Module 5: Mortality processes, levels, and trends

• The children's dying depends on 2 factors: (1) the likelihood a newborn will die in the first years of life and (2) the number of children born.
• 15% of all child deaths in 2017 – Pneumonia and other lower respiratory diseases.
• 12% of deaths – Preterm births and neonatal disorders.
• Child mortality refers to mortality of children under the age of 5.
• The younger a child is, the higher the risk of mortality.
• Premature birth (being born before the 37th week of gestation) is one of the major determinants of neonatal mortality.
• 10% of deaths – Diarrheal diseases.
• The World Health Organisation (WHO) says that diarrheal diseases are “both treatable and preventable".
• Oral rehydration therapy is a simple treatment for diarrhea.
• 9% of deaths – Congenital defects.
• 45% of deaths – Infectious diseases.
• Congenital defects are defined as physical or genetic abnormalities present at birth and include neural tube defects, heart defects, down

  syndrome, microcephaly, and others.
• Top 1 leading cause of children's mortality in the Philippines (2019) is the Neonatal Preterm Birth.
• To reduce the number of children dying, we need to know two things: WHERE and WHAT they’re dying from.
• India has suffered the most child deaths: 1 million in 2017.
• Boys are more likely to be born prematurely: the share of boys born before full-term pregnancy is higher than for girls.
• Boys tend to have a higher birthweight than girls – which can

  increase the risk of waiting to term to deliver – meaning that more boys are induced before the end of the pregnancy term.
• Although boys are, on average, heavier than girls at birth, they are less physiologically mature at birth.
• The Y-chromosome in boys increases their vulnerability.
• Biologically, males and females are differentiated by chromosomes: females have two X chromosomes (XX) and males one X and one Y chromosome (XY).
• Having two X chromosomes means that the newborn has a stronger immune system because X chromosomes contain a larger number of immune-related genes.
• But the stronger immune response of females comes with a cost. It’s the reason why women are more susceptible to autoimmune disorders such as HIV/AIDS.
• Sex hormones may be another key reason for weaker immune systems in males.
• Males have much higher amounts of testosterone which seem to inhibit two major parts of the immune system – B and T-lymphocytes.
• Overall, male hormones weaken the immune system relative to females.
• The fact that boys are more susceptible than girls to a range of health conditions is often summarized as the “male disadvantage”.
• In circumstances where both sexes are treated equally, we would therefore expect infant and child mortality rates to be slightly higher for boys.
• Smallpox was once an extremely common and deadly infectious disease, but it has been eradicated globally back in 1977 thanks to the vaccination against it.
• Vaccines create immunity in an individual by introducing a weakened or killed form of the pathogen that make us ill– such as

  bacteria or viruses.
• Herd immunity is a community protection that is created when a high percentage of the population is vaccinated, such that it [is] less likely that the infectious disease spreads.
• When the number of people in a population that are immune against a disease is reached, such that a disease no longer persists in the

  population, this is called the herd immunity threshold (HIT).
• Measles and pertussis are highly contagious airborne diseases and a larger share of people need to be vaccinated to stop the transmission. Because of this, these diseases have the highest HIT rates that need to be reached.
• In total there are now at least 28 human diseases against which we have effective vaccines. The smallpox vaccine was the very first vaccine.
• An early form of vaccination was referred to as ‘variolation’

  or more broadly as ‘inoculation’. Practiced for a long time in Asia, this was an ancient technique of deliberate smallpox infection.
• In 1796, English physician Edward Jenner demonstrated another method of inoculation in which he relied on cowpox.
• Edward Jenner called the procedure ‘vaccination’ after ‘vacca’ the Latin word for [the] cow because of the origin of this first vaccination from the cowpox virus.
• A number of innovations came in the development of a foot-powered injector called the “ped-o-jet”.
• Epidemiologist William Foege developed Eradication Escalation (E2) to contain smallpox outbreaks during October.
• In 1980, the WHO announced that smallpox had been eradicated.
• INFANT MORTALITY- death of an infant under one year of age.