A Longitudinal Analysis of the Mortality Spectrum of Children under 5 Years from 1990 to 2015 in Hubei Province of China

OBJECTIVES- This research analyzed trends of the mortality spectrum resulted from dynamics of the health care service for children under 5 years.METHODS- It was sampled 23 surveillance sites to establish a population-based surveillance network for children under 5 years by implementing a multistage randomized, stratified and cluster sampling since 1990 in Hubei province of China.RESULTS- Among children under 5 years, the mortality rates of pneumonia, birth asphyxia, preterm birth/low birth weight and accidental asphyxia declined from 12.9, 6.6, 4.3 and 3.5 in 1990 to 0.9, 0.7, 1.1 and 0.7 per 1,000 live births in 2015 respectively, and manifested a distinguished milestone at which pneumonia and birth asphyxia had been replaced by preterm birth/low birth weight after 2005 (P<0.05). The death proportions of pneumonia and birth asphyxia decreased from 22.2% and 11.4% in 1990 to 10.3% and 7.7% in 2015, while the death proportions of preterm birth/low birth weight and accidental asphyxia increased from 7.4% and 6.0 % in 1990 to 12.9% and 8.6% in 2015 accordingly. The proportions of clinical diagnosis, emergence treatment and death place at the county/district hospitals increased from 9.0%, 27.4% and 28.7% in 1990 to 75.5%, 67.7% and 60.4% in 2015, and had the significant differences between 1990 and 2015 in Hubei province (P<0.01).CONCLUSIONS- It was suggested that the trends of the mortality spectrum were mainly due to the improvement of the health care service for children under 5 years in Hubei province.