The leading cause of death in low-income countries worldwide in 2021 was lower respiratory infections, followed by stroke and ischemic heart disease. The death rate from lower respiratory infections that year was 59.4 deaths per 100,000 people. While the death rate from stroke was around 51.6 per 100,000 people. Many low-income countries suffer from health issues not seen in high-income countries, including infectious diseases, malnutrition and neonatal deaths, to name a few. Low-income countries worldwide Low-income countries are defined as those with per gross national incomes (GNI) per capita of 1,045 U.S. dollars or less. A majority of the world’s low-income countries are located in sub-Saharan Africa and South East Asia. Some of the lowest-income countries as of 2023 include Burundi, Sierra Leone, and South Sudan. Low-income countries have different health problems that lead to worse health outcomes. For example, Chad, Lesotho, and Nigeria have some of the lowest life expectancies on the planet. Health issues in low-income countries Low-income countries also tend to have higher rates of HIV/AIDS and other infectious diseases as a consequence of poor health infrastructure and a lack of qualified health workers. Eswatini, Lesotho, and South Africa have some of the highest rates of new HIV infections worldwide. Likewise, tuberculosis, a treatable condition that affects the respiratory system, has high incident rates in lower income countries. Other health issues can be affected by the income of a country as well, including maternal and infant mortality. In 2023, Afghanistan had one of the highest rates of infant mortality rates in the world.

This statistic shows the 20 countries * with the lowest infant mortality rate in 2024. An estimated 1.5 out of 1,000 live births died in the first year of life in Slovenia and Singapore in 2024. Infant mortality Infant mortality rates are often used as an indicator of the health and well-being of a nation. Monaco, Iceland, and Japan are among the top three countries with the lowest infant mortality rates with around 2 infant deaths per 1,000 infants within their first year of life. Generally, the countries with the lowest infant mortality also have some of the highest average life expectancy figures. Additionally, the countries with the highest density of physicians and doctors also generally report low infant mortality. Yet, many different factors contribute to differing rates, including the overall income of a country, health spending per capita, a mother’s level of education, environmental conditions, and medical infrastructure, to name a few. This creates a lot of variation concerning the level of childbirth and infant care around the world. The countries with the highest rates of infant mortality include Afghanistan, Mali, and Somalia. These countries experience around 100 infant deaths per 1,000 infants in their first year of life. While the reasons for high rates of infant mortality are numerous, the leading causes of death for children under the year five around the world are Pneumonia, Diarrhea, and Prematurity.

IntroductionAlthough child and adolescent health is the core of the global health agenda, the cause of death and its expected contribution to life expectancy (LE) among those aged 5–14 are under-researched across countries, especially in low- and middle-income countries (LMICs).MethodsDeath rates per 10 years age group including a 5–14-year-old group were calculated by the formula, which used the population and the number of deaths segmented by the cause of death and gender from the 2019 Global Burden of Disease (GBD) study. LE and cause-eliminated LE in 10-year intervals were calculated by using life tables.ResultsIn 2019, the global mortality rate for children and adolescents aged 5–14 years was 0.522 (0.476–0.575) per 1,000, and its LF was 71.377 years. In different-income regions, considerable heterogeneity remains in the ranking of cause of death aged 5–14 years. The top three causes of death in low-income countries (LICs) are enteric infections [0.141 (0.098–0.201) per 1,000], other infectious diseases [0.103 (0.073–0.148) per 1,000], and neglected tropical diseases and malaria [0.102 (0.054–0.172) per 1,000]. Eliminating these mortality rates can increase the life expectancy of the 5–14 age group by 0.085, 0.062, and 0.061 years, respectively. The top three causes of death in upper-middle income countries (upper MICs) are unintentional injuries [0.066 (0.061–0.072) per 1,000], neoplasm [0.046 (0.041–0.050) per 1,000], and transport injuries [0.045 (0.041–0.049) per 1,000]. Eliminating these mortality rates can increase the life expectancy of the 5–14 age group by 0.045, 0.031, and 0.030 years, respectively.ConclusionThe mortality rate for children and adolescents aged 5–14 years among LMICs remains high. Considerable heterogeneity was observed in the main causes of death among regions. According to the main causes of death at 5–14 years old in different regions and countries at different economic levels, governments should put their priority in tailoring their own strategies to decrease preventable mortality.

Background: In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs. Methods: We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1000 admissions with 95% confidence intervals (95%CI). Findings: ur search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95%CI 3.4-4.7%]. The most common causes of mortality (deaths/1000 admissions) were infectious (12 [95%CI 9-14]); respiratory (9 [95%CI 5-13]); and gastrointestinal (9 [95%CI 6-11]). Common causes of admission (cases/1000 admissions) were respiratory (255 [95%CI 231-280]); infectious (214 [95%CI193-234]); and gastrointestinal (166 [95%CI 143-190]). We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs. Implications: Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation. NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at sepsiscolab@bcchr.ca or visit our website.

This statistic shows the 20 countries* with the highest infant mortality rate in 2024. An estimated 101.3 infants per 1,000 live births died in the first year of life in Afghanistan in 2024. Infant and child mortality Infant mortality usually refers to the death of children younger than one year. Child mortality, which is often used synonymously with infant mortality, is the death of children younger than five. Among the main causes are pneumonia, diarrhea – which causes dehydration – and infections in newborns, with malnutrition also posing a severe problem. As can be seen above, most countries with a high infant mortality rate are developing countries or emerging countries, most of which are located in Africa. Good health care and hygiene are crucial in reducing child mortality; among the countries with the lowest infant mortality rate are exclusively developed countries, whose inhabitants usually have access to clean water and comprehensive health care. Access to vaccinations, antibiotics and a balanced nutrition also help reducing child mortality in these regions. In some countries, infants are killed if they turn out to be of a certain gender. India, for example, is known as a country where a lot of girls are aborted or killed right after birth, as they are considered to be too expensive for poorer families, who traditionally have to pay a costly dowry on the girl’s wedding day. Interestingly, the global mortality rate among boys is higher than that for girls, which could be due to the fact that more male infants are actually born than female ones. Other theories include a stronger immune system in girls, or more premature births among boys.

Objectives: To identify and map all trials in maternal health conducted in low- and middle-income countries (LMIC) over the 10-year period 2010-2019, to identify geographical and thematic trends, as well as compare to global causes of maternal death and pre-identified priority areas. Design: Systematic scoping review. Primary and secondary outcome measures: Extracted data included location, study characteristics and whether trials corresponded to causes of mortality and identified research priority topics. Results: Our search identified 7,269 articles, 874 of which were included for analysis. Between 2010 and 2019, maternal health trials conducted in LMICs more than doubled (50 to 114). Trials were conducted in 61 countries – 231 trials (26.4%) were conducted in Iran. Only 225 trials (25.7%) were aligned with a cause of maternal mortality. Within these trials, pre-existing medical conditions, embolism, obstructed labour, and sepsis were all under-represented when compared with number of maternal deaths globally. Large numbers of studies were conducted on priority topics such as labour and delivery, obstetric haemorrhage, and antenatal care. Hypertensive disorders of pregnancy, diabetes, and health systems and policy – despite being high-priority topics – had relatively few trials. Conclusion: Despite trials conducted in LMICs increasing from 2010 to 2019, there were significant gaps in geographical distribution, alignment with causes of maternal mortality, and known research priority topics. The research gaps identified provide guidance and insight for future research conducted in low-resource settings. Methods With support from an information specialist, a search strategy was devised to capture eligible studies (Supplemental Table 1). Search terms for maternal and perinatal health were derived from search strategies used by Cochrane Pregnancy and Childbirth to maintain and update their specialised register. We consulted the search filters developed by Cochrane EPOC to identify search terms relating to LMICs. The search strategy was applied to the Cochrane Central Register of Controlled Trials (CENTRAL), which retrieves records from PubMed/MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO’s International Clinical Trials Registry Platform (ICTRP), KoreaMed, Cochrane Review Group’s Specialised Registers, and hand-searched biomedical sources. Searching CENTRAL directly had the benefit of restricting search results to trials only, keeping the volume of citations to screen to a manageable level. Trial register records from ClinicalTrials.gov and WHO ICTRP were not included in the records retrieved from CENTRAL. The search was conducted on 1 May 2020. Citation management, identification of duplicates, and screening articles for eligibility were conducted using EndNote and Covidence. Two reviewers independently screened titles and abstracts of all retrieved citations to identify those that were potentially eligible. Full texts for these articles were accessed and assessed by two independent reviewers according to the eligibility criteria. At both steps, any disagreements were resolved through discussion or consulting a third author. Data collection and analysis For each included trial we extracted information on title, author, year of publication, location where the trial was conducted (country and SDG region), unit of randomisation (individual or cluster), category of intervention, intervention level (public health, community, primary care, hospital, and health system), and category of the primary outcome(s). The intervention and outcome categories were adapted from Cochrane’s list of ‘higher-level categories for interventions and outcomes’. For trials with more than one primary outcome, we identified a single, most appropriate outcome category through discussion and consensus amongst review authors. The level of intervention was determined based on the level of the healthcare system that the trial was primarily targeting – for example, trials recruiting women at an antenatal clinic were classified as primary care level. Public health and preventative care were defined as interventions for those in the community who were well, while home; and community care was defined as interventions for those in the community who were unwell. Based on the trial’s primary objective, we tagged each trial to one of 35 maternal health topics, as well as classified them by relevance to a cause of maternal death identified by Say et al in their global systematic analysis (Box 1). Included trials were additionally categorised into global research priority topics identified by Souza et al and Chapman et al. The research priorities identified by Souza et al were ranked based on the distribution of maternal health themes across the 190 priority research questions – i.e., the theme with the most research questions was considered the highest-ranked priority topic. This mirrored the process used by Chapman et al, where research topics with the greatest representation within the 100 research questions, based on percentage, were given the highest rank. For each trial identified in our review, we used the variables extracted to classify it according to priority topics identified in Souza et al or Chapman et al, where possible (Box 1). All data were extracted by two independent reviewers, with results compared to ensure consistency and any disputes resolved through discussion or consultation with a third author. As this was a scoping review, we did not perform quality assessments on individual trials. We conducted descriptive analyses using Excel to determine frequencies of extracted variables and used line graphs to explore trends. We assessed trends over time using proportions of each variable within studies available for a given year. While we initially planned to look at trends in individual countries and interventions, many had few or no data points.

Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

The Infant Mortality Rate (IMR) is a key indicator of a country’s healthcare quality, representing the number of infant deaths per 1,000 live births within the first year of life. High IMR is often linked to poverty, limited access to healthcare, malnutrition, and poor sanitation, while low IMR reflects better healthcare services, sanitation, maternal care, and socioeconomic conditions. This rate varies widely worldwide, with low-income countries experiencing the highest rates due to preventable causes like infections, birth complications, and preterm births. Interventions that improve maternal health, vaccination, prenatal care, and nutrition have been shown to reduce IMR significantly. Global health organizations, such as the World Health Organization (WHO) and UNICEF, actively work to lower IMR through policies, programs, and funding aimed at health education, sanitation, and nutrition in underserved regions. Monitoring IMR helps track health improvements and highlights areas needing urgent attention in healthcare and policy.

Globally, childhood pneumonia is one of the leading causes of under-five mortality especially in low-and middle-income countries. This study aimed to estimate the incidence, healthcare-seeking behavior, and barriers associated with seeking care for children suffering from severe pneumonia in rural Bangladesh. A prospective study was conducted in two districts at 81 randomly selected villages in rural Bangladesh. We collected data on 12,303 under-five children between 1st June 2018 to October 2019. Among surveyed children, a total of 154 severe pneumonia cases were recorded, resulting in an overall incidence of 1.3%. When seeking healthcare for their children, most (44.2%) mothers/caregivers availed the health care services from nearby pharmacies or local healthcare providers, followed by Health and Family Welfare Centre (37.0%), private clinics (23.4%), district hospitals (23.4%) health complexes (22.1%). Only 2% sought care at community clinics. Approximately 25% (n=38) of caregivers reported barriers to accessing healthcare. Among those who reported barriers, 39.5% cited an inability to find transportation as the main issue, followed by 26.3% who mentioned high cost of treatment, 10.5% who faced natural calamities including floods, and 2.6% who encountered political instability including strike. The incidence of severe pneumonia was below 2% in our rural areas of Bangladesh. Pharmacies and local healthcare providers were the most commonly used sources for care-seeking. Notable barriers to care-seeking included the lack of available transportation and the high cost of treatment.

This statistic presents the death rates for the five leading causes of deaths among adolescents aged 10 to 19 years in each WHO region in 2015 (per 100,000 population). In low- and middle-income countries in Africa the leading cause of death among those aged 10 to 19 years was lower respiratory infections with a death rate of **** per 100,000 population. In high income WHO countries road injury was the leading cause of death among adolescents with a rate of ***. Road injury was the only cause to be in the five leading causes of death among adolescents in every WHO region.

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1·32 million (95% UI 1·27–1·45) deaths (440000 [416000–518000; 33·3%] in females and 883000 [838000–967000; 66·7%] in males) globally, compared with less than 899000 (829000–948000) deaths in 1990. Deaths due to cirrhosis constituted 2·4% (2·3–2·6) of total deaths globally in 2017 compared with 1·9% (1·8–2·0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21·0 (19·2–22·3) per 100000 population in 1990 to 16·5 (15·8–18·1) per 100000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32·2 [25·8–38·6] deaths per 100000 population in 2017), and the high-income super-region had the lowest (10·1 [9·8–10·5] deaths per 100000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3·7 [3·3–4·0] per 100000 in 2017) and highest in Egypt in all years since 1990 (103·3 [64·4–133·4] per 100000 in 2017). There were 10·6 million (10·3–10·9) prevalent cases of decompensated cirrhosis and 112 million (107–119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33·2% for compensated cirrhosis and 54·8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases more than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Costeffective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH.

Background # Seasonal influenza virus is a common cause of acute lower respiratory infection (ALRI) in young children. In 2008, we estimated that 20 million influenza-virus-associated ALRI and 1 million influenza-virus-associated severe ALRI occurred in children under 5 years globally. Despite this substantial burden, only a few low-income and middle-income countries have adopted routine influenza vaccination policies for children and, where present, these have achieved only low or unknown levels of vaccine uptake. Moreover, the influenza burden might have changed due to the emergence and circulation of influenza A/H1N1pdm09. We aimed to incorporate new data to update estimates of the global number of cases, hospital admissions, and mortality from influenza-virus-associated respiratory infections in children under 5 years in 2018. # Methods # We estimated the regional and global burden of influenza-associated respiratory infections in children under 5 years from a systematic review of 100 studies published between Jan 1, 1995, and Dec 31, 2018, and a further 57 high-quality unpublished studies. We adapted the Newcastle-Ottawa Scale to assess the risk of bias. We estimated incidence and hospitalisation rates of influenza-virus-associated respiratory infections by severity, case ascertainment, region, and age. We estimated in-hospital deaths from influenza virus ALRI by combining hospital admissions and in-hospital case-fatality ratios of influenza virus ALRI. We estimated the upper bound of influenza virus-associated ALRI deaths based on the number of in-hospital deaths, US paediatric influenza-associated death data, and population-based childhood all-cause pneumonia mortality data in six sites in low-income and lower-middle-income countries. # Findings # In 2018, among children under 5 years globally, there were an estimated 109*5 million influenza virus episodes (uncertainty range [UR] 63*1-190*6), 10*1 million influenza-virus-associated ALRI cases (6*8-15*1); 870 000 influenza-virus-associated ALRI hospital admissions (543 000-1 415 000), 15 300 in-hospital deaths (5800-43 800), and up to 34 800 (13 200-97 200) overall influenza-virus-associated ALRI deaths. Influenza virus accounted for 7% of ALRI cases, 5% of ALRI hospital admissions, and 4% of ALRI deaths in children under 5 years. About 23% of the hospital admissions and 36% of the in-hospital deaths were in infants under 6 months. About 82% of the in-hospital deaths occurred in low-income and lower-middle-income countries. # Interpretation # A large proportion of the influenza-associated burden occurs among young infants and in low-income and lower middle-income countries. Our findings provide new and important evidence for maternal and paediatric influenza immunisation, and should inform future immunisation policy particularly in low-income and middle-income countries.

Reliable statistics on maternal morbidity and mortality are scarce in low and middle-income countries, especially in rural areas. This is the case in Mozambique where many births happen at home. Furthermore, a sizeable number of facility births have inadequate registration. Such information is crucial for developing effective national and global health policies for maternal and child health. The aim of this study was to generate reliable baseline socio-demographic information on women of reproductive age as well as to establish a demographic surveillance platform to support the planning and implementation of the Community Level Intervention for Pre-eclampsia (CLIP) study, a cluster randomized controlled trial. This study represents a census of all women of reproductive age (12–49 years) in twelve rural communities in Maputo and Gaza provinces of Mozambique. The data were collected through electronic forms implemented in Open Data Kit (ODK) (an app for android based tablets) and household and individual characteristics. Verbal autopsies were conducted on all reported maternal deaths to determine the underlying cause of death. Between March and October 2014, 50,493 households and 80,483 women of reproductive age (mean age 26.9 years) were surveyed. A total of 14,617 pregnancies were reported in the twelve months prior to the census, resulting in 9,029 completed pregnancies. Of completed pregnancies, 8,796 resulted in live births, 466 resulted in stillbirths and 288 resulted in miscarriages. The remaining pregnancies had not yet been completed during the time of the survey (5,588 pregnancies). The age specific fertility indicates that highest rate (188 live births per 1,000 women) occurs in the age 20–24 years old. The estimated stillbirth rate was 50.3/1,000 live and stillbirths; neonatal mortality rate was 13.3/1,000 live births and maternal mortality ratio was 204.6/100,000 live births. The most common direct cause of maternal death was eclampsia and tuberculosis was the most common indirect cause of death. This study found that fertility rate is high at age 20–24 years old. Pregnancy in the advanced age (>35 years of age) in this study was associated with higher poor outcomes such as miscarriage and stillbirth. The study also found high stillbirth rate indicating a need for increased attention to maternal health in southern Mozambique. Tuberculosis and HIV/AIDS are prominent indirect causes of maternal death, while eclampsia represents the number one direct obstetric cause of maternal deaths in these communities. Additional efforts to promote safe motherhood and improve child survival are crucial in these communities.

Sociodemographic and mortality characteristics of deceased children under five years of age in seven countries with Child Health and Mortality Prevention Surveillance (CHAMPS) surveillance sites, overall and by site of enrollment.

BackgroundPneumonia, diarrhoea, and malaria are among the leading causes of death in children. These deaths are largely preventable if appropriate care is sought early. This review aimed to determine the percentage of caregivers in low- and middle-income countries (LMICs) with a child less than 5 years who were able to recognise illness in their child and subsequently sought care from different types of healthcare providers.Methods and FindingsWe conducted a systematic literature review of studies that reported recognition of, and/or care seeking for episodes of diarrhoea, pneumonia or malaria in LMICs. The review is registered with PROSPERO (registration number: CRD42011001654). Ninety-one studies met the inclusion criteria. Eighteen studies reported data on caregiver recognition of disease and seventy-seven studies on care seeking. The median sensitivity of recognition of diarrhoea, malaria and pneumonia was low (36.0%, 37.4%, and 45.8%, respectively). A median of 73.0% of caregivers sought care outside the home. Care seeking from community health workers (median: 5.4% for diarrhoea, 4.2% for pneumonia, and 1.3% for malaria) and the use of oral rehydration therapy (median: 34%) was low.ConclusionsGiven the importance of this topic to child survival programmes there are few published studies. Recognition of diarrhoea, malaria and pneumonia by caregivers is generally poor and represents a key factor to address in attempts to improve health care utilisation. In addition, considering that oral rehydration therapy has been widely recommended for over forty years, its use remains disappointingly low. Similarly, the reported levels of care seeking from community health workers in the included studies are low even though global action plans to address these illnesses promote community case management. Giving greater priority to research on care seeking could provide crucial evidence to inform child mortality programmes.

Dataset Description: This dataset contains materials from a parent study within the Smart Triage program of research. Materials include the parent study protocol and associated documents. See the Metadata section below for links to related publications and datasets. Background: Pediatric sepsis remains a leading cause of under-five mortality in low- and middle-income countries (LMICs), where delayed recognition and treatment contribute to high fatality rates. While early intervention with antibiotics and fluids improves outcomes, timely care depends on effective triage—yet many facilities lack standardized, validated tools suited to their context. Existing triage systems like WHO’s ETAT are widely used but face limitations in adaptability and evaluation due to inconsistent data and resource constraints. Quality of care—timely, safe, and efficient services—remains suboptimal in many LMICs, hindered by nonspecific clinical presentations, staffing shortages, and systemic barriers. To address these gaps, we developed Smart Triage, a digital triage platform incorporating predictive modeling, vital sign measurement, and treatment tracking to streamline pediatric sepsis management. Feasibility studies show it expedites treatment and improves clinician satisfaction. We are now expanding Smart Triage + QI to four sites in Uganda to enhance sepsis care through evidence-based quality improvement and optimize resource use for sustainable health system strengthening. Methods: This is a pre- (Phase I) and post- (Phase II) evaluation of Smart Triage + QI at 4 Ugandan hospitals. Phase I: Collect data on pre-selected clinical predictors and outcomes. This data provides baseline information to evaluate the effectiveness of the quality improvement system and potential target areas. Phase II: Collect data to evaluate the effectiveness of Smart Triage + QI based on the primary and secondary outcomes. This period is a component of the quality improvement program with the goal of optimizing care of children with severe infections/suspected sepsis. Ethics Declaration: This study was approved by the Makerere University School of Public Health Institutional Review Board in Uganda (SPH-2021-41) and the Uganda National Institute of Science and Technology (HS1745ES) . Associated datasets: Smart Triage: Clinical Data - QI NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business days. Some files may remain restricted to CoLab members. These files are deemed more sensitive by the file owner and are meant to be shared on a case-by-case basis. Please contact the CoLab coordinator at sepsiscolab@bcchr.ca or visit our website.

Oxytocic Medicine Market Outlook

The global oxytocic medicine market size was valued at approximately USD 150 million in 2023 and is expected to reach around USD 250 million by 2032, growing at a compound annual growth rate (CAGR) of 6.2% during the forecast period. This growth can be attributed to several factors including the increasing prevalence of labor induction procedures, rising incidences of postpartum hemorrhage, and advancements in pharmaceutical formulations of oxytocic drugs.

One of the primary growth factors for the oxytocic medicine market is the rising number of childbirths requiring medical intervention. With advancements in medical technology and increased awareness about maternal and fetal health, there has been a significant rise in the number of labor inductions carried out globally. This trend is particularly noticeable in developed countries where elective labor induction is more common. Moreover, the growing awareness and accessibility of maternity care services in developing regions are also contributing to the demand for oxytocic medicines.

Another significant growth driver is the increasing incidences of postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide. Oxytocic drugs like oxytocin and misoprostol are critical in the management and prevention of PPH. The high efficacy and relatively low cost of these medications have led to their widespread adoption in both hospital and outpatient settings. Furthermore, global health initiatives aimed at reducing maternal mortality rates, especially in low-income countries, have been promoting the use of oxytocic medicines as part of essential maternal healthcare.

Misoprostol, a prostaglandin analogue, plays a pivotal role in the management of postpartum hemorrhage (PPH) due to its uterotonic properties. It is often used as an alternative to oxytocin, especially in low-resource settings where refrigeration for oxytocin is not feasible. The ease of administration, either orally or vaginally, makes Misoprostol a versatile option in various clinical scenarios. Its inclusion in the World Health Organization's list of essential medicines highlights its importance in global maternal health strategies. Despite its benefits, the use of Misoprostol requires careful monitoring to manage potential side effects such as fever and shivering, ensuring that its advantages in preventing PPH are maximized while minimizing risks.

Advancements in pharmaceutical sciences have also played a crucial role in market growth. The development of synthetic oxytocic drugs, which offer more controlled and sustained release compared to their natural counterparts, has expanded the treatment options available to healthcare providers. Innovations in drug delivery systems, such as injectable and oral formulations, have improved the efficacy and ease of administration of these medicines, making them more accessible to a broader patient population.

Regionally, North America holds a significant share of the oxytocic medicine market, driven by high healthcare expenditure, advanced medical infrastructure, and a well-established pharmaceutical industry. Europe follows closely, with a strong focus on maternal health and government initiatives supporting childbirth and postpartum care. Meanwhile, the Asia Pacific region is expected to witness the highest growth rate due to increasing healthcare investments, rising birth rates, and improving access to maternal healthcare services. The Middle East and Africa, and Latin America, while currently representing smaller market shares, are also showing promising growth potential due to improving healthcare infrastructure and increased focus on maternal health.

Product Type Analysis

The oxytocic medicine market is segmented by product type into natural oxytocic and synthetic oxytocic. Natural oxytocic products, derived from animal sources, have been used traditionally in childbirth for their efficacy in inducing labor and controlling bleeding. Despite their long history of use, natural oxytocic medicines are gradually being overshadowed by synthetic oxytocic due to better consistency in their action and fewer side effects.

Synthetic oxytocic medicines, such as synthetic oxytocin and carbetocin, are formulated to have a more predictable pharmacokinetic profile. This

Smart Postpartum Uterine Tonus Sensor Market Outlook

According to our latest research, the global smart postpartum uterine tonus sensor market size reached USD 489 million in 2024, reflecting a robust demand for advanced maternal health monitoring solutions. The market is experiencing a strong growth trajectory, with a recorded CAGR of 12.7% from 2025 to 2033. By the end of 2033, the market is forecasted to achieve a significant valuation of USD 1,431 million. This notable expansion is primarily driven by the rising global awareness around maternal health, increasing investments in smart healthcare technologies, and the growing prevalence of postpartum complications that require continuous and accurate uterine monitoring.

One of the primary growth factors propelling the smart postpartum uterine tonus sensor market is the escalating burden of postpartum hemorrhage (PPH) and related complications worldwide. PPH remains a leading cause of maternal morbidity and mortality, particularly in low- and middle-income countries. Healthcare providers and policymakers are increasingly prioritizing the adoption of innovative monitoring devices that enable real-time assessment of uterine contractility, thereby facilitating timely interventions and improving patient outcomes. The integration of smart sensors with digital health platforms allows for seamless data collection, remote monitoring, and prompt clinical decision-making, which significantly enhances the quality of postpartum care. Furthermore, the increasing penetration of advanced wearable and implantable sensors is revolutionizing the management of postpartum patients, supporting the market's sustained growth.

Technological advancements in sensor design and connectivity are further accelerating the adoption of smart postpartum uterine tonus sensors. Manufacturers are leveraging miniaturization, wireless communication protocols, and artificial intelligence (AI)-powered analytics to develop highly sensitive and user-friendly devices. These innovations are enabling continuous, non-invasive monitoring of uterine tone, reducing the need for manual palpation, and minimizing patient discomfort. The growing integration of these sensors with electronic health records (EHRs) and telemedicine platforms is also fostering a shift towards personalized and data-driven maternal care. Additionally, the rising focus on home-based healthcare solutions, especially in the wake of the COVID-19 pandemic, is expanding the market reach to non-hospital settings such as homecare and maternity clinics.

Government initiatives and supportive reimbursement policies are playing a pivotal role in the widespread adoption of smart postpartum uterine tonus sensors. Various national and international health organizations are launching awareness campaigns and funding programs to promote maternal health technologies, particularly in regions with high maternal mortality rates. Regulatory agencies are also streamlining approval processes for innovative sensor devices, encouraging market players to invest in research and development. Moreover, the collaboration between public health authorities, private healthcare providers, and technology companies is facilitating the deployment of smart uterine monitoring solutions across diverse healthcare infrastructures. This collaborative approach is expected to drive further market expansion and bridge existing gaps in postpartum care delivery.

From a regional perspective, North America currently dominates the smart postpartum uterine tonus sensor market, owing to its advanced healthcare infrastructure, high adoption of digital health technologies, and strong presence of leading market players. Europe follows closely, supported by favorable government policies and a well-established maternal care ecosystem. The Asia Pacific region is anticipated to exhibit the fastest growth during the forecast period, driven by increasing healthcare investments, rising awareness about maternal health, and a large population base. Latin America and the Middle East & Africa are also witnessing gradual market penetration, primarily attributed to improving healthcare access and growing initiatives to reduce maternal mortality. Overall, the regional landscape underscores the global momentum towards smarter, safer, and more efficient postpartum care solutions.

Carbetocin Duratocin Sales Market Outlook

The global Carbetocin Duratocin market size was valued at approximately USD 500 million in 2023 and is expected to grow to around USD 800 million by 2032, exhibiting a CAGR of 5.2% over the forecast period. Key growth factors contributing to this expansion include the rising incidence of postpartum hemorrhage and the increasing adoption of Carbetocin Duratocin in labor induction procedures.

One of the primary growth factors driving the Carbetocin Duratocin market is the increasing prevalence of postpartum hemorrhage (PPH), which remains a leading cause of maternal mortality worldwide. The need for effective management of PPH has led to a growing demand for Carbetocin Duratocin, a drug known for its efficacy in reducing blood loss during childbirth. Additionally, the rise in cesarean deliveries globally has further amplified the need for robust uterotonic agents, thereby boosting market growth.

Advancements in healthcare infrastructure, particularly in developing regions, are also playing a crucial role in the market's expansion. Improved access to maternal healthcare services and the increasing number of healthcare facilities equipped to handle obstetric emergencies are driving the adoption of Carbetocin Duratocin. Government initiatives focused on reducing maternal mortality rates are further promoting the use of this drug, especially in low and middle-income countries where healthcare resources have historically been limited.

Technological advancements and ongoing research in the field of obstetrics have led to the development of more effective and safer formulations of Carbetocin Duratocin. The advent of new delivery methods, such as oral formulations, is expected to expand the market's reach and acceptance among healthcare providers and patients. The pharmaceutical industry's focus on innovation and the introduction of new products are anticipated to provide a significant impetus to market growth during the forecast period.

The regional outlook for the Carbetocin Duratocin market reveals significant growth potential across various geographies. North America and Europe are expected to lead the market due to well-established healthcare systems and high awareness levels regarding maternal health. The Asia Pacific region is projected to witness the fastest growth, driven by increasing government investments in healthcare infrastructure and rising awareness about the benefits of Carbetocin Duratocin in managing childbirth-related complications. Latin America and the Middle East & Africa are also expected to experience moderate growth owing to improving healthcare facilities and growing emphasis on maternal health.

Oxytocin, a naturally occurring hormone, plays a crucial role in childbirth and lactation. It is often administered to induce labor and control bleeding after delivery. Despite its widespread use, oxytocin has certain limitations, such as the need for refrigeration and intravenous administration, which can be challenging in low-resource settings. As a result, there is a growing interest in developing alternatives like Carbetocin Duratocin, which offers stability at room temperature and a longer duration of action. This shift towards more stable and effective uterotonic agents is particularly important in regions with limited access to healthcare facilities, where the management of postpartum hemorrhage is critical to improving maternal health outcomes.

Product Type Analysis

The Carbetocin Duratocin market is segmented by product type into injectable and oral formulations. Injectable Carbetocin Duratocin remains the most widely used form, given its rapid onset of action and high efficacy in managing postpartum hemorrhage. This segment is expected to maintain its dominance throughout the forecast period, driven by its extensive use in hospital settings and emergency obstetric care. The injectable formulation's ability to quickly reduce uterine bleeding makes it a preferred choice among healthcare providers.

However, the oral formulation segment is anticipated to witness significant growth during the forecast period. The oral form of Carbetocin Duratocin offers several advantages, including ease of administration, better patient compliance, and reduced need for medical supervision. Ongoing research and development activities aimed at improving the bioavailability and efficacy of oral formulations are expected to drive their adoption in bot

Abstract

OBJECTIVE

The overall objective is to assure evidence-based policies for vaccine and preventive drug delivery in low-income countries (LIC) in order to reduce child morbidity and mortality.

Hypotheses: Current practice is to consider health issues as independent problems - e.g. TB, malaria, HIV, measles, rotavirus diarrhoea, vitamin A or iron deficiency - that can be solved with specific interventions which have separate and additive effects. However, our interventions in childhood may have a more general impact on the immune system with far-reaching consequences for survival - the so-called non-specific effects (NSE)1,2. These NSE often differ for boys and girls. Taking the non-specific and sex-differential effects of vaccines and micronutrients into consideration in the planning of health intervention policies could contribute importantly to better child health.

BACKGROUND

Both observational studies and randomised clinical trials (RCT) conducted by the Bandim Health Project (BHP) group in West Africa have shown consistently that the main childhood interventions with vaccines and micronutrients used by the international health community have NSE, i.e. effects which are not explained by the prevention of the targeted infection or deficiency. These effects are often sex-differential2-7. The effects can be major; high-titre measles vaccine (HTMV) was associated with 2-fold higher mortality for girls2, and providing BCG at birth halved neonatal mortality among low-birth-weight (LBW) children. WHO recommends schedules for delivery of vaccines and micronutrients. These schedules are often not followed. Many children receive vaccines out-of-sequence; e.g. BCG simultaneously with diphtheria-tetanus-pertussis vaccine (DTP), DTP with measles vaccine (MV), or DTP after MV. Such variations have very different NSE on overall mortality8-11 though it has not yet been recognised.

RELEVANCE

The implication of NSE is that interventions ought to be monitored or tested for their overall effect on mortality in different environments. Hence, more data on NSE in other environments are needed. For this to happen, we need more study sites and researchers involved in such research. The present proposal will train a small network of young scientists in monitoring and assessing the NSE of vaccines and other interventions. In the initial phase, monitoring systems will be set up at six Health and Demographic Surveillance System (HDSS) sites within the INDEPTH Network. Risk factors for delay in uptake of childhood interventions will be examined with emphasis on possible differences between boys and girls. We will examine the causes of out-of-sequence vaccinations. The impact of major variations in implementation will be examined. If NSE are similar in other LICs, the effect on child survival is expected to be very large. In a longer perspective, we will therefore train the sites in implementing trials assessing potential variations in policy. In conclusion, the proposal will establish a research training network in order to provide better evidence-based policies for delivery of vaccines and other health interventions in LIC.

METHODS

• The project follows up all children born in the DSS area since September 2010 and their mothers, for a period of 3 years (Jan 2011 - Dec 2013)

• We administer structured questionnaires to the eligible children's mothers or their guardians to collect information on morbidity, health seeking behavior, cause of death (for those who have died)

• We collect anthropometric measurements from all children every round to monitor nutritional status and growth

• Through the NUHDSS, we collect socioeconomic, demographic, migration and pregnancy outcome data for all the mothers and their households

DATA COLLECTED

• Background characteristics

• Antenatal care, delivery and post natal care

• Birth histories for the mothers

• Child's vital health Status

• Breastfeeding and child feeding practices

• Anthropometric measurements for children

• Detailed Vaccination history of the child

• Child morbidity and health seeking practices

Geographic coverage

Two urban informal settlements, Korogocho and Viwandani, in Nairobi City (the capital city) of Kenya.

Analysis unit

The unit of analysis is the Child

Universe

The survey covered all mothers who gave birth from september 2010 in the Demographic Surveillance Area

Kind of data

Sample survey data [ssd]

Sampling procedure

All NUHDSS female members who gave birth since September 2010 and their children were enrolled in the study. No samples were drawn.

Mode of data collection

Face-to-face [f2f]

Research instrument

DATA COLLECTION

Once recruited into the study, the mother and child are followed up approximately every 4 months

QUESTIONNAIRES

A recruitment questionnaire is administered during the first visit, an update 1 questionnaire is administered during the first follow up visit, update 2 during the second follow up visit and so on. the content of the questionnaires keep changing from recruitment questionnaire to the subsequent follow up visits. but from update 3 onward the questionnaires are the same as documented below;

RECRUITMENT (First Visit)

Data Collected

• Consent

• Background characteristics

• Antenatal care, delivery and post natal care

• Birth histories for the mothers

• Child's vital health Status

• Breastfeeding and child feeding practices

• Anthropometric measurements for mother and child

• Vaccination history

• Child morbidity and health seeking practices

• Post partum sexual activity

• Postpartum contraceptive use

• Future intentions

• Perception of HIV risk and condom use

• Migration and poverty

• Exposure calendar

UPDATE 1 (Second Visit)

Data Collected (comparing update 1 to recruitment questionnaires)

• Consent (same)

• Background characteristics (same)

• OBA voucher questions (new questions added)

• Child's vital health Status (question 4.10 dropped)

• Breastfeeding and child feeding practices

• Anthropometric measurements for mother and child (same)

• Vaccination history (same)

• Child morbidity and health seeking practices (same)

• Post partum sexual activity (question 8.1p added, questions 8.2 dropped)

• Postpartum contraceptive use (questions 9.1, 9.2, 9.3, 9.7p, 9.8, 9.9, 9.10 dropped)

• Future intentions (only question 10.6 remained)

• Perception of HIV risk and condom use (only questions 11.8, 11.9 remains)

• Exposure calendar (same)

• Migration and poverty (questions 15.1, 15.2, 15.3 dropped)

UPDATE 2 (Third Visit)

Data Collected (comparing update 2 to update 1 questionnaires)

• Consent (same)

• Background characteristics (same)

• OBA voucher questions (dropped)

• Child's vital health Status (same)

• Breastfeeding and child feeding practices (questions 5.18, 5.19 dropped)

• Anthropometric measurements for mother and child (same)

• Vaccination history (same)

• Child morbidity and health seeking practices (same)

• Post partum sexual activity (same)

• Postpartum contraceptive use (same)

• Future intentions (same)

• Perception of HIV risk and condom use (same)

• Exposure calendar (same)

• Migration and poverty (same)

UPDATE 3 (Fourth Visit)

Data Collected (comparing update 3 to update 2 questionnaires)

• Consent (same)

• Background characteristics (same)

• Child's vital health Status (same)

• Anthropometric measurements for mother and child (same)

• Child morbidity and health seeking practices (same)

• Post partum sexual activity (same)

• Postpartum contraceptive use (same)

• Future intentions (same)

• Perception of HIV risk and condom use (same)

• Exposure calendar (same)

• Migration and poverty (same)

UPDATE 4 (Fifth Visit)

Data Collected (comparing update 4 to update 3 questionnaires)

• Consent (same)

• Background characteristics (same)

• Child's vital health Status (same)

• Anthropometric measurements for mother and child (same)

• Child morbidity and health seeking practices (same)

• Post partum sexual activity (same)

• Postpartum contraceptive use (same)

• Future intentions (same)

• Perception of HIV risk and condom use (same)

• Exposure calendar (same)

• Migration and poverty (same)

UPDATE 5 (Sixth Visit)

Data Collected (comparing update 5 to update 4 questionnaires)

• Consent (same)

• Background characteristics (same)

• Child's vital health Status (same)

• Anthropometric measurements for mother and child (same)

• Child morbidity and health seeking practices (same)

• Post partum sexual activity (same)

• Postpartum contraceptive use (same)

• Future intentions (same)

• Perception of HIV risk and condom use (same)

• Exposure calendar (same)

• Migration and poverty (same)

UPDATE 6 (Seventh Visit)

Data Collected (comparing update 6 to update 5 questionnaires)

SAME

UPDATE 7 (Eight Visit)

Data Collected (comparing update 7 to update 6 questionnaires)

SAME

UPDATE 8 (Nineth Visit)

Data Collected (comparing update 8 to update 7 questionnaires)

SAME

UPDATE 9 (Tenth Visit)

Data Collected (comparing update 9 to update 8 questionnaires)

SAME

Cleaning operations

Data editing took place at a number of stages throughout the processing, including:

a) Office editing and coding

b) During data entry

c) Structure checking and completeness

d) Secondary editing

Detailed documentation of the editing of data can be found in the "Standard Procedures Manual"