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Adeyinka DA, Muhajarine N. Disentangling the link between social determinants of health and child survival in Nigeria during the Sustainable Development Goals era: a hierarchical path analysis of time-to-event outcome. J Biosoc Sci 2024; 56:357-375. [PMID: 38095080 DOI: 10.1017/s0021932023000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
While social determinants of health have been perennially linked to child survival in resource-limited countries, the precise and tested pathways to effect are not clearly understood. The objective of this study was therefore to identify the critical pathways as posited a priori in a model through which social factors (at maternal, household, and community levels) determine neonatal, infant, and under-five mortalities in Nigeria. Using a novel analytic approach (hierarchical path modelling for predicting accelerated failure time) to estimate (in)direct and total effects of social determinants of child survival, we analysed 30,960 live births (weighted data for representativeness), obtained from the 2016/2017 Nigeria Multiple Indicator Cluster Survey. There were three outcome variables: time until occurrence of neonatal, infant, and under-five mortalities. The independent variables were layered factors related to child, maternal, household and community. Geographical region, rurality of residence, infrastructural development, maternal education, contraceptive use, marital status, and maternal age at birth were found to operate more indirectly on neonatal, infant, and under-five survival. Child survival is due to direct effects of child's sex (female), gestational type (singleton), birth spacing (children whose mothers delivered at least two years apart), and maternal age at delivery (20-34 years). According to the path coefficients, the indirect effects of geographical regions are the most influential determinants of child survival, accounting for 30% (neonatal), 37.1% (infant) and 39.9% (under-five) of the total effects. This study offers comprehensive set of factors, and linked pathways, at the maternal, household, and community levels that are associated with child survival in Nigeria. To accelerate progress towards Sustainable Development Goal targets for child survival and reduce geographical inequities, stakeholders should implement more impactful policies that promote maternal education, contraceptive use and improve living conditions of women (especially in rural areas of northern Nigeria). Future research should focus on identifying the most effective interventions for addressing these social determinants of child survival in Nigeria.
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Affiliation(s)
- Daniel Adedayo Adeyinka
- Saskatchewan Population Health and Evaluation Research Unit, Saskatoon, SK, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Nazeem Muhajarine
- Saskatchewan Population Health and Evaluation Research Unit, Saskatoon, SK, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Elif Öztürk M, Yabancı Ayhan N. Evaluation of malnutrition and screening tools in hospitalized children. Clin Nutr ESPEN 2023; 57:770-778. [PMID: 37739737 DOI: 10.1016/j.clnesp.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/29/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. METHODS A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. RESULTS A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than -2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p < 0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p < 0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p > 0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. CONCLUSIONS Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.
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Affiliation(s)
- Meryem Elif Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Nurcan Yabancı Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey.
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Sheikh MR, Khan SU, Ahmed M, Ahmad R, Abbas A, Ullah I. Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model. BMC Public Health 2023; 23:1612. [PMID: 37612693 PMCID: PMC10464234 DOI: 10.1186/s12889-023-16526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Child mortality is a major challenge to public health in Pakistan and other developing countries. Reduction of the child mortality rate would improve public health and enhance human well-being and prosperity. This study recognizes the spatial clusters of child mortality across districts of Pakistan and identifies the direct and spatial spillover effects of determinants on the Child Mortality Rate (CMR). METHOD Data of the multiple indicators cluster survey (MICS) conducted by the United Nations International Children's Emergency Fund (UNICEF) was used to study the CMR. We used spatial univariate autocorrelation to test the spatial dependence between contiguous districts concerning CMR. We also applied the Spatial Durbin Model (SDM) to measure the spatial spillover effects of factors on CMR. RESULTS The study results showed 31% significant spatial association across the districts and identified a cluster of hot spots characterized by the high-high CMR in the districts of Punjab province. The empirical analysis of the SDM confirmed that the direct and spatial spillover effect of the poorest wealth quintile and MPI vulnerability on CMR is positive whereas access to postnatal care to the newly born child and improved drinking water has negatively (directly and indirectly) determined the CMR in Pakistan. CONCLUSION The instant results concluded that spatial dependence and significant spatial spillover effects concerning CMR exist across districts. Prioritization of the hot spot districts characterized by higher CMR can significantly reduce the CMR with improvement in financial statuses of households from the poorest quintile and MPI vulnerability as well as improvement in accessibility to postnatal care services and safe drinking water.
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Affiliation(s)
| | - Sami Ullah Khan
- Department of Economics, Gomal University, Dera Ismail Khan, KP, Pakistan.
| | - Munir Ahmed
- Department of Management Sciences, COMSATS University Islamabad, Vehari Campus, Vehari, Pakistan
| | - Rashid Ahmad
- School of Economics, Bahauddin Zakariya University, Multan, Pakistan
| | - Asad Abbas
- Department of Economics, COMSATS University Islamabad, Vehari Campus, Vehari, Pakistan
| | - Irfan Ullah
- Reading Academy, Nanjing University of Information Science and Technology, Nanjing, China
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Islam MZ, Rahman MM, Khan MN. Effects of short birth interval on different forms of child mortality in Bangladesh: Application of propensity score matching technique with inverse probability of treatment weighting. PLoS One 2023; 18:e0284776. [PMID: 37083714 PMCID: PMC10121045 DOI: 10.1371/journal.pone.0284776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The prevalence of Short Birth Interval (SBI) is higher in Low- and Middle-Income countries (LMICs), including Bangladesh. Previous studies in LMICs have estimated the effects of SBI on child mortality by comparing two unequal groups of mothers based on their socio-economic status. This approach may lead to overestimation or underestimation of the true effect of birth interval on child mortality, particularly when sample sizes are relatively small. OBJECTIVE We determined the effects of SBI on several forms of child mortality in Bangladesh by comparing two equal groups created by applying the propensity score matching technique. METHODS This study analyzed data from 5,941 mothers and 1,594 health facilities extracted from the 2017/18 Bangladesh Demographic and Health Survey and the 2017 Bangladesh Health Facility Survey. The exposure variable was SBI (defined as the interval between two subsequent births <33 months: yes, no), while the outcome variables were neonatal mortality (defined as mortality within 28 days of birth: yes, no), infant mortality (defined as mortality within 1 year of birth: yes, no), and under-five mortality (defined as mortality within 5 years of birth: yes, no). Multilevel Poisson regression based on inverse probability treatment weights was used to determine the association between exposure and outcome variables. RESULTS The prevalence rates of neonatal, infant, and under-five mortality were 48.8, 30.8, and 23.1 per 1000 live births, respectively. Newborns of SBI mothers were found to have a 63% higher likelihood of neonatal mortality (aPR, 1.63; 95% CI, 1.08-2.46) compared to newborns of non-SBI mothers. Furthermore, the prevalence of infant mortality and under-five mortality was 1.45 times higher (aPR, 1.45; 95% CI, 1.01-2.08) and 2.82 times higher (aPR, 2.82; 95% CI, 2.16-3.70), respectively, among babies born in a short interval of their immediately preceding sibling as compared to babies born in a normal interval of their immediately preceding sibling. CONCLUSIONS Findings of this study indicate that SBI is an important predictor of child mortality. Consequently, around 1 million children born in a short interval every year in Bangladesh are at risk of dying before reaching their fifth birthday. This indicates a challenge for Bangladesh to achieve the SDG 3 target to reduce neonatal and under-five mortality to 12 and 25 deaths per 1000 live births, respectively. Hence, awareness-building programs about the adverse effects of SBI and strengthening existing healthcare facilities are important.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - Md Mostafizur Rahman
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
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Ahmad S, Javeed S, Raza S, Baleanu D. A novel fractional model for the projection of households using wealth index quintiles. PLoS One 2022; 17:e0277472. [PMID: 36395109 PMCID: PMC9671317 DOI: 10.1371/journal.pone.0277472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/28/2022] [Indexed: 11/19/2022] Open
Abstract
Forecasting household assets provides a better opportunity to plan their socioeconomic activities for the future. Fractional mathematical models offer to model the asset-holding data into a piece of scientific evidence in addition to forecasting their future value. This research focuses on the development of a new fractional mathematical model based on the wealth index quintile (WIQ) data. To accomplish the objective, we used the system of coupled fractional differential equations by defining the fractional term with the Caputo derivative and verified it with the stability tests considering the steady-state solution. A numerical solution of the model was obtained using the Adams-Bashforth-Moulton method. To validate the model, we used real-time data obtained from the household series of surveys in Punjab, Pakistan. Different case studies that elucidate the effect of quintiles on the population are also presented. The accuracy of results between real-world and simulated data was compared using absolute and relative errors. The synchronization between the simulated results and real-time data verifies the formulation of the fractional WIQ model. This fractional model can be utilized to predict the approximation of the asset-holding of the households. Due to its relative nature, the model also provides the opportunity for the researchers to use the WIQs of their respective regions to forecast the households' socioeconomic conditions.
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Affiliation(s)
- Shakoor Ahmad
- Department of Mathematics, COMSATS University Islamabad, Chak Shahzad Islamabad, Pakistan
| | - Shumaila Javeed
- Department of Mathematics, COMSATS University Islamabad, Chak Shahzad Islamabad, Pakistan
- Department of Mathematics, Near East University, Mathematics Research Center, Nicosia /Mersin, Turkey
- * E-mail:
| | - Saqlain Raza
- Respiratory Care Department, College of Applied Medical Sciences in Jubail, Imam Abdulrahman bin Faisal University, Jubail, Saudi Arabia
| | - Dumitru Baleanu
- Department of Mathematics, Cankaya University, Ankara, Turkey
- Institute of Space Sciences, Magurele-Bucharest, Romania
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Karaye IM, Stone KW, Horney JA. Determinants of Under-Five Mortality in an Armed Conflict Setting: Empirical Findings from the Demographic and Health Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14179. [PMID: 36361059 PMCID: PMC9658916 DOI: 10.3390/ijerph192114179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Insurgencies like Boko Haram may impact the physical health and well-being of adults and children living in geographic areas under their political control. However, it is difficult to obtain reliable health data in conflict-affected areas. This study explored the potential to use data from the Demographic and Health Surveys (DHS) to examine the determinants of under-five mortality in Northern Nigeria. Data were derived from DHS conducted before and after the start of the Boko Haram insurgency in 2009. A multi-level mixed effects logistic regression model was used to identify predictors of under-five mortality in an armed conflict setting. Results were reported as adjusted odds ratios (aOR) and 95% confidence intervals (CI). Residence in an armed conflict setting was not significantly associated with under-five mortality (aOR = 1.06; 95% CI: 1.00, 1.10). However, twin gestation (aOR = 3.18; 95% CI:2.96, 3.42), wealth index of family (richest versus poorest: aOR = 0.42; 95% CI: 0.37, 0.47), religion of mother (Islam versus Christianity: aOR = 1.50; 95% CI: 1.43, 1.57); highest educational level of mother (higher versus none: aOR = 0.33; 95% CI: 0.29, 0.37), and parity of mother, significantly predicted death before the fifth birthday. Repeated studies are needed to assess the impact of Boko Haram insurgency on physical health outcomes, particularly in areas where primary data collection is difficult or impossible.
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Affiliation(s)
- Ibraheem M. Karaye
- Department of Population Health, Hofstra University, Hempstead, NY 11549, USA
| | - Kahler W. Stone
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN 37132, USA
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Islam MZ, Billah A, Islam MM, Rahman M, Khan N. Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis. J Glob Health 2022; 12:04070. [PMID: 36057919 PMCID: PMC9441110 DOI: 10.7189/jogh.12.04070] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Methods Eight databases, PubMed, CINAHL, Web of Science, Embase, PsycINFO, Cochrane Library, Popline, and Maternity and Infant Care, were searched, covering the period of January 2000 to January 2022. Studies that had examined the association between SBI and any form of child mortality were included. The findings of the included studies were summarized through fixed-effects or random-effects meta-analysis and the model was selected based on the heterogeneity index. Results A total of 51 studies were included. Of them, 19 were conducted in Ethiopia, 10 in Nigeria and 7 in Bangladesh. Significant higher likelihoods of stillbirth (odds ratio (OR) = 2.11; 95% confidence interval (CI) = 1.32-3.38), early neonatal mortality (OR = 1.58; 95% CI = 1.04-2.41), perinatal mortality (OR = 1.71; 95% CI = 1.32-2.21), neonatal mortality (OR = 1.85; 95% CI = 1.68-2.04), post-neonatal mortality (OR = 3.01; 95% CI = 1.43-6.33), infant mortality (OR = 1.92; 95% CI = 1.77-2.07), child mortality (OR = 1.67; 95% CI = 1.27-2.19) and under-five mortality (OR = 1.95; 95% CI = 1.56-2.44) were found among babies born in short birth intervals than those who born in normal intervals. Conclusions SBI significantly increases the risk of child mortality in LMICs. Programmes to reduce pregnancies in short intervals need to be expanded and strengthened. Reproductive health interventions aimed at reducing child mortality should include proper counselling on family planning, distribution of appropriate contraceptives and increased awareness of the adverse effects of SBI on maternal and child health.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.,Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Arif Billah
- Department of Social Work and Counselling, Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Malaysia
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mostafizur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
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Wardani Y, Huang YL, Chuang YC. Factors Associated with Infant Deaths in Indonesia: An Analysis of the 2012 and 2017 Indonesia Demographic and Health Surveys. J Trop Pediatr 2022; 68:6655516. [PMID: 35924318 DOI: 10.1093/tropej/fmac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND This exploratory study aimed to investigate factors related to infant deaths using a conceptual framework that explains the risk factors of infant deaths in developing countries. METHODS The study adopted a cross-sectional study design and used data from the 2012 and 2017 Indonesia Demographic and Health Surveys, with a sample of 3694 singleton live births in 2012 and 3413 in 2017. RESULTS Female infants had a lower chance of mortality compared to male infants [adjusted odds ratio (aOR) = 0.51; 95% confidence interval (CI) = 0.34-0.77]. Infants with a smaller birth size had a higher risk of infant death compared to those with an average size (aOR = 5.66; 95% CI = 3.66-8.77). The risk of infant death with a preceding birth interval of ≥24 months was lower than that with a preceding birth interval of <24 months (aOR = 0.48; 95% CI = 0.26-0.90). An older maternal age was a risk factor for infant death compared to younger mothers (aOR = 3.61; 95% CI = 1.42-9.23). Infants who were born in Sumatra (aOR = 0.38; 95% CI = 0.16-0.89) and Java and Bali (aOR = 0.33; 95% CI = 0.14-0.78) were less likely to die than infants who were born in Papua and Maluku. CONCLUSIONS A higher infant death risk was associated with male babies and a shorter birth interval (<24 months). Mothers who perceived their babies to be small and mothers who were older (35-49 years old) were high-risk factors for infant mortality. Mothers who lived in Java and Bali as well as Sumatera were less likely to experience infant mortality compared to those who lived in Papua and Maluku.
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Affiliation(s)
- Yuniar Wardani
- School of Public Health, Taipei Medical University, Taipei City 11031, Taiwan.,Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta 55164, Indonesia
| | - Ya-Li Huang
- School of Medicine, Department of Public Health, Taipei Medical University, Taipei City 11031, Taiwan
| | - Ying-Chih Chuang
- School of Public Health, Taipei Medical University, Taipei City 11031, Taiwan
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Rachmawati PD, Kurnia ID, Asih MN, Kurniawati TW, Krisnana I, Arief YS, Mani S, Dewi YS, Arifin H. Determinants of under-five mortality in Indonesia: A nationwide study. J Pediatr Nurs 2022; 65:e43-e48. [PMID: 35216837 DOI: 10.1016/j.pedn.2022.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The mortality rate for infants and children under five in Indonesia is an ongoing challenge for the government, with figures exceeding the targets set for the country by the Sustainable Development Goals (SDGs). OBJECTIVES This study aims to discover the factors causing under-five mortality in Indonesia. METHODS This study will employ a cross-sectional study design with data sourced from the 2017 Indonesian Demographic and Health Survey (IDHS) between July and September 2017. The sample included 10,014 women who had given birth in the five years prior to the survey. The data was analyzed using Binary logistic regression with a significance level of p < 0.05. RESULTS The significant factors relating to under-five mortality in Indonesia are: mother's age at birth (AOR = 2.04; 95% CI 95% = 1.11-3.77); birth weight (AOR = 7.60; 95% CI 95% = 5.17-11.19); the sex of the child (AOR = 1.80; 95% CI 95% = 1.28-2.52); frequency of using the internet (AOR = 1.13; 95% CI 95% = 0.02-0.95); residence (AOR = 0.64; 95% CI 95% = 0.33-0.94); and birth interval (AOR = 0.52; 95% CI 95% = 0.29-0.92). Birth weight is the more likely cause for under-five mortality in Indonesia. CONCLUSIONS This study revealed that the characteristics of mothers, children, the area of residence, and the behavior of the mother affect the under-five mortality. PRACTICE IMPLICATIONS Pediatric nurses can have a role to play in developing knowledge about health for both mothers and families. Additionally, accessible health education on issues from planning a pregnancy to childcare should be promoted in both rural and urban areas as well as a campaign on proper hygiene practices.
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Affiliation(s)
| | | | | | | | - Ilya Krisnana
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
| | | | - Smriti Mani
- Govt College of Nursing, Medical College and Hospital, Kolkata, India; OSD, Nursing Directorate, Govt of West Bengal, India.
| | | | - Hidayat Arifin
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia.
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Aklil MB, Temesgan WZ, Anteneh KT, Debele TZ. Knowledge and Attitude Towards Short Birth Interval among Rural Women who Gave Birth in the Last Three Years at Dembecha District, Northwest Ethiopia, 2019. SAGE Open Nurs 2022; 8:23779608221107997. [PMID: 35800116 PMCID: PMC9253980 DOI: 10.1177/23779608221107997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/04/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background A woman can have fewer children when intervals between consecutive births are
optimal. This has great importance for the well-being of women, pregnancy
outcomes, and the long-term health of children under the age of five. We can
save 2millon of the 11 million deaths of children under the age of five per
year by avoiding short birth intervals. It is affected by the knowledge and
attitude of women, particularly rural women, who had a high fertility rate.
To our deep review, this is the first study done in Ethiopia. Hence, this
study aimed to assess knowledge and attitude towards short birth intervals
and associated factors among rural women who gave birth in the last three
years at Dembecha district, northwest Ethiopia. Method A community-based cross-sectional study was conducted from September 20 to
October 20, 2019. A cluster sampling technique was employed to select the
study participants and data were collected using a pre-tested,
semi-structured, interviewer-administered questionnaire. Bivariable and
multivariable logistic regression model was fitted to identify factors
associated with knowledge and attitude towards short birth interval. The
level of significant association was declared using the adjusted odds ratio
(AOR) with 95% confidence interval (CI) and a p-value of <0.05. Result From the total study participants, 66.4% (95% CI: 63.0–70.0) had good
knowledge and 45.9% (95% CI: 42.3–49.8) had a positive attitude towards
short birth intervals. In multivariable logistic regression: marital status,
antenatal care follow-up, maternal occupation, and wealth status were
significantly associated with knowledge. In addition, antenatal care
follow-up and maternal occupation were significantly associated with
attitude. Conclusion Majority of the participants had poor knowledge and a positive attitude
towards short birth intervals. Hence, interventions should be done to
optimize women's knowledge and attitude towards short birth intervals by
enhancing antenatal care utilization.
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Affiliation(s)
- Mastewal Belayneh Aklil
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubedle Zelalem Temesgan
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kiber Temesgen Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tibeb Zena Debele
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Shifti DM, Chojenta C, Holliday E, Loxton D. Effects of short birth interval on neonatal, infant and under-five child mortality in Ethiopia: a nationally representative observational study using inverse probability of treatment weighting. BMJ Open 2021; 11:e047892. [PMID: 34408041 PMCID: PMC8375759 DOI: 10.1136/bmjopen-2020-047892] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess the effect of short birth interval (SBI) on neonatal, infant, and under-five mortality in Ethiopia. DESIGN A nationally representative cross-sectional survey. SETTING This study used data from the Ethiopia Demographic and Health Survey 2016. PARTICIPANTS A total of 8448 women who had at least two live births during the 5 years preceding the survey were included in the analysis. OUTCOME MEASURES Neonatal mortality (death of the child within 28 days of birth), infant mortality (death between birth and 11 months) and under-five mortality (death between birth and 59 months) were the outcome variables. METHODS Weighted logistic regression analysis based on inverse probability of treatment weights was used to estimate exposure effects adjusted for potential confounders. RESULTS The adjusted ORs (AORs) of neonatal mortality were about 85% higher among women with SBI (AOR=1.85, 95% CI=1.19 to 2.89) than those without. The odds of infant mortality were twofold higher (AOR=2.16, 95% CI=1.49 to 3.11) among women with SBI. The odds of under-five child mortality were also about two times (AOR=2.26, 95% CI=1.60 to 3.17) higher among women with SBI. CONCLUSION SBI has a significant effect on neonatal, infant and under-five mortality in Ethiopia. Interventions targeting SBI are warranted to reduce neonatal, infant and under-five mortality.
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Affiliation(s)
- Desalegn Markos Shifti
- St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Centre for Women's Health Research, School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine Chojenta
- Centre for Women's Health Research, School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Elizabeth Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
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Naz L, Patel KK, Uzoma IE. Crucial predicting factors of under-five mortality in Sierra Leone. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Trends in and determinants of neonatal and infant mortality in Nigeria based on Demographic and Health Survey data. J Biosoc Sci 2020; 53:924-934. [PMID: 33118890 DOI: 10.1017/s0021932020000619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study aimed to assess the changes in neonatal and infant mortality rates in Nigeria over the period 1990 to 2018 using Nigerian Demographic and Health Survey (NDHS) data, and assess their socio-demographic determinants using data from the most recent survey conducted in 2018. The infant mortality rate was 87 per 1000 live births in 1990, and this increased to 100 per 1000 live births in 2003 - an increase of around 15% over 13 years. Neonatal and infant mortality rates started to decline steadily thereafter and continued to do so until 2013. After 2013, neonatal morality rose slightly by the year 2018. Information for 27,465 infants under 1 year of age from the NDHS-2018 was analysed using bivariate and multivariate analysis and the Cox proportional hazard technique. In 2018, infant deaths decreased as wealth increased, and the incidence of infant deaths was greater among those of Islam religion than among those of other religions. A negative association was found between infant deaths and the size of a child at birth. Infant mortality was higher in rural than in urban areas, and was higher among male than female children. Both neonatal and infant death rates varied by region and were found to be highest in the North West region and lowest in the South region. An increasing trend was observed in neonatal mortality in the 5-year period from 2013 to 2018. Policy interventions should be focused on the poor classes, women with a birth interval of less than 2 years and those living in the North West region of the country.
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Adeyinka DA, Muhajarine N, Petrucka P, Isaac EW. Inequities in child survival in Nigerian communities during the Sustainable Development Goal era: insights from analysis of 2016/2017 Multiple Indicator Cluster Survey. BMC Public Health 2020; 20:1613. [PMID: 33109141 PMCID: PMC7590598 DOI: 10.1186/s12889-020-09672-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child survival is a major concern in Nigeria, as it contributes 13% of the global under-five mortalities. Although studies have examined the determinants of under-five mortality in Nigeria, the comparative roles of social determinants of health at the different stages of early childhood development have not been concurrently investigated. This study, therefore, aimed to identify the social determinants of age-specific childhood (0-59 months) mortalities, which are disaggregated into neonatal mortality (0-27 days), post-neonatal mortality (1-11 months) and child mortality (12-59 months), and estimate the within-and between-community variations of mortality among under-five children in Nigeria. This study provides evidence to guide stakeholders in planning for effective child survival strategies in the Nigerian communities during the Sustainable Development Goals era. METHODS Using the 2016/2017 Nigeria Multiple Indicator Cluster Survey, we performed multilevel multinomial logistic regression analysis on data of a nationally representative sample of 29,786 (weighted = 30,960) live births delivered 5 years before the survey to 18,497 women aged 15-49 years and nested within 16,151 households and 2227 communities. RESULTS Determinants of under-five mortality differ across the neonatal, post-neonatal and toddler/pre-school stages in Nigeria. Unexpectedly, attendance of skilled health providers during delivery was associated with an increased neonatal mortality risk, although its effect disappeared during post-neonatal and toddler/pre-school stages. Also, our study found maternal-level factors such as maternal education, contraceptive use, maternal wealth index, parity, death of previous children, and quality of perinatal care accounted for high variation (39%) in childhood mortalities across the communities. The inclusion of other compositional and contextual factors had no significant additional effect on childhood mortality risks across the communities. CONCLUSION This study reinforces the importance of maternal-level factors in reducing childhood mortality, independent of the child, household, and community-level characteristics in the Nigerian communities. To tackle childhood mortalities in the communities, government-led strategies should prioritize implementation of community-based and community-specific interventions aimed at improving socioeconomic conditions of women. Training and continuous mentoring with adequate supervision of skilled health workers must be ensured to improve the quality of perinatal care in Nigeria.
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Affiliation(s)
- Daniel Adedayo Adeyinka
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada.
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria.
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada
- Saskatchewan Population Health and Evaluation Research Unit, Saskatoon, Saskatchewan, Canada
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Elon Warnow Isaac
- Department of Paediatrics, College of Medical Sciences, Gombe State University, Gombe, Nigeria
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Vijay J, Patel KK. Risk factors of infant mortality in Bangladesh. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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