[Effect of maternal death on family dynamics and infant survival]. / Efecto de la muerte materna sobre la dinámica familiar y la sobrevivencia infantil.

Family adjustments, which are generated by a maternal death, have been analysed previously in Mexico by using a reduced number of cases in rural areas. This study was design in order to establish changes in family dynamic generated b y a maternal death and to analyse child surviving after one year of birth. Family members of maternal deaths cases, which occurred during 1988-89 in the Federal District, were interviewed by first time in order to know information related to family dynamic and women's characteristics. A second interview was made after one year of birth for cases in which the newborn survived hospital discharge. Simple frequencies were calculated and using X2 test compared groups. Main consequences were family disintegration, child acquiring new roles and economic problems when woman was the main or the only one support of the family. Child surviving was higher than we expected considering other national or international reports. Children were mainly integrated to their grandparent's family.

Maternal mortality regionalization and trend in Mexico (1937-1995)

BACKGROUND: The objectives were to establish regions by level of maternal mortality in order to evaluate its trend from 1937-1995 and to analyze characteristics of cases which occurred from 1990-1995. METHODS: Regionalization of the country by maternal mortality level was carried out using Poisson regression. Level and mortality trends were analyzed globally and compared by regions using Poisson and linear regression. Characteristics of cases were analyzed from 1990-1995 using proportions and X2 test. RESULTS: Four well-differentiated and independent regions were established. Low and medium maternal mortality rate regions were found in northern and northwestern Mexico. High and very high maternal mortality regions were found in the South and the Southeast of the country. Even when maternal mortality had descended, the speed of the descent has decreased and in the last few years, maternal mortality has increased. The quality of health care is a challenge for regions with low mortality rates, while the problem of accessibility is present in those with very high mortality rates. CONCLUSION: The employment of this regionalization approach in maternal mortality analysis would be useful to determine specific problems for each region. The establishment of programs according to this analysis could contribute to decrease in maternal mortality cases in Mexico.

[Coverage of 4 health programs for pre-school children in marginal urban areas in Mexico City]. / Cobertura de 4 programas de salud para pre-escolares en áreas urbanas marginales de la ciudad de México.

The aim this paper was to evaluate the coverage provided by four preschool child health programs (vaccinations, oral hydration therapy, healthy child care and sick child care). To make coverage operational, we designed indicators to compare the utilization of each program with the condition or health problems considered as needed. These results are part of a broad evaluative research called "Coverage and Quality of Primary Health Care" (CQPHC) carried out by the National Institute of Public Health (NIPH) in the State of Mexico in 1988. The population under study was a random sample of the total of preschool children detected in the household survey. We only analyzed data including children from 1-4 years to ensure that all studied children had completed the basic vaccination schemes. For the vaccination program, we observed a coverage of 47.7%, twice as much as that of the oral hydration program that only reached was 21.9%, whereas that of the sick child care program was 63.8%, the former being 2.0 times less than the latter. We can conclude that the different coverage found for each program is basically due to the lack socialization of the concept of need and to the extent of participation of the concept to make these services available to the population.

[The causes of perinatal death in the health institutions of Mexico City]. / Causas de muerte perinatal en instituciones de salud de la ciudad de México.

We determined the main causes of death in 798 perinatal deaths which took place among 32,701 births at several health institutions in Mexico City during the summer of 1984, in accordance with the Wigglesworth Classification. We evaluated the concordance among the codifiers of the causes, with a 92% result (P less than 0.0001). The main causes of death were: conditions associated to asphyxia and prematurity in all health institutions (public assistance, social security and private hospitals). The distribution according to birth weight showed that, in almost 50% of the deaths due to asphyxiation, the child's birth weight was greater than 2,500 g, which suggests that their were deficiencies in the medical attention given to those children.