Dynamics of infant mortality changes in Podkarpackie province in the years 2000–2017, forecast for the future. Retrospective study

Introduction
Mortality among children is a major problem for many countries and international organisations. Although mortality among children under five years old is declining around the world (including infant mortality), in many countries this progress is still worryingly slow.

Aim of the study
To determine dynamics of infant mortality changes in the Podkarpackie province in the years 2000–2017 and study the trend for the future.

Material and methods
The material for the study was information on infant deaths registered in the years 2000–2017 in Poland and the Podkarpackie province, taking into account the child’s sex and place of residence. The data was obtained from the Central Statistical Office. The total mortality rate of infants and newborns per 1000 live births and the average annual rate of decline in the infant mortality rate were calculated. In mortality forecasts for the subsequent years 2018–2025, a curvilinear regression model was applied using the exponential function.

Results
In the years 2000–2017 in Podkarpackie province, infant mortality, like neonatal mortality, decreased by more than a half (from 7.17 deaths per 1000 live births in infants in 2000 and 5.13 deaths per 1000 live births in newborns to 3.28 and 2.42, respectively, per 1000 live births in 2017). The average annual rate of decline in infant mortality in Poland amounted to 4.1%, while in Podkarpackie province it was 4.5%. In the group of newborns, the rate was slightly lower and amounted to 3.9% and 4.3%, respectively. In Poland, the excess mortality of boys between 20 and 25% was found, while in Podkarpackie large fluctuations were observed (from 4% to 43% in particular years). The number of infant deaths both in the city and in the countryside decreased by 45–60%, in the Podkarpackie province and in Poland. The forecast value of infant mortality in Podkarpackie province for 2018–2025 is between 3.80 (2018) and 2.85 (2025) per 100 live births.

Conclusions
In the years 2000–2017 in Podkarpackie province, infant mortality as well as neonatal mortality decreased by more than a half (from 7.17 deaths per 1000 live births for infants and 5.13 per 1000 live births for newborns in 2000 to 3.28 and 2.42, respectively, in 2017). The phenomenon of excess mortality of boys was found among infants. The infant mortality rate in rural areas in Podkarpackie province remained at a similar level to the national rate, while in the city in 2004–2006 it clearly exceeded it. The predicted infant mortality up to 2025 will show a downward trend.