. Trends in several different factors which might have led to this breakthrough were examined including: income, nutrition, breastfeeding practices, maternal education, immunizations, access to health services, provision of water supplies and sanitation, and anti-malarial programs. Of these, improved access to health services appears to have been the most important factor. At a time when the number of hospital beds per capita was dropping, increasing numbers of health care professionals, particularly nurses, were becoming available to staff primary health care facilities built in the 1960s. These were provided at least partly in response to the growing political turmoil enveloping the nation at that time. Certain Nicaraguan cultural attributes may have added to the impact of the reforms. Efforts in the field of public health made since the 1979 insurrection appear to have maintained the decline in child mortality.
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- De Kadt E. Making health policy management intersectoral: issues of information analysis and use in less developed countries. Soc Sci Med. 1989;29(4):503–514. doi: 10.1016/0277-9536(89)90196-2. [DOI] [PubMed] [Google Scholar]
- Garfield R. M., Vermund S. H. Changes in malaria incidence after mass drug administration in Nicaragua. Lancet. 1983 Aug 27;2(8348):500–503. doi: 10.1016/s0140-6736(83)90523-8. [DOI] [PubMed] [Google Scholar]
- Halperin D. C., Garfield R. Developments in health care in Nicaragua. N Engl J Med. 1982 Aug 5;307(6):388–392. doi: 10.1056/NEJM198208053070634. [DOI] [PubMed] [Google Scholar]
- Rosero-Bixby L. Infant mortality in Costa Rica: explaining the recent decline. Stud Fam Plann. 1986 Mar-Apr;17(2):57–65. [PubMed] [Google Scholar]
- Wolfe B. L., Behrman J. R. Determinants of child mortality, health, and nutrition in a developing country. J Dev Econ. 1982 Oct;11(2):163–193. doi: 10.1016/0304-3878(82)90002-5. [DOI] [PubMed] [Google Scholar]