Determinants Of Child Mortality Research Articles

Exploring the determinants of under-five mortality and morbidity from infectious diseases in Cambodia—a traditional and machine learning approach

Cambodia has made progress in reducing the under-five mortality rate and burden of infectious diseases among children over the last decades. However the determinants of child mortality and morbidity in Cambodia is not well understood, and no recent analysis has been conducted to investigate possible determinants. We applied a multivariable logistical regression model and a conditional random forest to explore possible determinants of under-five mortality and under-five child morbidity from infectious diseases using the most recent Demographic Health Survey in 2021–2022. Our findings show that the majority (58%) of under-five deaths occurred during the neonatal period. Contraceptive use of the mother led to lower odds of under-five mortality (0.51 [95% CI 0.32–0.80], p-value 0.003), while being born fourth or later was associated with increased odds (3.25 [95% CI 1.09–9.66], p-value 0.034). Improved household water source and higher household wealth quintile was associated with lower odds of infectious disease while living in the Great Lake or Coastal region led to increased odds respectively. The odds ratios were consistent with the results from the conditional random forest. The study showcases how closely related child mortality and morbidity due to infectious disease are to broader social development in Cambodia and the importance of accelerating progress in many sectors to end preventable child mortality and morbidity.

Correlates of Child Mortality in Pakistan: A Hazards Model Analysis

This study investigated factors associated with child mortality in an area in Rawalpindi, one of the large cities of Pakistan. Using both demographic and anthropological methods, the research was conducted to specifically examine the process and mechanisms whereby a link is established between child mortality and its covariates. Controlling for the socioeconomic status as a determinant of child mortality, the study population was limited to a lower income stratum living in a homogeneous environment where all households had equal access to health-related and other facilities. Results of the proportional hazards model analysis on 1301 index children suggest that non-economic factors like maternal health-seeking behavior were related to high child mortality. The cultural norm of bearing a large number of children was the most significant correlate. In order of significance, this was followed by contraceptive use, current age of the mother, age at marriage, and the hygienic conditions of the household. The study provides strong evidence of familial clustering of mortality by order of the household.

Determinants of mortality in children aged under two years in Bangladesh using two approaches: an analysis of the Bangladesh Demographic and Health Survey 2014 data

Aims: Mortality in children aged under two years is a severe public health problem in many developing countries. The aims of the study were to reveal the prevalence and factors associated with mortality in children under two years in Bangladesh. Methods: Data were analyzed using the Bangladesh Demographic and Health Survey 2014. A total of 7886 participant data used in this study. The chi-square test of association was performed with dependent and independent variables to measure the prevalence rate, while the final model binary logistic and log-binomial regressions were used to identify the potential risk factors for under-two mortalities. Results: The prevalence of under-2 mortalities in Bangladesh was 3.9%. Regression analysis revealed that a lower level of paternal education, succeeding birth interval less than 24 months, multiple birth babies, and smaller than the average size at birth were significantly associated with children’s mortality under two years in Bangladesh. Conclusions: Despite improvements in the reduction of child mortality in Bangladesh, many children died within the first 24 months of life, mostly preventable. Programs towards increasing education levels and pregnancy intervals might help in preventing infant mortality in Bangladesh. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 413-421

Socio-demographic and environmental determinants of child mortality in rural communities of Ogun State, Nigeria.

Nigeria's under five-mortality was 132 per 1000 in 2018. The statistic makes Nigeria the country with the third-highest under-five mortality globally. It implies that the government may not achieve the Sustainable Development Goal (SDG) of 25 per 1000 births by 2030. This situation is of grave concern to policymakers and other stakeholders interested in the country's development. This study provides unique community micro-level information on child mortality determinants in rural communities where the country's health system is weakest. The study used a sample of 1350 pregnant women aged 20-44 who attended antenatal care in22 health facilities in selected rural communities of Ogun State, South-west Nigeria. The multicollinearity diagnostics tests conducted between the dependent variable and predictors showed no abnormality in the values of the variance inflation factor, eigenvalues, and condition indexes. Logistics regression results showed that the socio-demographic characteristics such as the respondent's age, educational level, number of living children, and husband's education directly affected child mortality. In contrast, the husband has another wife had an indirect effect on child mortality. Environmental factors that directly impacted child mortality included the type of household toilet facility, source of water supply, and household waste disposal practices. These findings indicate that policies and programs to reduce child mortality in rural Nigeria must address socio-demographic and context-specific factors, especially at the community level.

Socio-economic, macroeconomic, demographic, and environmental variables as determinants of child mortality in South Asia.

The study empirically examines the effects of socio-economic (human capital), macroeconomic (per capita GDP), demographic (fertility rate, urbanization), and environmental variables (carbon emissions) on child mortality in South Asia. For empirical analysis, panel cointegration technique is used by using data for five South Asian countries for the period 1973 to 2015. First, it is found that the variables have unit roots at levels but are stationary at first differences, which indicates the possibility of cointegration. Cointegration test results show that long-run cointegrating relationship holds among variables. Fully Modified OLS (FMOLS) and Dynamic OLS (DOLS) methods are applied to find the parameter estimates. The results of long-run estimates show that human capital, per capita income, and urbanization reduce child mortality while high fertility rate and environmental degradation increase child mortality in the region. It is also found that trade openness, immunization, food security, and high life expectancy also decrease child mortality and that population density increases child mortality.

Socioeconomic Determinants of Child Mortality (Under Age One): Reported by Mothers of Reproductive Age in Punjab, Pakistan

The future of a nation lies in the hands of its children. Health of children should be the first priority of a nation. It is an indicator of social and economic development. Pakistan falls among high child mortality rate countries. The aim of this paper is to assess the socioeconomic determinants of child mortality in the Punjab. For this purpose, the study obtains data from Multiple Indicator Cluster Survey (2014), conducted by Punjab Bureau of statistics. The data were collected with the help of well-designed three questionnaires from 38,405 households of Punjab. The STATA is used to apply Logistic model to determine the factors affecting child mortality. The dependent variable is dichotomous in nature based on this question “Have you ever given birth to a boy or girl who was born alive but later died?” and response is either yes or no. According to the empirical results of the study, area of residence, source of drinking water, women ever attended school and their level of education, women media awareness, women smoking and wealth quintiles are important socioeconomic determinants of child mortality. But comparatively, wealth quintiles have greater influence on reducing child mortality. The study suggests some policies to improve the situation, e.g., allocation of more budget for health, initiative of health care programs for women and infant, particularly in rural areas of Punjab.

До питання сучасного стану деяких соціально-економічних детермінант дитячої смертності в Україні

До питання сучасного стану деяких соціально-економічних детермінант дитячої смертності в Україні

Individual, Household and Community-Level Effects of Infant and Child Mortality in Nigeria: A Logistic Regression Approach

Research has shown that knowledge about the determinants of childhood mortality at the individual level is not enough to address the problem because the characteristics of the environment where a child is born tend to alter individual level characteristics and thereby affect child survival. The study used data from the 2013 Nigeria Demographic and Health Survey (NDHS). The fact that a child was either dead or alive was assumed to be accurately recorded. Hence, logistic regression model was used to model whether a child is dead or alive with respect to the selected predictor variables. Results from the study reveal that infant and child mortality in Nigeria is determined more by individual household than by community, and that geographical variations also exist. This study has identified significant risk factors that will help policy makers to formulate policies that will improve childhood survival.

Effect of birth interval and wealth on under-5 child mortality in Nigeria

BackgroundThere exists a number of studies on the causes and determinants of childhood mortality in the developing world. However, to best of our knowledge, none of the existing studies have examined the effect of wealth and birth interval on childhood mortality in Nigeria. This study is an attempt to fill that gap. MethodsData for this study comes from the Nigeria Demographic and Health Survey 2013, which is a nationally representative cross-sectional survey. This study uses information on 119,386 under-5 children to analyze the effect of wealth and birth interval on childhood mortality. Bi-variate and Cox regression technique were applied for analyzing the cross-sectional data drawn from representative survey. ResultsUnder-5 mortality was higher in mothers who were poor, illiterate and working either as a professional/technical worker or as an agricultural worker. Children whose mothers were illiterate and had less than two years of the birth interval had the highest under-5 mortality. Younger mothers (aged less than 20 years) lost more children. Under-5 deaths were more among those mothers who were poor and had less than two years of birth interval. The child mortality was significantly high in poor households with low birth interval. ConclusionUnder-5 mortality is low among those who had higher wealth status and more than two years of birth interval. In order to reduce or eradicating the effect of birth interval and wealth effect, there is burning need to control the economic inequality and birth interval.

Study on Child Mortality Determinants in EAG States and Assam

Study on Child Mortality Determinants in EAG States and Assam

Household resources as determinants of child mortality in Ghana.

Although the association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations. This study investigated the contribution of several household resources to child mortality, beyond the influence of maternal education as a measure of socioeconomic status. This secondary analysis used data from the 2007 Ghana Maternal Health Survey to explore the relationship of child mortality to household resources. The analysis of 7183 parous women aged 15-45 years examined household resources for their association with maternal reports of any child's death for children aged less than 5 years using a survey-weighted logistic regression model while controlling for sociodemographic and health covariates. The overall household resources index was significantly associated with the death of one or more child in the entire sample (adjusted odd ratios (OR)=0.95; 95% confidence interval (CI): 0.92, 0.98]. In stratified analysis, this finding held for women living in rural but not in urban areas. Having a refrigerator at the time of interview was associated with lower odds of reporting child mortality (OR=0.63; 95%CI: 0.48, 0.83). Having a kerosene lantern (OR=1.40; 95%CI: 1.06, 1.85) or flush toilet (OR=1.84; 95%CI: 1.23, 2.75) was associated with higher odds of reporting child mortality. Adjusted regression models showed only possession of a refrigerator retained significance. Possession of a refrigerator may play a role in child mortality. This finding may reflect unmeasured socioeconomic status or the importance of access to refrigeration in preventing diarrheal disease or other proximal causes of child mortality in sub-Saharan Africa.

Prevalence and determinants of childhood mortality in Nigeria

BackgroundChildhood mortality has remained a major challenge to public health amongst families in Nigeria and other developing countries. The menace of incessant childhood mortality has been a major concern and this calls for studies to generate new scientific evidence to determine its prevalence and explore predisposing factors associated with it in Nigeria.MethodData was obtained from Nigeria DHS, 2013. The study outcome variable was the total number of children lost by male partners and female partners respectively who were married. The difference between the numbers of child births and the number of living children was used to determine the number of children lost. Study variables were obtained for 8658 couples captured in the data set. Descriptive statistics were computed to examine the presence of over-dispersion and zero occurrences. Data were analysed using STATA Software version 12.0. Zero-inflated negative binomial (ZINB) regression analysis was carried out to determine the factors associated with childhood mortality. Results of ZINB were reported in terms of IRR and 95% confidence interval (CI).ResultsThe age (mean ± std.) of male and female participants were 36.88 ± 7.37 and 28.59 ± 7.30 respectively. The data showed that 30.8% women reported loss of children and 37.3% men reported the same problem. The study revealed age (years), region, residence, education, wealth index, age at first birth and religion of father and mother as factors associated with childhood mortality. In terms of education, secondary and tertiary educated fathers exhibited 3.8% and 12.1% lower risk of childhood mortality respectively than non-educated fathers. The results showed that the risk of childhood mortality are 26.7%, 39.7 and 45.9% lower among the mothers having primary, secondary and tertiary education respectively than those with no formal education. The mothers living in rural areas experienced 28.3% increase in childhood mortality than those in urban areas, while the fathers in rural areas experienced 33.5% increase in childhood mortality than the urban areas. The risk of childhood mortality was significantly lower in middle, richer and richest (11.1%, 37.5 and 49%) economic quintiles respectively when compared to the risk of childhood mortality with female spouse who are poorest. Similar results were obtained for the fathers, with reduction in the incidence-rate ratio of 3.3%, 20.2 and 28.7% for middle, richer and richest economic quintiles respectively, compared to the poorest status. Furthermore, region and religion were found to be significant factors associated with childhood mortality in Nigeria.ConclusionThe findings suggested that age, region, residence, education, wealth index, age at first birth and religion of fathers and mothers are key determinants associated with childhood mortality. The correlation between childhood mortality and fathers’ and mothers’ ages were found to increase the incidence of the outcome for every unit increase in age. The converse was however, true for age at first birth which was also statistically significant. The implication of this study is that policy makers and stakeholders in health care should provide for improved living standards to achieve good life expectancy meeting SDG3.

Infant Mortality Juvenile and Inequality Income in Niger: Evidence for Regional Differences through Two Case Studies

In this study, we sought to highlight a side of the interrelations between income inequality and health indicators, and other assess the problem taking into account the socio-professional status and regional inequalities. In support databases of EDSN 1998 and EDSN-MICS 2006; after calculating the indicators of inequality, it appears in a preliminary analysis that income inequality has increased in Niger from 1998 to 2006. The analysis of these indicators by region confirms and reinforces the existence of a regional disparity in income inequality. Finally, the level of income inequality by region is itself a determinant of child mortality in Niger. Thus, regions with low child mortality also have the lowest rates of poverty in Niger.

Determinants of Mortality in Children under Five Years of Age with Severe Acute Malnutrition Admitted to the Yalgado Ouédraogo Teaching Hospital (Burkina Faso)

Determinants of Mortality in Children under Five Years of Age with Severe Acute Malnutrition Admitted to the Yalgado Ouédraogo Teaching Hospital (Burkina Faso)

Determinants of Mortality in Children under Five Years of Age with Severe Acute Malnutrition Admitted to the Yalgado Ouédraogo Teaching Hospital (Burkina Faso)

Determinants of Mortality in Children under Five Years of Age with Severe Acute Malnutrition Admitted to the Yalgado Ouédraogo Teaching Hospital (Burkina Faso)

Determinants of Mortality in Children under Five Years of Age with Severe Acute Malnutrition Admitted to the Yalgado Ouédraogo Teaching Hospital (Burkina Faso)

Background: To determine critical factors associated with severely malnourished children under five this case-control study was conducted. Methods: The data of a total of 433 children aged 0-59 months and admitted to the Hospital Yalgado Ouedraogo, (CHU – YO) between January 31, 2009 to January 31, 2013, were included in the analysis: 72 for the case group and 361 for the control group. Clinical and treatment records were accessed and data were analyzed. Results: For clinical signs, determinants of mortality were diarrhea [OR = 4.6; (95%CI 2.6-8.2], anorexia [OR = 2.7; (95%CI 1.4-5.0] and hepatomegaly [OR = 2.6; (95%CI 1.4-4.8]. For infections, determinants of mortality were pediatric HIV/AIDS [OR = 10.9; (95%CI 5.6-21.5] and digestive illnesses [OR = 5.1 (95%CI 2.8-9.4)]. Regarding the complications of malnutrition, determinants of mortality were severe dehydration [OR = 16.4 (95%CI 8.0-33.5)], skin lesions [OR = 14.3 (95%CI 6.4 -31.9)], heart failure [OR = 6.8 (95%CI 2.5-19.0)] and severe anemia [OR = 3.2(95%CI 1.4-7.1)]. For biochemical indicators, low serum sodium [OR = 0.7(95%CI 0.5-1.0)] and potassium levels [OR = 0.9(95%CI 0.9-1.0)] were the critical factors. In addition the risk of death was associated with low value of MUAC [OR = 0.9 (95% CI 0.8-0.9)]. Conclusions: The risk of death of children with severe acute malnutrition varies according to different factors studied.

Determinants of Child Mortality in Africa: A Methodological Discussion

Current literature is ambiguous regarding the significance of public health expenditure in reducing mortality rate among children in cross country studies. In fact, several previous studies found the relationship between these two variables to be insignificant. Such findings indicate the existence of a huge inefficiency in public sector of struggling countries and discourage supports provided by donating entities. This study addresses the disagreement in the literature by pointing out how results are sensitive to the use of non-stationary variables that are used often in the literature. Using a Panel Vector Autoregressive model, no empirical evidence for the role of public health expenditure in reducing child mortality is found when non-stationary variables are used. However, results are significantly different as soon as stationary variables are substituted in the same model. In fact, the elasticity of under five mortality rate with respect to per capita public health expenditure is about -0.22 for African countries in the sample.

Mapping the determinants of child mortality in Nigeria: estimates from mortality index

Although the risk factors of child mortality in Sub-Saharan Africa have received much attention in the literature, detailed spatially varying relationships among these factors have remained unknown. The assumption is that the determinants exact matching influence across space but there are good reasons to doubt the veracity of this claim. This study examines the spatially varying relationships of determinants of child mortality in Nigeria, using data from Demographic and Health Surveys. We control the duration of exposure to the risks of mortality by computing the mortality index of individual women. Based on this, we used geographically weighted regression to map the varying effects of the risk factors. The results show that there are huge variations, across space, in the contributions of all the variables considered. We established that factors that made consistent contributions, albeit at different scales, include women’s education, household headship, wealth index, and toilet facilities. The observed variations indicate that cultural, political, and climatic factors operate with these determinants to shape the level of impact on the survival chance of children.

Mortalidad en la niñez enla Argentina: disparidades regionales y sociales frente a la cuarta meta del Milenio

This paper analyses childhood mortality in Argentina. It posits that the gaps between regions and social groups hinder the achievement of the objective agreed in the Millennium Declaration. Administrative data and micro data from two sources are used to illustrate the magnitude of these gaps: the national population and housing census for north-west Argentina, a region with one of the highest rates of mortality in the country, and the living conditions survey (ECV). Mortality indicators are established and the determinants of childhood mortality are explored using answers given by women aged 15-49 years to questions on the number of children they have had and the number of surviving children.

Did the 2008–2009 Food and Financial Crises Affect Child Mortality? The Case of Sub-Saharan Africa

We estimate an aggregate model of child mortality on a panel of 40 African countries over the period 1995–2007. This model is then used to assess the impact of the 2008–2009 food and financial crises on child mortality, by comparing the number of child deaths computed under a “business-as-usual scenario” with those computed under the actual 2008–2009 “crisis scenario”. According to the simulation results, the 2008–2009 food price rise and recession caused a statistically non-significant additional 27,000 child deaths. However, if the 2008–2009 changes in other determinants of child mortality are factored in, the number of child deaths declined by 15,000. This unexpected result is explained by the fact that the effects of the rise in domestic food prices and the recession were offset in most of the region by the protective effect on the under-five mortality rate of a surge in food production, and by a rise in public expenditure on and foreign aid to the health sector.