Mortality, Morbidity and Health Questions and Answers

Answer: B

According to the Sample Registration System Bulletin of December 2011, the infant mortality rate in urban areas of India was 31 per 1,000 live births for 2010. The rural rate was much higher, at 51, and the rate for the whole country was 47.

The values 25, 35 and 40 are not the urban figure in that bulletin, though 40 is closer to the rate of some earlier years.

Answer: C

Post-neonatal mortality is the probability of dying after the first month and before the first birthday. It covers deaths from 28 days up to one year of age and is separate from neonatal mortality, which covers the first month.

The probability of dying in the first month is neonatal mortality, the probability of dying in the first year is infant mortality, and dying between the first and the fifth birthday is child mortality.

Answer: B

The Coale and Demeny regional model life tables were derived from 192 life tables. They were produced in 1966 from a large collection of life tables, and they group these into four regional families, which are called North, South, East and West.

The figures 176, 186 and 190 are close but are not the number of tables used.

Answer: B

The matching is regional model life tables with Coale and Demeny, logit model life tables with Brass, model life tables with the United Nations, and factor analysis in identifying model life tables with Ledermann, which is the code i iii iv ii. Coale and Demeny produced the regional tables, Brass developed the logit system, the United Nations published a set of model tables, and Ledermann used factor analysis to derive his.

The other codes pair at least two of these names with the wrong system.

Answer: B

Both statements are true, but the reason is not the correct explanation of the assertion, as the key gives. Male life expectancy is lower than female in developed countries, and more men smoke than women, which is one contributing factor.

However, higher male mortality arises from several causes together, including occupational hazards, accidents, alcohol, heart disease and biological differences, so smoking is a part of the explanation but not the whole of it. The options making either statement false are wrong.

Answer: A

Nutritional status can be measured by stunting, wasting and underweight, the three standard anthropometric indicators of undernutrition of children: low height for age, low weight for height and low weight for age.

Food intake and Vitamin A doses describe diet or supplements and not the outcome, and height, weight and BMI are raw measurements rather than the standard set of indicators used.

Answer: D

The official key gives all the above for the data needed to calculate the infant mortality rate.

The basic rate is the number of deaths under one year in a year divided by the live births of that year, so one year of data is enough. Refinements use two consecutive years, because some infants who die in a year were born in the previous one, and a three-year average is used where numbers are small and the rate fluctuates.

Since each of A, B and C is used in some form, the key takes D. This is a matter of practice, so the key is kept as published.

Answer: C

The denominator for the Maternal Mortality Ratio is the total number of live births in a given time.

The ratio is maternal deaths per 100,000 live births, because the births stand in for pregnancies when pregnancies cannot be counted.

The number of women of reproductive age or of total population would give a maternal death rate, which is a different indicator. Pregnancies are not usually counted, since many end without registration, so they are not the denominator in practice.

Answer: C

The denominator for the Infant Mortality Rate is the total number of live births in a given time.

The rate is the number of deaths of infants under one year per thousand live births in the same year, because the babies born are the ones at risk of dying in infancy.

Pregnancies include those that end in abortion or stillbirth, who are not at risk of an infant death. Live births plus stillbirths adds babies who were never alive, and the total population is far too wide a base, which would give a death rate for the whole population.

Answer: C

Perinatal mortality is made up of late foetal deaths plus early neonatal deaths, so option C is correct. The perinatal period runs from the late stage of pregnancy, about 28 weeks, to the first week after birth, which is the early neonatal period of seven days. Late foetal deaths alone (A) are stillbirths, and early neonatal deaths alone (B) are only the postnatal part. Option D combines early foetal deaths, which are abortions or miscarriages, with late neonatal deaths, which fall in the second to fourth week, so neither belongs to the perinatal period.