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Pakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue.

The study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as “cases,” while those who survived beyond a specific timeframe were referred to as “noncases.” To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the “syncmrates” package in Stata 15.

During the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly.

This study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604

The purpose of this paper is to investigate the effect of flood occurrence on mortality rate and life expectancy amongst 53 African countries.

The study utilizes panel data from the period 2000–2018 on 53 African countries and system generalized method of moments (system GMM) for the analysis.

The result indicates that flood occurrence causes the destruction of health facilities and the spread of diseases which reduces life expectancy. In addition, flood occurrence increases mortality rate amongst 53 African countries.

The study recommends that governments amongst African countries should implement strategies being enshrined in Conference of Parties (COP, 2021) on climate change. This will help to reduce the level of climate change and flood occurrence.

Previous studies focussed on the adverse effect of flood occurrence without considering the issue of life expectancy amongst African countries. This study contributes to existing empirical studies by examining the effect of flood occurrence on mortality rate and life expectancy amongst African countries.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-07-2022-0508.

The purpose of this paper is to study the effect of government health expenditure on the health of children (under-five mortality rate and prevalence rate of stunting) among West African countries.

The study utilizes heterogeneous panel from the period 1990 to 2018 among 16 West African countries for the analysis. The effect of government health expenditure on under-five mortality rate is measured in per 1,000 live births while that of stunting is measured in percentage. The study employs Pooled Mean Group (PMG) estimation technique and Impulse Response Functions (IRFs) for the analysis.

The results indicate that government health expenditure has negative effect on under-five mortality rate and prevalence rate of stunting in the long-run but not significant in the short-run. In addition, the IRFs result indicates that under-five mortality rate and prevalence rate of stunting both respond negatively to shocks in government health expenditure.

Governments should ensure that inefficiencies in the public health sector are reduced by licensing the health workers of this sector and allowing independent bodies to appoint the heads of health institutions. This will improve the delivering of health services for the health of children.

Previous studies carried out have not examined the short-run and long-run effects of the relationship under study among West African countries.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2022-0212

South Africa is in the last stage of the first demographic transition (FDT) – yet already depicts aspects of the second transition. The last stage of the FDT is characterized by lower levels of fertility closer to or at the replacement level of the average of 2.1 children per woman, and improvements in mortality displayed by declining infant and childhood mortality leading to increasing life expectancy at birth. The second demographic transition (SDT) is driven by lifestyle changes that are determinants of demographic patterns. Such lifestyle changes are declining marriage rates, increasing attention on human development, and thus changing family formation patterns. South Africa’s youth are at the centre of this transition. The population census of 2011 shows an age structure of South Africa that is characterized by a larger proportion of 20-35-year-olds. This resulted from a long period of declining fertility and to some extent improvements in mortality at all ages. This age structure, with adequate investments - is expected to yield a period of economic growth resulting from a reduced dependency ratio. However, improved health care, investments in human development, and higher employment opportunities are required to harness the benefit. This chapter aims to explore the national and provincial preparedness of South African youth to contribute to economic growth of the country. In particular, the chapter will focus on demographic factors such as sex ratio; youth mortality and morbidity; and youth fertility levels as these factors are highly correlated with human development.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

The basic purpose of this paper was to check the perceived impact of socio-economic on the fertility rate (FR) in Pakistan. It also explored the factors which play an important role on FR of urban and rural resident women.

A few studies were carried out this particular issue in Pakistan but this issue was not mentioned in such a way as the current study highlights. Data were collected through questionnaires from rural and urban areas. The main variables were chosen for this purpose were the income of the households, their education level and the mortality rate. FR is measured in terms of number of children which are above 5 years of age and married couple has stopped the further fertility intentions; Monthly income of the families were taken and the education was in the years of schooling. The ordinary least square (OLS) model was used for the estimation.

The results of this study showed that, in urban areas this association is very strong while in rural areas this is relatively weak due to sharp differences in income brackets. Families with high level of income tend to have few children. Female education is also negatively correlated with FR. Higher level of female education has negative effect on FR. Mortality rate has significant positive association with FR. Higher mortality rate compel families to have more birth as probability of living is low. There is inverse association between income and FR.

The best way to determine how birth rates are changing is not the crude birth rate (CBR) but the total fertility rate (TFR). This measure provides an age-controlled estimation of “how many kids a woman beginning her childbearing years now would have over her whole life if current birth rates remain stable”.

Mortality rate has significant positive association with FR. Higher mortality rate compel families to have more birth as probability of living is low. There is inverse association between income and FR.

This study aims to examine the effects of industrial production (IP), inflation and investment on suicide mortality in Turkey as a developing country over the 1988–2018 period.

Fourier cointegration test and dynamic ordinary least square regression were used in this study.

IP and investment have a statistically significant and negative impact on suicide mortality, whereas inflation has a statistically significant and positive effect on suicide mortality.

The results of this study have important implications for policymakers and potentially the creation and implementation of suicide prevention policies. Not only do investment promotion, IP and disinflation policies in developing countries have a significant effect on economic growth but they also have a substantial impact on mental health.

Although previous studies have investigated the impact of economic growth and unemployment on suicide deaths in Turkey, no research has probed the effect of economic factors, except for unemployment and gross domestic product, on suicide. Thus, given the hidden unemployment and informal sector in developing economies, it is vital to examine the impact of IP, inflation and investment on mental health.

This study aims to explore whether globalization and technology are harmful to health using a global panel data set of 52 countries over the period 1990–2019.

The study focused on four continents: Africa, the Americas, Asia/Oceania and Europe. The authors used four advanced econometric methodologies, which include the standard panel fixed effect (FE), Arellano–Bover/Blundell–Bond dynamic panel, Hausman–Taylor specification and two-stage least squares (FE-2SLS)/Lewbel-2SLS approaches.

The empirical evidence highlights the significance of globalization and technology in promoting global health. The findings suggest that globalization has various impacts on global health indicators and that technology is useful in tracking, monitoring and promoting global health. In addition, the empirical evidence indicates that a truly health-centred process of globalization and technological innovation can only be realized by ensuring that the interests of countries and vulnerable populations to health risks are adequately considered in international decision-making regarding global economic integration.

The authors suggest that achieving the aspiration of global health will entail the use of globalization and information technology to extend human activities and provide equal access to global health.

Malnutrition has a significant effect on the onset and progression of infective pathology. The malnutrition status in COVID-19 cases are not understood well. Prognostic Nutritional Index (PNI) is a new and detailed assessment of nutrition and inflammation cases. This study aims to investigate the effect of PNI on mortality in COVID-19 patients.

In total, 334 patients (males, 142; females, 192; 64.5 ± 12.3 years of age) with COVID-19 bronchopneumonia were enrolled in this investigation. Cases were divided into two groups with respect to survival (Group 1: survivor patients, Group 2: non-survivor patients). Demographic and laboratory variables of COVID-19 cases were recorded. Laboratory parameters were calculated from blood samples taken following hospital admission. PNI was calculated according to this formula: PNI = 5 * Lymphocyte count (10⁹/L) + Albumin value (g/L).

When the patients were assessed with respect to laboratory values, leukocytes, neutrophils, CRP, ferritin, creatinine and D-Dimer parameters were significantly lower in Group 1 patients than Group 2 patients. Nevertheless, serum potassium value, lymphocyte count, calcium and albumin values were significantly higher in Group 1 cases than in Group 2 cases. PNI value was significantly lower in Group 2 cases than in Group 1 cases (39.4 ± 3.7 vs 53.1 ± 4.6).

In this retrospective study of COVID-19 cases, it can be suggested that PNI may be a significant risk factor for mortality. In conclusion of this research, high-risk patients with COVID-19 can be determined early, and suitable medical therapy can be begun in the early duration.

This study aims to explore the efficacy of government policy directions in mitigating the effects of the COVID-19 pandemic by employing a panel of 22 countries throughout the 2020-second quarter of 2022.

The panel autoregressive distributed lag (ARDL) model is employed to examine this phenomenon and to investigate the long-run effects of government policy decisions on infection and mortality rates from the pandemic.

The study reveals the following key findings: (1) Income support and debt relief facilities and stringent standards of governments are associated with reduced infection and death rates. (2) The response of governments has resulted in decreased mortality rates while simultaneously leading to an unexpected increase in infection rates. (3) Containment and healthcare practices have led to a decrease in infection rates but an increase in mortality rates, presenting another counterintuitive outcome. Despite the expectation that robust government responses would decrease infection rates and that healthcare containment practices would reduce mortality, these results highlight a lack of health equity and the challenge of achieving high vaccination rates across countries.

To effectively combat the spread of COVID-19, it is crucial to implement containment health practices in conjunction with tracing and individual-level quarantine. Simply implementing containment health measures without these interconnected strategies would be ineffective. Therefore, policy implications derived from containment health measures should be accompanied by targeted, aggressive, and rapid containment strategies aimed at significantly reducing the number of individuals infected with COVID-19.

This study concludes by suggesting the importance of implementing economic support in terms of income, and debt relief has played a crucial role in mitigating the spread of COVID-19 infections and reducing fatality rates.

To effectively combat the spread of COVID-19, it is crucial to implement containment health practices in conjunction with tracing and individual-level quarantine. Simply implementing containment health measures without these interconnected strategies would be ineffective. Therefore, policy implications derived from containment health measures should be accompanied by targeted, aggressive, and rapid containment strategies aimed at significantly reducing the number of individuals infected with COVID-19.

This research makes a unique contribution to the existing literature by investigating the impact of government responses on reducing COVID-19 infections and fatalities, specifically focusing on the period before COVID-19 vaccinations became available.