1 Unité de Recherche en Organisation et Evaluation, Ecole de Santé Publique CP 590, Université Libre de Bruxelles, B-1070 and Centre d'Etudes Biomédicales, Ministère de la Santé Publique de Belgique
To the Editor.
In a recent article,1 Bloom discussed the problem of future reductions in infant mortality. He has proposed three ways of meeting this problem: by determining the efficacy, effectiveness, and cost of each intervention in medical care, by substituting less expensive interventions in place of more expensive care, and by separating social solutions from medical solutions for illness.
We appreciate his proposals, but we find that such an approach rules out the following two steps: (1) It is necessary to have a better understanding of the current changing trends in neonatal and postneonatal mortality.