In Tamaulipas, the infant mortality rate shows a slight decrease in the last 3 years, in the 2008 13.29 deaths were observed per thousand minors of 1 year and in the 2010 an 10.36 rate was registered. Among the main causes is death by asphyxia and trauma at birth with a rate of 4.37 and 3.5 in 2008 and 2010 respectively.
The strategy of megadoses supplementation proved to be one of the health interventions with the highest cost benefit, so from the 2010, supplementation with a dose of 50,000 UI of vitamin A for all newborns was implemented as one more strategy to reduce infant mortality.
In Tamaulipas during the 2010, 32,509 births were presented, with a percentage of 5.96 of Prematurez and 7.2 of low weight.
The patterns of mortality in children under the age of five are heterogeneous and depend on the region of the world in question. The global causes of infant mortality show that 90% of deaths occur in 42 countries, of these, diarrhea and pneumonia as well as neonatal pathology explain around 74% of them.
Neonatal mortality refers to deaths that occur between zero and 28 days of life after birth; and mainly reflects the care received by the mother during pregnancy and at the time of delivery, during the 2010 a neonatal mortality of 10.30 per one thousand births was observed, where the General Hospital of Tampico is identified with a higher rate, followed by the General Hospital of Nuevo Laredo and the General Hospital of Reynosa.
On the other hand, post-neonatal mortality is mainly related to socioeconomic conditions, and more frequently to quality of life. In areas with low infant mortality, the neonatal component corresponds to the highest proportion of deaths.
In the study by Andrade et al., Where income and schooling were selected as indicators to detect differences in perinatal mortality, income was the variable that best explained the disparity in the IMR. In the study by Alves et al. of 2007, the highest IMR was in the district with the lowest income.
Another related factor is breastfeeding, in the study by Alves and Cols., It was found that the temporary increases of the infant mortality rate in the areas with higher economic income were correlated with the lack of promotion and the almost zero lactation maternal, once this factor was corrected, the mortality rates fell again, similar evidence was found by Sena and Cols.
Increase the quality of life of the newborn through actions to prevent diseases and protect health.
- Perform the procedures of Integrated Care and control of healthy children in the child under one year.
- Train those responsible for the care of children, in the measures of care at home and in the identification of warning signs of the most common diseases in this population group.
- Promote healthy eating behaviors in pregnant women, fathers, mothers and those under the age of one year, improve their knowledge, to reduce the prevalence of low birth weight, malnutrition, anemia and vitamin A deficiency in this age group.
- Identification and timely monitoring of inborn errors of metabolism.
- Identification and timely monitoring of defects at birth.
Improve the quality of life in newborns, with disease prevention and health protection actions, through integrated care, prioritizing problems with a risk approach and assuring effectiveness in the provision of services, in order to contribute to the decrease in neonatal mortality.
Have trained and qualified personnel to prevent, attend and identify opportunely the inherent risks to the newborn, that offer service with humanistic and professional sense.
Prevention of diseases in the population under one year.
- Prevention actions during the perinatal period.
- Complete physical exploration.
- Application of vitamin K and vitamin A.
- Ophthalmic prophylaxis.
- Prevention and timely detection of certain conditions originating in the perinatal period.
- Vaccination with BCG and Hepatitis B.
- Encourage exclusive breastfeeding during the first 6 months.
- Identification of risk factors for low birth weight and prematurity.
- Orient mothers about alarm signs and symptoms.
- Schedule appointments for healthy child control.
- Encourage early stimulation.
- Screening of neonatal screening for the identification of inborn errors of metabolism.
- Auditory screen shot.
- Timely detection of congenital malformations.
- Identification and reference to specialized medical units for handling.
Training and updating of health personnel.
- Strengthening the response capacity of health personnel for pediatric emergency care.
- Update in the management of neonatal resuscitation.
- Promote the "At birth register me" strategy.
Evaluation, supervision and analysis of the morbidity and mortality of the newborn and less than 1 year.
The consultation of the 7 days allows the identification of some defects at birth, not detected at the time of assistance to the newborn, such as:
- Isolated hydrocephalus.
- Microtia atresia.
- Congenital heart disease
- Equus varus foot
- Congenital hip dislocation.
- Abnormalities in limb reduction.
- Congenital adrenal hyperplasia.
- Hearing loss or deafness
- Defects of eyeballs (enophthalmos, microphthalmia).
The control of the 28 days will allow us to continue with the control of the newborn, monitoring its growth and development, the detection of congenital hypothyroidism through the neonatal screening through blood puncture of the heel, to those neonates that are not has made its detection at birth or seven days of life. In the same way we will continue with your vaccination scheme.
The activities to be carried out in these are:
- History of the evolution of the newborn, breastfeeding and presence of signs and symptoms of alarm.
- Physical examination, somatometry (weight, height).
- Identification of birth defects.
- Sample taking (in the first consultation), for neonatal screening test in heel between the 3 and 5 day of birth.
- Guidance on the signs and symptoms of alarm.
- Guidance on exclusive breastfeeding, newborn care, vaccination scheme, nutrition, growth and development.
- Orientation on early stimulation.
Sample taking for neonatal screening
All neonatal screening tests must be performed on the newborn, using the filter paper technique or test strips; The test is performed with heel blood (3er at 5º Day of births).
To any newborn that comes out positive, confirmatory tests should be performed: determination of TSH and T4 free in blood and thyroid profile (in case of having the resources). In the case of a positive case, thyroid scintigraphy and determination of bone age will be performed to have a proven case of Congenital Hypothyroidism; he You must locate the child to start your treatment with L - Thyroxine, doing control at four weeks to adjust the dose of the medication. The treatment must be followed and it will continue until two years of age, where its continuation will be reassessed.
Vaccinations to the newborn
Before the neonate leaves the unit where the delivery was attended, the first immunizations should be administered according to the current scheme, such as hepatitis B and antituberculous (BCG). In the same way, the mother should be instructed on the importance of continuing with the timely administration of the scheme.
- Attack to the general state (fever, hypothermia, alterations in the state of alertness, crying, modification of posture and attitude, changes of coloration).
- Rejection of the oral route (alterations of suction and / or swallowing, vomiting).
- Signs of respiratory distress.
- Hyperemia and / or purulent discharge based on umbilical cord.
- Diarrheic stools, dehydration and / or abdominal distension.
- Progressive jaundice.
- Defects at birth.
ACCORDING TO RISK, CONTINUE CONTROL IN THE FIRST LEVEL UNIT OR REFER TO A UNIT OF GREATER RESOLUTION CAPACITY.
Every newborn must receive stimulation to favor the development of their potential capacity. It must provide necessary information to parents, so that they are responsible for stimulating children from their first days of life.
Stimulation activities from zero to four weeks of life:
- Talk to the girl while she is fed or dressed.
- Stimulate your hearing, by means of a sound object (rattle or bell).
- Lying on your back, flex and extend your legs alternately.
- Lying on your stomach, moving your legs as if you were crawling.
- Take it by the hands and gently carry it forward.
- Change it from a shaded environment to an illuminated one, to provide luminous stimuli.
ACCORDING TO THE EVALUATION OF ITS DEVELOPMENT, CONTROL IN THE FIRST LEVEL UNIT MUST BE CONTINUED OR REFER TO A UNIT OF GREATER RESOLUTION CAPACITY.
Excluding private medicine, health services in Tamaulipas are provided by institutions that serve the insured population and those that are responsible for the health of the uninsured population, the Social Protection in Health System, the IMSS and ISSSTE, primarily for the first group and IMSS-opportunities and the Ministry of Health for the second.
To serve the population under the responsibility of the Ministry of Health and SPSS, currently the State Health System has 404 health units, first level, 14 clinics, 289 health centers, 3 health centers with hospital, 3 specialized hospitals, 15 general hospitals, 5 comprehensive hospitals, 46 mobile units, 29 UNE, in these units there are 2724medicals and 3986 nurses, where 746 are general practitioners and / or family members.
Health services increase at a faster rate than the population, the latter in turn make greater use of these services, in such a way that now it is necessary to develop strategies aimed at reducing inequalities, using resources more efficiently and improving the quality of health services. to contribute to Mexico's healthier population. The Health Services increase at a faster rate than the population, and it is the population who in turn makes greater use of these services, so that now it is necessary to develop strategies aimed at reducing inequalities, using more efficiently all resources (human , material and financial) and improve the quality thereof, in order to contribute to Mexico have a healthier population.