The Western Galilee experience: reducing infant mortality in the Arab population

Until the end of the 1980s almost no intensive intervention plan was applied to narrow the vast gap (over 100%) in infant mortality between Jews and Arabs in the Western Galilee region of Israel. A special committee appointed by the Ministry of Health instituted measures to reduce the gap, including monitoring mortality rates by establishing an online and real-time computerized information system to analyze the information without delay. Based on the epidemiologic findings, an intervention program was implemented, using health education to reduce mortality due to seasonal infections--gastroenteritis in summer and upper respiratory and hyperthermia in winter. Within 1 year these infections had abated, resulting in significantly reduced mortality. The next step was the development of an ultrasound preventive campaign using sophisticated sonography to screen pregnant women in risk groups for lethal congenital defects and convincing them to discontinue the pregnancy. These two measures reduced infant mortality dramatically. The campaign has been widened to the entire northern district and is presently addressing, as a primary prevention, the traditionally difficult problem of consanguineous marriages--the major cause of congenital defects in the Arab population.