Under-five mortality and child-abuse-related-deaths in the former USSR. Is there an under-reporting of abuse-related deaths?

摘要

The study explores the former USSR countries `Under-fives’ Child Mortality Ratesud(CMR) and Child-Abuse-Related-Deaths (CARD), since the end of the Soviet Unionudand asks whether there has been an `under-reporting’ of CARD?udW.H.O. under-five mortality rates per million (pm) were extracted for 1988-90udcompared with 2008-10 for CMR and confirmed and possible CARD.udPossible CARD are Undetermined Deaths(UnD) and Ill-Defined Signs & Symptomsud(IDSS) and as these categories have been linked to under-reporting of CARD.udCMR and CARD odds ratio calculated and correlated to determine possible underreportingudof CARD.udSeven countries met the UNICEF objective of reducing CMR; five halving their previousudUSSR rate.udRussian CARD at 29pm is highest but six countries rates were less than 10pm.udUndetermined Deaths (UnD) increased in Kazakhstan 13-fold, Belarus 8 times,udUkraine seven and in Russia more than four.udIll-defined deaths trebled in Belarus, and rose more than 25% in Kazakhstan, Georgiaudand Ukraine.udCARD significantly correlated with UnD but not with CMR.udOdds ratios of CMR to CARD categories were substantial, more than 4.1:1 in Belarus,udKazakhstan, Russia and Ukraine, indicating possible under-reporting of CARD.udDespite CMR improvements, this first-ever study of former USSR countries should alertudthe authorities of Belarus, Kazakhstan, the Russian Federation and the Ukraine to theudextent of possible child abuse.