Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114781

John A. Ross, PhD and John Stover. The Futures Group, 80 Glastonbury Blvd, Glastonbury, CT 06033, 860 633 3501, jross@futuresgroup.com

Contraceptive use affects infant/child survival through fewer deaths via fewer pregnancies and births; and by new distributions of births across the mortality risk categories of first, upper order, older age, and short interval births. Repeat DHS surveys in 36 countries provide the changing distribution of births and risk ratios. These, together with baseline mortality rates and numbers of births through time, permit trend estimates for numbers of deaths by risk group and changes in mortality overall and by risk group. The overall IMR is driven down if births shift toward the safer groups and if the risk ratios themselves decline toward one (i.e. toward mortality in the safest, “index” group). Other influences such as better health care can modify the ratios through time, bringing them all closer to the index rate of one. On the other hand, the index group can by itself experience sharply lower mortality, tending by comparison to raise the other ratios. For projections we assume favorable trends in contraceptive use and use the empirical associations between increased use and improved distributions of births across risk categories. Risk ratios are kept constant, and varied according to past experience and chosen targets, to explore the consequences for future deaths. We present the results of projections through 2015 using contraceptive prevalence levels consistent with the TFR projections of the UN Population Division and compare the resulting impact of child survival with the progress needed to achieve the Millennium Development Goals.

Learning Objectives:

• Show for the first time the systematic links from the TFR and CPR to the mortality risk of different birth categories.

Keywords: Birth Outcomes, Infant Mortality

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation