2 research outputs found
Changing Cause of Death Profile in Morocco: The Impact of Child-survival Programmes
This study was carried out to evaluate the trends in cause-specific
mortality and the impact of child-survival programmes in Morocco. Two
national surveys on causes and circumstances of child deaths were
conducted in Morocco in 1988 and 1998 (ECCD-1 and ECCD-2 respectively).
These surveys were based on a representative sample of deaths of
children aged less than five years (432 and 866 re\uadspectively).
Causes of death were assessed by verbal autopsy and were validated on a
subsample of 94 cases. Data on causes of deaths were matched with death
rates from demographic surveys (Enqu\ueate Nationale
D\ue9mographique \ue0 Passages R\ue9p\ue9t\ue9s and
Demographic and Health Survey) to compute cause-specific death rates.
Morocco underwent a dramatic mortality decline since independence, and
the decline in mortality among children aged less than five years was
particularly rapid over the 1988-1997 period, at an average rate of -6%
a year, and faster for children (aged 1-4 year(s)) than for infants.
The decline in mortality varied markedly by causes of death and was
most pronounced for causes due to vaccine-preventable diseases, such as
neonatal tetanus, measles, whooping cough, tuberculosis, for diarrhoeal
diseases and malnutrition, and for selected infectious diseases.
However, mortality due to acute lower respiratory infection (ALRI)
outside the neonatal period did not change significantly as was the
case for some neonatal conditions (birth trauma and prematurity) and
for accidents. The decline in cause-specific mortality could be
attributed to the success of public-health programmes: the Expanded
Programme on Immunization, the management of diarrhoeal diseases and
malnutrition, and the use of antibiotics for selected infectious
diseases. It is likely that improve\uadments in living conditions,
child-feeding practices, hygiene, and sanitation also contributed to
the decline in mortality, although these could not explain the
magnitude of the changes for target diseases. In contrast, the ALRI
programme, which started after 1997, could not have any effect yet, and
conditions of delivery and care of the newborn improved only marginally
over the study period