Russia's baby-death tally to adhere to world rules Change will send reported rate up

January 22, 1993|By Kathy Lally | Kathy Lally,Moscow Bureau

MOSCOW -- Russia's already bleak health profile is about to get worse as the nation drops old reporting methods and accepts world standards.

Russia's reported infant mortality rates, already much higher than those of other developed nations, are expected to soar this year because of a change in definitions, health officials said yesterday.

Russia, which reported the 31st-highest infant mortality rate of 180 countries last year, will fall lower this year, said Nikolai Vaganov, deputy minister of health care.

Last year, Russia recorded 17 deaths per 1,000 births; this year, using the new calculations, the rate is expected to rise to 21 per 1,000, Mr. Vaganov said.

The increase in the reported infant mortality rate comes at a time when the birthrate is decreasing. The rate is 11.1 births per 1,000 population. "Two-thirds of the Russian territory had more deaths than births," Mr. Vaganov said.

The higher infant mortality rate will put Russia close to countries such as Panama, where last year's infant mortality rate was 21 per 1,000, Uruguay (22 per 1,000) and Mexico (29 per 1,000).

The rate is 8.9 in the United States, six in France and Italy, and four in Japan.

"The child death rate was a forbidden topic until 1986," Mr. Vaganov said. The first information was printed in the weekly Literaturnaya Gazeta, as Mikhail S. Gorbachev began his

glasnost campaign.

Infants who died within a week of birth traditionally were not counted in the infant mortality rate. In addition, newborns who were unable to breathe on their own were declared stillborn. In the West, such an infant would be put on a respirator if the heart was beating but the infant was unable to breathe.

Now, Russia plans to follow standards set by the World Health Organization and will have to try to save more infants who until now were officially considered dead.

"It is not a matter of statistics alone," Mr. Vaganov said. "It will put additional responsibility on doctors to provide a baby with intensive care even if it is not breathing yet but, perhaps, its heart is beating."

Some Russian doctors objected to the change when it first came under discussion in the summer, arguing that Russia had neither the means nor the medicine to raise the standard.

Mr. Vaganov said Russia also has had an increase in the number of babies born weighing less than 2.2 pounds, about 28 percent of whom survive.

Russia's high infant mortality rate is generally attributed to poor nutrition, poor medical care and a generally low level of health. Frequent abortions are a factor in some women's pregnancy complications.

Mr. Vaganov said many infants die of bronchitis and other lung diseases.

Another government report yesterday said 15 percent to 20 percent of all schoolchildren suffer from chronic illnesses. Every year, more than 40 million adults contract contagious diseases -- in a population of 150 million -- and 25,000 die of them.

The new calculations also will affect life expectancy figures in Russia, where it is now calculated at 69 years, Mr. Vaganov said, "but at least those will be honest figures."

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