Statistical utilization of maternity and child welfare records.

The collection and analysis of statistical material relating to mortality and morbidity has long been an important part of the functions of Public Health Authorities. Much of the data analysed at a national level is transmitted through the local authority and reciprocal arrangements have developed whereby statistical analysis of its own problems by each authority runs pari passu with centralized statistics for the country as a whole. In the field of child welfare, the rapid fall in infant mortality has shifted emphasis on the one hand to the importance of the antenatal period in relation to the hard core of neonatal mortality, and on the other to less immediately lethal aspects of child health. In both these fields local authorities have responsibilities which call for periodic assessment. The characteristics of Maternity and Child Welfare data of most interest to vital statisticians are that they cover all or nearly all of a complete population in the demographic sense, and that they record first-hand observations of events and conditions which might otherwise be missed. The data are, however, frequently less precise than can be obtained by trained investigators. A brief account of the methods now being adopted by the Maternity and Child Welfare Department of the City of Birmingham will illustrate the scope and limitations of Public Health material, and may be of interest to medical statisticians engaged in comparable tasks. The Maternity and Child Welfare Department, through its frequent contact with most of the city's mothers and children, has studied intensively aspects of neonatal mortality and the care of immature infants; but a considerable corpus of informa tion collected by midwives and health visitors regarding surviving children has not hitherto been available in a form amenable to systematic analysis. To utilize more effectively all existing data and to meet other administrative needs, the Senior Assistant Medical Officer of Health for Maternity and Child Welfare sought the assistance of the Central Statistical Office in re-designing some of the forms, and in planning a mechanized record system. Thus on January 1, 1949, was inaugurated a new system of records intended to make more readily available the medical and social histories of all children in the city under the age of 5 years. No radical changes in departmental policy or organization were involved, since health visitors were already visiting about 98 per cent, of all births to Birmingham residents at 41