Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India

Background and Objective: The paucity of knowledge on mortality patterns in a state such as Bihar with its population of 200 million contributes to misdirected planning and prioritization of health expenditure. This study aims to estimate the regional differences in mortality rates between a region...

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Main Authors: Sharon Cynthia, Miriam Thankam George, Philip Finny, Mathew Santhosh Thomas, Lois Joy Armstrong
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Current Medical Issues
Subjects:
Online Access:http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=1;spage=37;epage=43;aulast=Cynthia
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author Sharon Cynthia
Miriam Thankam George
Philip Finny
Mathew Santhosh Thomas
Lois Joy Armstrong
author_facet Sharon Cynthia
Miriam Thankam George
Philip Finny
Mathew Santhosh Thomas
Lois Joy Armstrong
author_sort Sharon Cynthia
collection DOAJ
description Background and Objective: The paucity of knowledge on mortality patterns in a state such as Bihar with its population of 200 million contributes to misdirected planning and prioritization of health expenditure. This study aims to estimate the regional differences in mortality rates between a region in North Bihar and the rest of state and country. Methodology: Using a multi-stage cluster design, 4159 households were interviewed across six Community Development blocks in North Bihar, identifying deaths between the Chhath festivals of 2014 and 2015. The cause of death was assessed by verbal autopsy and coded using the International Classification of Disease 10. Proportionate and specific mortality rates were calculated. Results: Of 229 deaths, only 7% were registered. The epidemiological transition level for the region was 1.12 with an infant mortality rate of 72 per 1000 live births (95% confidence interval [CI] 55.7–88.4) and under-five mortality rate of 93.2 per 1000 live births (95% CI 74.6–111.7). These rates were double that of the state estimates. Among infant deaths, infections predominated over prematurity while in adult deaths diseases of the respiratory system exceed diseases of the circulatory system as seen in the state and country mortality rates. Conclusions: This study indicates that regional mortality patterns widely differ from state and national average estimates. Deaths due to maternal and neonatal conditions along with communicable diseases still predominate over other causes. Obtaining disaggregated information on causes of death by strengthening the vital registration system will bring these variations into focus.
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spelling doaj.art-f9c53634c1034ac18e9eb3f8ca08a8db2023-02-16T12:13:30ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542023-01-01211374310.4103/cmi.cmi_92_22Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, IndiaSharon CynthiaMiriam Thankam GeorgePhilip FinnyMathew Santhosh ThomasLois Joy ArmstrongBackground and Objective: The paucity of knowledge on mortality patterns in a state such as Bihar with its population of 200 million contributes to misdirected planning and prioritization of health expenditure. This study aims to estimate the regional differences in mortality rates between a region in North Bihar and the rest of state and country. Methodology: Using a multi-stage cluster design, 4159 households were interviewed across six Community Development blocks in North Bihar, identifying deaths between the Chhath festivals of 2014 and 2015. The cause of death was assessed by verbal autopsy and coded using the International Classification of Disease 10. Proportionate and specific mortality rates were calculated. Results: Of 229 deaths, only 7% were registered. The epidemiological transition level for the region was 1.12 with an infant mortality rate of 72 per 1000 live births (95% confidence interval [CI] 55.7–88.4) and under-five mortality rate of 93.2 per 1000 live births (95% CI 74.6–111.7). These rates were double that of the state estimates. Among infant deaths, infections predominated over prematurity while in adult deaths diseases of the respiratory system exceed diseases of the circulatory system as seen in the state and country mortality rates. Conclusions: This study indicates that regional mortality patterns widely differ from state and national average estimates. Deaths due to maternal and neonatal conditions along with communicable diseases still predominate over other causes. Obtaining disaggregated information on causes of death by strengthening the vital registration system will bring these variations into focus.http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=1;spage=37;epage=43;aulast=Cynthiaepidemiological transition levellife tablemortalityverbal autopsyvital statistics certification
spellingShingle Sharon Cynthia
Miriam Thankam George
Philip Finny
Mathew Santhosh Thomas
Lois Joy Armstrong
Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
Current Medical Issues
epidemiological transition level
life table
mortality
verbal autopsy
vital statistics certification
title Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
title_full Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
title_fullStr Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
title_full_unstemmed Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
title_short Missing the trees for the forest: A survey of sub-district-level mortality pattern in North Bihar, India
title_sort missing the trees for the forest a survey of sub district level mortality pattern in north bihar india
topic epidemiological transition level
life table
mortality
verbal autopsy
vital statistics certification
url http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=1;spage=37;epage=43;aulast=Cynthia
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