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Tesfa D, Tiruneh SA, Azanaw MM, Gebremariam AD, Engdaw MT, Kefale B, Abebe B, Dessalegn T. Time to death and its determinants among under-five children in Sub-Saharan Africa using the recent (2010-2018) demographic and health survey data: country-based shared frailty analyses. BMC Pediatr 2021; 21:515. [PMID: 34789187 PMCID: PMC8597287 DOI: 10.1186/s12887-021-02950-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 10/06/2021] [Indexed: 11/18/2022] Open
Abstract
Background Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. There are disproportional survivals among children in the world. Therefore, the study aimed to assess the Survival status of under-five mortality and determinants in Sub-Saharan African Countries using the recent DHS data. Methods The data was retrieved from the birth record file from the standard Demographic and Health Survey dataset of Sub-Saharan Africa countries. Countries that have at least one survey between 2010 and 2018 were retrieved. Parametric shared frailty survival analysis was employed. Results A total of 27,221 (7.35%) children were died before celebrating their fifth birthday. Children at an early age were at higher risk of dying and then decrease proportionally with increased age. The risk of death among rich and middle family were lowered by 18 and 8% (AHR =0.82, 95% CI: 0.77-0.87) and (AHR = 0.92, 95% CI: 0.87-0.97) respectively, the hazard of death were 11, 19, 17, 90 and 55% (AHR = 1.06, 95% CI: 1.00-1.12), (AHR = 1.11,95%CI:1.04-1.19), (AHR = 1.17, 95% CI:1.12-1.23), (AHR = 1.90, 95%CI: 1.78-2.04) and (AHR = 1.55, 95% CI:1.47-1.63) higher than among children in rural, use unimproved water, delivered at home, born less than 18 months and between 18 and 23 months birth intervals respectively. The hazard of death was 7% among females and low birth weights (AHR = 0.93, 95%CI: 0.90 – 0.97) and (AHR = 0.93 95%CI: 0.89-0.97) respectively. There was also a significant association between multiple births and birth orders (AHR = 2.11, 95%CI: 2.51 – 2.90), (AHR = 3.01, 95%CI: 2.85-3.19) respectively. Conclusions Death rate among under-five children was higher at an early age then decreases as age advanced. Wealth status, residence, water source, place of delivery, sex of the child, plurality, birth size, preceding birth interval, and birth order were the most predictor variables. The health care program should be designed to encourage a healthy family structure. The health care providers should intervene in the community to inspire maternal health services.
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Affiliation(s)
- Desalegn Tesfa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Melaku Tadege Engdaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Belayneh Kefale
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bedilu Abebe
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tsion Dessalegn
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Yaya S, Zegeye B, Ahinkorah BO, Oladimeji O, Shibre G. Regional variations and socio-economic disparities in neonatal mortality in Angola: a cross-sectional study using demographic and health surveys. Fam Pract 2020; 37:785-792. [PMID: 33247937 DOI: 10.1093/fampra/cmaa083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inequalities in neonatal mortality rates (NMRs) in low- and middle-income countries show key disparities at the detriment of disadvantaged population subgroups. There is a lack of scholarly evidence on the extent and reasons for the inequalities in NMRs in Angola. OBJECTIVE The aim of this study was to assess the socio-economic, place of residence, region and gender inequalities in the NMRs in Angola. METHODS The World Health Organization Health Equity Assessment Toolkit software was used to analyse data from the 2015 Angola Demographic and Health Survey. Five equity stratifiers: subnational regions, education, wealth, residence and sex were used to disaggregate NMR inequality. Absolute and relative inequality measures, namely, difference, population attributable fraction (PAF), population attributable risk (PAR) and ratio, were calculated to provide a broader understanding of the inequalities in NMR. Statistical significance was calculated at corresponding 95% uncertainty intervals. FINDINGS We found significant wealth-driven [PAR = -14.16, 95% corresponding interval (CI): -15.12, -13.19], education-related (PAF = -22.5%, 95% CI: -25.93, -19.23), urban-rural (PAF = -14.5%, 95% CI: -16.38, -12.74), sex-based (PAR = -5.6%, 95% CI: -6.17, -5.10) and subnational regional (PAF = -82.2%, 95% CI: -90.14, -74.41) disparities in NMRs, with higher burden among deprived population subgroups. CONCLUSIONS High NMRs were found among male neonates and those born to mothers with no formal education, poor mothers and those living in rural areas and the Benguela region. Interventions aimed at reducing NMRs, should be designed with specific focus on disadvantaged subpopulations.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.,The George Institute for Global Health, The University of Oxford, Oxford, UK
| | - Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Olanrewaju Oladimeji
- Department of Public Health, Walter Sisulu University, Eastern Cape, South Africa.,Center for Community Healthcare, Research and Development, Abuja, Nigeria.,Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Gebretsadik Shibre
- Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Yaya S, Kota K, Buh A, Bishwajit G. Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone. BMC Public Health 2020; 20:855. [PMID: 32503478 PMCID: PMC7273659 DOI: 10.1186/s12889-020-08985-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/24/2020] [Indexed: 12/30/2022] Open
Abstract
Background Immunization of women during pregnancy to protect them and their infants against tetanus, pertussis and influenza is recommended by the World health Organization (WHO). However, there is limited information about the coverage rate and associated factors in low-income countries. The aim of this study was to measure the prevalence and predictors of taking tetanus toxoid among pregnant women in Sierra Leone. Methods This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2017. In total 8722 women aged between 15 and 49 years were included in this study. Outcome variable was taking of Tetanus Toxoid vaccination during the last pregnancy. Data were analyzed using cross-tabulation and logistic regression methods. Results The overall prevalence of receiving TT immunization during women’s last pregnancy was 96.3% and that of taking at least two doses was 82.12%. In the regression analysis, women from Mende ethnicity had a 0.48 fold lower chance of being immunized (OR = 0.480, 95% CI = 0.385,0.59768) than those from the other ethnicity. In addition, women who attended at least four ANC visits had higher odds of receiving TT vaccine (OR = 1.919, 95% CI = 1.639,2.245) compared to those who attended less ANC visits. Stratified by areas, this association was observed in both urban (OR = 2.661, 95% CI = 1.924,3.679) and rural areas (OR = 1.716, 95% CI = 1.430,2.059). Attending at least four ANC visits showed a positive association with receiving at least two doses TT (OR = 2.434, 95% CI = 1.711,3.464) in both urban (OR = 2.815, 95% CI = 1.413,5.610) and rural areas (OR = 2.216, 95% CI = 1.463,3.356) as well. Conclusion Higher number of ANC visits, mass media exposure and higher wealth quintile increased the odds of receiving TT immunization. In addition, minimum two doses which were identified to reduce neonatal mortality. Therefore, immunization campaigns targeting improved utilization of healthcare and immunization services by women of childbearing age in Sierra Leone are strongly recommended.
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Affiliation(s)
- Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, The University of Oxford, Oxford, UK.
| | - Komlan Kota
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Amos Buh
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ghose Bishwajit
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, K1N 6N5, Canada
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Karlsson L, Lundevaller EH, Schumann B. Neonatal Mortality and Temperature in Two Northern Swedish Rural Parishes, 1860-1899-The Significance of Ethnicity and Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041216. [PMID: 32070044 PMCID: PMC7068363 DOI: 10.3390/ijerph17041216] [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] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to analyze the association between season of birth and daily temperature for neonatal mortality in two Swedish rural parishes between 1860 and 1899. Further, we aimed to study whether the association varied according to ethnicity (indigenous Sami reindeer herders and non-Sami settlers) and gender. The source material for this study comprised digitized parish records from the Demographic Data Base, Umeå University, combined with local weather data provided by the Swedish Meteorological and Hydrological Institute. Using a time event-history approach, we investigated the association between daily temperature (at birth and up to 28 days after birth) and the risk of neonatal death during the coldest months (November through March). The results showed that Sami neonatal mortality was highest during winter and that the Sami neonatal mortality risk decreased with higher temperatures on the day of birth. Male neonatal risk decreased with higher temperatures during the days following birth, while no effect of temperature was observed among female neonates. We conclude that weather vulnerability differed between genders and between the indigenous and non-indigenous populations.
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Affiliation(s)
- Lena Karlsson
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, 901 87 Umeå, Sweden; (E.H.L.)
- Department of Sociology, Umeå University, 901 87 Umeå, Sweden
- Correspondence:
| | - Erling H. Lundevaller
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, 901 87 Umeå, Sweden; (E.H.L.)
- Department of Statistics, Umeå University, 901 87 Umeå, Sweden
| | - Barbara Schumann
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, 901 87 Umeå, Sweden; (E.H.L.)
- Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
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Van Malderen C, Amouzou A, Barros AJD, Masquelier B, Van Oyen H, Speybroeck N. Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa: a decomposition analysis. BMC Public Health 2019; 19:760. [PMID: 31200681 PMCID: PMC6570834 DOI: 10.1186/s12889-019-7111-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background In sub-Saharan Africa, socioeconomic factors such as place of residence, mother’s educational level, or household wealth, are strongly associated with risk factors of under-five mortality (U5M) such as health behavior or exposure to diseases and injuries. The aim of the study was to assess the relative contribution of four known socioeconomic factors to the variability in U5M in sub-Saharan countries. Methods The study was based on birth histories from the Demographic and Health Surveys conducted in 32 sub-Saharan countries in 2010–2016. The relative contribution of sex of the child, place of residence, mother’s educational level, and household wealth to the variability in U5M was assessed using a regression-based decomposition of a Gini-type index. Results The Gini index – measuring the variability in U5M related to the four socioeconomic factors – varied from 0.006 (95%CI: 0.001–0.010) in Liberia 2013 to 0.034 (95%CI: 0.029–0.039) in Côte d’Ivoire 2011/12. The main contributors to the Gini index (with a relative contribution higher than 25%) were different across countries: mother’s educational level in 13 countries, sex of the child in 12 countries, household wealth in 11 countries, and place of residence in 8 countries (in some countries, more than one main contributor was identified). Conclusions Factors related to socioeconomic status exert varied effects on the variability in U5M in sub-Saharan African countries. The findings provide evidence in support of prioritizing intersectoral interventions aiming at improving child survival in all subgroups of a population.
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Affiliation(s)
- Carine Van Malderen
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
| | - Agbessi Amouzou
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | | | - Bruno Masquelier
- Centre de Recherche en Démographie, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Institut National d'Etudes Démographiques (INED), Paris, France
| | - Herman Van Oyen
- Department of Public Health and Surveillance, Sciensano, Brussels, Belgium.,Department of Public Health, Ghent University, Ghent, Belgium
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
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