Perinatal mortality in Ecuador. Report to the USAID mission in Ecuador.

Resumen

Researchers analyzed data from nationwide surveys 2 maternity hospitals and the vital registration system to estimate national and regional perinatal mortality rates for Ecuador. The national surveys provided the most reliable data on infant mortality in Ecuador because of widespread under- and misreporting to vital registration. The infant mortality rate (IMR) fell from 98 (1965-1969) to 58 (1982-1987) for a decline of 2.4 deaths/year. The immunization and oral rehydration therapy programs probably contributed to the bulk of this retardation since neonatal deaths only declined .6 deaths/year. Early neonatal and perinatal mortality rates were higher on the coast of Ecuador especially rural areas (22.7 and 34.4 respectively) than the Sierra (15.6 and 28.6 respectively). Nevertheless survival rates for early newborns ranked higher in the maternity hospital in the Sierra (Quito) than the hospital on the coast (Guayaquil) even though the coast has the higher average birth weight. 70% of all pregnancy women in Ecuador did not receive any antenatal care or only insufficient care. Moreover 60% delivered at home without a health professional. These 2 occurrences low contraceptive use (20-30%) and a high teenage pregnancy rate strongly contributed to low birth and prematurity the 2 major causes of newborn and fetal deaths in Ecuador. The researchers recommended that child survival programs conduct early screening of all pregnancy women refer high risk cases concentrate efforts on the coast analyze the differences in intrahospital mortality by concentrating on quality of care and/or the level of risk of the populations and strengthen family planning services. They suggested that the vital registration system initiate direct institutional reporting and train vital registrars (especially those in coastal areas) in correct use of the stillbirth/live birth definitions.