6 курс / Неонатология / Научное_обоснование_механизмов_управления_младенческой

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N

Fx = W x ×1000 x ,

where Fx - is the age-specific fertility rate;

Nx - is the number of births to women at the age of "x";

Wx - the average annual number of women aged "x".

Total Fertility Rate (TFR).

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СКР = n × Fx ×0,001

where Fx – age coefficients;

n is - the length of the age interval.

Crude death rate:

where M is the total number of deaths;

T - is the time interval;

P - the average population.

The infant mortality rate occupies a special place among mortality indicators because:

-characterizes the standard of living and quality of life of the population;

-reflects the almost equal probability of dying with the age of 55 years.

The indicator was calculated from mortality tables as the probability of death in the first year of life, obtained by dividing the number of deaths of children under 1 year of age by the total number of births and using the Rats formula. Children who die before the age of 1 year in the reference year "t" belong to two adjacent generations of births. Some of them were born in the same year "t" in which they died. The other part was born in the previous year "t - 1". This information was previously shown on a diagram - a demographic grid as a system of squares, the horizontal lines of which cut off the years of age, the vertical ones - the years of calendar years. The number of births in the calendar year "t" is conventionally depicted as points on the 0 axis between the

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vertical axes "t" and "t + 1" (between the beginning of the calculation year and its end). Diagonally from the points on the 0 axis, symbolizing dates of birth, straight lines are drawn from left to right and from bottom to top, called life lines. In the event of a person's death, the life line breaks, ending with the point of death (figure 2.1).

The ABCD square on the Lexis grid combines the death points of children who died before the age of 1 year in the calendar year "t" of children born in the same calendar year "t" (ACD triangle) and in the previous calendar year "t - 1" (triangle ABC).

Figure 2.1 - A fragment of the Lexis demographic grid.

Calculation of infant mortality is carried out according to the formula

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those born, respectively, in the reference year "t" and the previous year "t - 1";

Nt and Nt−1 - the number of births, respectively, in the reference year "t" and the previous year "t - 1".

This formula turned out to be the most accurate of all possible calculation options, since the initial units of observation of the population underwent a preliminary grouping according to demographic populations of the I, II, III kind and elementary demographic populations of the Lexis demographic grid, which makes it possible to obtain numerical values of directly unobservable quantities (for example, the number of people in exact age), calculate the empirical values of the corresponding probabilities of demographic events for each interval of age or duration of the state.

Populations of the first kind include points of events that occurred in the exact age interval from 0 to 1 year in the populations born in the Republic of Ingushetia from 2017 to 2021 (figure 2.2).

Age line

I lineLife

Figure 2.2 - The totality of the I-th kind of demographic grid.

Populations of the second kind include the points of events that occurred in the populations of those born in the Republic of Ingushetia from 2017 to 2021. within a certain time interval (figure 2.3).

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Figure 2.3 - The totality of the II kind of demographic grid.

Sets of the III kind include points of events that occurred during a certain interval of the duration of the state and a certain interval of calendar time, cover events that occurred in the life of not one, but two adjacent generations (figure 2.4).

Figure 2.4 - The totality of the III kind of demographic grid.

Elementary collections of events are collections limited by all three coordinates: the time of birth, the time of observation, and the duration of the state (figure 2.5).

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In our case, a modification of the Lexis grid (Press grid) was used. For the purpose of a more detailed study of infant mortality and calculation of its structural breakdown, the Press grid was carried out on a monthly basis.

The formulas for calculating the structural indicators of infant mortality were used: early neonatal, neonatal, late neonatal, postneonatal mortality, as well as the stillbirth rate.

To assess the activities of maternal and child health services proposed by WHO [205], the ratio of late (from 28 days of life to 1 year) and early (stillbirth and death from 0 to 27 days of life) [infant mortality] = P/R coefficient and assessed on a scale:

The structure of infant mortality in the Republic of Ingushetia was calculated by the main classes of causes of death and its change for 2017-2021.

The work used methods of non-parametric statistics, with the help of which the incidence of mothers who gave birth to children in the Republic of Ingushetia in 2017– 2021 was assessed. Morbidity rates for individual nosological forms were calculated, time series were analyzed, regression coefficients, determinations, and the probability of an error-free forecast were calculated to confirm the presence of trends in dynamic series.

Identification of trends in indicators created the basis for forecasting - a probabilistic assessment obtained by prospective extrapolation of a series (extension into the future of a trend observed in the past).

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- availability of medical workers providing emergency medical care, pers. per 10 thousand population;

- the number of physical persons of doctors and paramedical personnel of the main workers at the occupied official stations (departments) of emergency medical care;

N - the number of resident population at the end of the reporting year.

- Provision of the population with doctors providing specialized medical care, pers. per 10 thousand population"

, where

- provision of the population with doctors providing specialized medical care, pers. per 10 thousand population;

- number of physical persons doctors of the main workers in busy positions in medical organizations providing medical care in inpatient conditions

N - the number of resident population at the end of the reporting year.

- “Sufficiency of the population with paramedical workers working in state and municipal medical organizations, pers. per 10 thousand population"

, where

- provision of the population with paramedical workers working in state and municipal medical organizations, pers. per 10 thousand population;

- the number of individuals of paramedical personnel of key employees in positions held in state and municipal medical organizations;

N - the number of resident population at the end of the reporting year.

- "The share of specialists admitted to professional activities through the accreditation procedure, of the total number of working specialists,%"

, where

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Where:

n is the number of necessary observations; t - is a confidence criterion;

G - variance (measure of fluctuation of a sign in the general population);

∆ - is the marginal sampling error.

The features recorded in a sociological survey are attributive in nature, and therefore the measure of fluctuation is the variance of the alternative feature pq, where

P - is the proportion of this feature, set in advance q = 1 – p

when calculating the required number of random samples, the maximum value of the dispersion G2 = pq = 0,5 * 0,5 was used).

To determine the confidence number (t), we proceeded from the knowledge that at t = 2 the probability of asserting a discrepancy between the sample and the general population is 0,954. When conducting sociological research, it is sufficient to ensure the probability of displaying a sample of data from the general population (representativeness). The maximum discrepancy between the data of the sample and the general population is ∆= 5% or 0,05. Thus, with these parameters, the minimum sample size should be at least 400.

The organizational model of infant mortality management is based on the key determinants of infant mortality, determined by the method of correlation-regression analysis of actual and predicted values of medical-demographic, organizationalmedical, medical-social determinants, measures to control their change and effective management, as well as responsibility centers for the implementation of these measures.

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