Determinants Of Infant Mortality Research Articles

Determinants of Infant Mortality in Assam, India: Modelling with Generalised Linear Regression Model for Count Data

Determinants of Infant Mortality in Assam, India: Modelling with Generalised Linear Regression Model for Count Data

Uncovering the rural–urban gap in determinants of infant mortality in Punjab-Pakistan

ObjectiveThe main objective of this research is to observe the various socio-economic, demographic, health-seeking, and environmental factors influencing infant mortality and the rural–urban division in Punjab, Pakistan. MethodsThe study used the data of 38,405 households from the Multiple Indicator Cluster Survey that was conducted by the Bureau of Statistics Punjab during 2017–18. This survey assessed 125 indicators i.e., health, education, etc. created by UNICEF to assess the well-being of mothers and children in Punjab, Pakistan. Results and conclusionThe mother, the child, and the family are the three main risk factors for infant death, according to our research in Pakistan. The socioeconomic position of the household, social practices, environment, and usage of medical services are the key factors that help in reducing infant death. Women's education, birth spacing, and household economic position all played a significant role in the decline in infant mortality. The health of infants born in rural Punjab is at risk due to a large rural–urban gap in the determinants of infant mortality. Uncovering and addressing this disparity has become a pressing health priority in Pakistan.

Assessment of knowledge and attitudes toward determinants of infant mortality in Head Start teachers, teacher aides, caregivers, and family support workers

Assessment of knowledge and attitudes toward determinants of infant mortality in Head Start teachers, teacher aides, caregivers, and family support workers

Geographical disparities and determinants of infant mortality in Ethiopia: mapping and spatial analysis using EDHS data

BackgroundInfant mortality remains a public health challenge in Ethiopia. Exploring infant mortality will aid in tracking the progress toward achieving sustainable development goals.ObjectiveThe study aimed to explore the geographical variations and associated factors of infant mortality in Ethiopia.MethodA total of 11,023 infants from the 2016 Ethiopian Demographic and Health Survey (EDHS) data were extracted and included in the analysis. EDHS used a two-stage cluster sampling design with a census enumeration area as the primary sampling unit and households as the secondary sampling unit. Arc GIS software was used for spatial analysis using clusters for exploring geographical variations in infant mortality. A binary logistic regression was employed using R software to identify the significant determinants of infant mortality.ResultsThe study revealed that the spatial distribution of infant mortality was non-random in the country. Infants whose mothers not receiving ANC (AOR = 1.45; 95%CI: 1.17, 1.79), not breastfed status (AOR = 3.94; 95%CI: 3.19, 4.81), poor wealth index (AOR = 1.36; 95%CI: 1.04, 1.77), male infants (AOR = 1.59; 95%CI: 1.29, 1.95), birth order of six or above (AOR = 3.11; 95%CI: 2.08, 4.62), small birth size (AOR = 1.27; 95%CI: 1.26, 1.60), birth spacing [(≤ 24 months (AOR = 2.29; 95%CI: 1.79, 2.92), 25–36 months (AOR = 1.16; 95%CI: 1.12, 1.49)], multiple births (AOR = 6.82; 95%CI: 4.76, 10.81), rural residence (AOR = 1.63; 95%CI: 1.05, 2.77) and regions [Afar (AOR = 1.54; 95%CI: 1.01, 2.36), Harari (AOR = 1.56; 95%CI: 1.04, 2.56), and Somali (AOR = 1.52; 95%CI: 1.03, 2.39)] were the determinants of infant death in Ethiopia.ConclusionsThere is a great geographical disparity in infant mortality rates across regions. Afar, Harari, and Somali regions were verified as hot spot areas. ANC usage, breastfed status, wealth index, sex of the infant, birth order, birth size, birth spacing, birth type, residence, and region were the determinants of infant death in Ethiopia. Therefore, appropriate interventions need to be implemented in the hot spots to alleviate the risk factors for infant mortality.

Determinant factors of infant mortality in Bima District in 2012

The infant mortality is the death of a child before the age of one year, can be caused by endogenous and exogenous factors. The infant mortality rates influenced by family income, maternal age, birth spacing, the frequency of the ANC visits, the place of delivery, birth weight, breastfeeding, immunisation, maternal knowledge about infant care, clean water sources sanitationary and education related to infant mortality. The purpose of this research was to identify the determinant factors of infant mortality in Bima regency. The type of research is observational analytic, with a case-control study design. The cases were infant who died in January to December 2012, while the control were infant who still alive on the same period. Cases and controls were selected from the community of Bima District. They were selected by using stratified proportional sampling technique and in total they were 153 respondents with a ratio of 1 to 2. Data was collected through interviews and midwives registers documentation. Data were analysed using chi square test and logistic regression. The result showed that the birth weight <2500 gr OR=6.69 (95%CI: 2.11-21.16), birth spacing <24 months OR=6.69 (95%CI: 2.11-21.16), maternal age <20 or >35 years OR=6.63 (95%CI: 1.84-23.90), not exclusively breastfeeding OR=6.23 (95%CI: 2.10-18.46), education related to infant mortality OR=6.02 (95%CI: 2.17-16.65) and clean water sources sanitationary OR=3.72 (95%CI: 1.35-10.25). It can be concluded that birth weight <2500 gr, spacing births <24 months, maternal age <20 or >35 years, not exclusively breastfeeding, education related to infant mortality, clean water sources sanitationary were determinants of infant mortality with the overall contribution of 61.1%. Improving education and promotion related to nutritional requirement for pregnant women, delay in age of marriage, pregnancy planning and exclusive breastfeeding in Bima District are highly essential.

A multi country comparison of the Tuberculosis and Endocrine related mortality in public health perspective

Introduction: The aim of the study is to examine tuberculosis and endocrine-related deaths worldwide from WHO ICD-10 data with multi-country comparisons. Material and Method: ICD-10 mortality data of WHO was used. Given mortality codes were examined, and mortality data records for 14 countries between 1996 and 2017 were used. Results: For people over 60 ages, the most common mortality was reported for endocrine, nutritional and metabolic diseases, followed by respiratory related deaths. Respiratory related mortality is the most dominant mortality among other tuberculosis mortality and endocrine, nutrition and metabolic diseases related mortality. The most frequent mortality was reported in 2005, followed by 2004 and 2003. Infant deaths and 60 and above age mortality differences between gender groups were statistically insignificant for all mortality causes of the research (p>0.05). For under 60 ages, respiratory and other tuberculosis related mortalities were significantly higher in the male patients (p<0.05). Cause, year and country parameters were determinants of infant mortality with statistically significant rates (p<0.05). However, effect of gender on infant mortality for research causes was insignificant (p>0.05). For under 60 age group; cause, gender, year and country parameters had significant effect on mortality rates (p<0.05). Cause, gender, year and country parameters were not effective on mortalities above 60 ages (p>0.05). Conclusion: Although there is no sufficient data to establish a direct relationship on TB-related deaths and endocrine-related deaths, the occurrence of both diseases in similar countries according to the World Bank development evaluation with same trends indicates the questioning of the relationship between these two disease groups.

Determinant of infant mortality in Ethiopia: demographic, socio economic, maternal and environmental factors

Determinant of infant mortality in Ethiopia: demographic, socio economic, maternal and environmental factors

Levels, Trends and Determinants of Infant Mortality in Nigeria: An Analysis using the Logistic Regression Model

This paper presents a statistical analysis of the levels, trends and determinants of infant mortality in Nigeria using the logistic regression model. Infant mortality data for each of the five years preceding the 2003, 2008, 2013 and 2018 Nigeria Demographic Health Survey (NDHS) was retrieved and used for the analysis. Findings from the study revealed that infant mortality rates decline have stagnated in the five year period prior to the 2018 survey with an Annual Rate of Reduction (ARR) of 0% relative to an initial ARR of 5.7% between 2003 and 2008. The ARR of 2.039% over the 15 year period spanning 2003 to 2018 suggests that the rate of infant mortality reduction is slow. This study also showed that maternal characteristics such as age and educational levels as well as cultural practises like use of clean water and toilet facilities were statistically significant determinants of infant mortality in Nigeria with P-values < 0.05 across each of the survey years.

Determinants of infant mortality and representation in bioarchaeological samples: A review

AbstractIn bioarchaeological contexts, a complex relationship exists between infant representation in the age‐at‐death distribution, gestational and young child mortality rates, and the total fertility rate. The representation of infants in a skeletal sample may be influenced by a range of social, biological, and archaeological factors. To better understand the interactions between representation, fertility, and mortality, this study evaluates the relationship between infant‐juvenile age‐at‐death proportions, fertility rates, and a range of gestational and early childhood mortality measures. The statistical component of this study found the correlation between fertility rates and infant‐juvenile proportions was stronger than with any mortality rate variable of interest. This suggests that the proportion of infants in a mortuary sample is a stronger indicator of fertility than it is of infant‐juvenile mortality. Social, biological, and archaeological variables potentially influencing infant representation in skeletal samples are discussed and a strongly contextualized and holistic approach to infant and juvenile mortality is recommended.

The Determinants of Infant Mortality in Brazil, 2010-2020: A Scoping Review.

Despite the implementation of social and health policies that positively affected the health of the populations in Brazil, since 2009 the country has experienced a slower decline of infant mortality. After an economic and political crisis, Brazil witnessed increases in infant mortality that raised questions about what are the determinants of infant mortality after the implementation of such policies. We conducted a scoping review to identify and summarize those determinants with searches in three databases: LILACS, MEDLINE, and SCIELO. We included studies published between 2010 and 2020. We selected 23 papers: 83% associated infant mortality with public policies; 78% related infant mortality with the use of the health system and socioeconomic and living conditions; and 27% related to individual characteristics to infant mortality. Inequalities in the access to healthcare seem to have important implications in reducing infant mortality. Socioeconomic conditions and health-related factors such as income, education, fertility, housing, and the Bolsa Família. Program coverage was pointed out as the main determinants of infant mortality. Likewise, recent changes in infant mortality in Brazil are likely related to these factors. We also identified a gap in terms of studies on a possible association between employment and infant mortality.

Health capabilities and the determinants of infant mortality in Brazil, 2004\u20132015: an innovative methodological framework

BackgroundDespite the implementation of a set of social and health policies, Brazil has experienced a slowdown in the decline of infant mortality, regional disparities and persistent high death levels, raising questions about the determinants of infant mortality after the implementation of these policies. The objective of this article is to propose a methodological approach aiming at identifying the determinants of infant mortality in Brazil after the implementation of those policies.MethodA series of multilevel panel data with fixed effect nested within-clusters were conducted supported by the concept of health capabilities based on data from 26 Brazilian states between 2004 and 2015. The dependent variables were the neonatal, the infant and the under-five mortality rates. The independent variables were the employment rate, per capita income, Bolsa Família Program coverage, the fertility rate, educational attainment, the number of live births by prenatal visits, the number of health professionals per thousand inhabitants, and the access to water supply and sewage services. We also used different time lags of employment rate to identify the impact of employment on the infant mortality rates over time, and household income stratified by minimum wages to analyze their effects on these rates.ResultsThe results showed that in addition to variables associated with infant mortality in previous studies, such as Bolsa Família Program, per capita income and fertility rate, other factors affect child mortality. Educational attainment, quality of prenatal care and access to health professionals are also elements impacting infant deaths. The results also identified an association between employment rate and different infant mortality rates, with employment impacting neonatal mortality up to 3 years and that a family income below 2 minimum wages increases the odds of infant deaths.ConclusionThe results proved that the methodology proposed allowed the use of variables based on aggregated data that could hardly be used by other methodologies.

Under five and infant mortality in Chile (1990-2016): Trends, disparities, and causes of death

BackgroundChild health has been a health policy priority for more than a century in Chile. Since 2000, new health and intersectoral interventions have been implemented. However, no recent analyses have explored child mortality and equity in Chile, an indispensable input to guide policies towards the achievement of the Sustainable Development Goals, specially, in the context of a deeply unequal country such as many other Latin American countries. Thus, the objectives of this study are to analyze the variations in the risk and the causes of death among Chilean children aged <5 years, to identify the determinants, and to measure inequality of infant mortality from 1990 to 2016.Materials and methodsAn observational study was conducted to analyze the Chilean children's mortality from 1990 to 2016 using under five deaths and live births data from the Vital Statistics System. To describe the variation in the risk of death, a time series analysis was performed for each of the under five mortality rate components. A comparative cause of death analysis was developed for Neonatal and 1–59 months’ age groups. The determinants of infant mortality were studied with a descriptive analysis of yearly rates according to mother’s and child factors and bivariate logistic regression models at the individual level. Finally, simple and complex measures of inequality at individual level were estimated considering three-year periods.ResultsRegarding under 5 mortality: (i) Child survival has improved substantially in the last three decades, with a rapid decline in under five mortality rate between 1990 and 2001, followed by a slower reduction; (ii) early neonatal mortality has become the main component of the under five mortality rate (50.6%); (iii) congenital abnormalities have positioned as the leading cause of death; (iv) an important increase in live births below 1,000 grs. Regarding infant mortality: (i) birth weight and gestational age are the two most relevant risk factors in the neonatal period, while social variables are more significant for post-neonatal mortality and, (ii) the inequality according to mother’s education has shown a steady decline, with persistent inequalities in post-neonatal period.ConclusionsThe Chilean experience illustrates child health achievements and challenges in a country that transitioned from middle-to high-income in recent decades. Although inequity is one of the main challenges for the country, the health sector by granting universal access was able to reduce disparities. However, closing the gap in post-neonatal mortality is still challenging. To overcome stagnation in neonatal mortality, new and specific strategies must address current priorities, emphasizing the access of vulnerable groups.

Determinantes sociales de la mortalidad infantil en municipios de frontera en Colombia, 2005-2011

Introducción. En Colombia, las tasas de mortalidad infantil de los municipios fronterizos presentan diferencias significativas en comparación con el promedio nacional, por lo que resulta prioritario identificar sus determinantes en estas zonas, con el fin de orientar el desarrollo de políticas en salud pública.Objetivo. Identificar algunos determinantes sociales de la mortalidad infantil en municipios fronterizos de Colombia en el periodo 2005-2011.Materiales y métodos. Estudio ecológico en el que se construyeron tres modelos de regresión para las siguientes categorías: 1) determinantes estructurales; 2) determinantes intermedios de condiciones de vida y trabajo, factores de tipo comportamental y biológico, y factores psicosociales, y 3) determinantes intermedios del sistema de salud colombiano.Resultados. Los datos encontrados sugieren que la mortalidad infantil de los municipios fronterizos se relaciona con condiciones de etnia, raza, educación, índice de dependencia infantil, bajo peso al nacer, calidad del agua, ruralidad, jefatura femenina del hogar, cobertura de vacunación, cobertura de control prenatal, satisfacción con los servicios de salud y afiliación al sistema de salud.Conclusiones. La mayoría de determinantes de la mortalidad infantil en estos municipios se sale del alcance del sector salud; por tanto, el Estado enfrenta dos desafíos importantes: implementar un abordaje transectorial y transfronterizo, y dar una respuesta institucional con un enfoque de equidad en salud que se adapte a las necesidades y a la cultura de cada municipio y región.

Proximate determinants of infant mortality in Ethiopia, 2016 Ethiopian demographic and health surveys: results from a survival analysis

BackgroundIn Ethiopia, large scale health care efforts had been done to promote infant health and survival. However, nationwide data is lacking on the survival status and proximate determinants of infant mortality in Ethiopia. Therefore, this study was aimed to identify the survival status and determinants of infant mortality in Ethiopia using Ethiopian Demographic and Health Survey (EDHS).MethodsThe data source for this study was the 2016 Ethiopian Demographic and Health Survey. Records of all 10,641 live births and survival informations of all 2826 infants born 5 years before the survey were reviewed. Kaplan-Meier method and Cox proportional hazards regression model were employed to identify the proximate determinants associated with the infant mortality.ResultsThe results of Kaplan-Meier estimation showed that the highest infant deaths occurred in the early months of life immediately after birth and declined in the later months of follow-up time. About 65% of infant deaths occurred during the first month’s of life. Using the Cox proportional hazard model we found that: mothers’ level of education, preceding birth interval, plurality, size of child at birth and sex of child as significant predictors of infant mortality. The risk of dying in infancy was lower for babies of mothers with secondary education (RR = 0.68, 95% CI: 0.56–0.98), higher education (RR = 0.51, 95% CI:0.45–0.80), for preceding birth interval longer than 47 months (RR = 0.51, 95% CI: 0.27, 0.92) and higher for birth interval shorter than 24 months (RR = 2.02, 95% CI:1.40–2.92), for multiple births (RR = 4.07, 95% CI: 1.14–14.50), for very small size of infants (RR = 3.74, 95% CI:1.73–8.12), for smaller than average size infants (RR = 3.23, 95% CI: 1.40–7.41) and for female infants (RR = 1.26, 95% CI: 1.01–1.56) compared to the reference category.ConclusionsA significant proportion of infants died during the study period of which nearly two third of deaths occurred during the first months of life. Thus, close monitoring and supporting reproductive age mothers to increase the uptakes of family planning and antenatal care and follow-up is highly recommended to increase the infant survival.

Determinants of infant mortality in Pakistan: evidence from Pakistan Demographic and Health Survey 2017–18

The infant mortality rate was very high in Pakistan until the early 1990s, at 86 deaths/1000 live births. It has decreased 24 points and declined to 62 deaths/1000 in the last 3 decades, but Pakistan is still in the group of countries with highest infant mortality rate. The present study aimed to assess the magnitude of infant mortality in Pakistan and its causes and associated risk factors. For this study, data from the 2018 Pakistan Demographic and Health Survey were used. Risk factors for infant mortality were first examined in bivariate analyses. Chi-square test was employed to understand the significance level of the categorical difference of independent variables. The Cox proportional hazard model was used to account for potential confounders that function as risk factors for infant deaths. Large differentials in infant survival by socioeconomic and demographic factors indicate poor coverage of social and health schemes for the public. Mothers who did not use the ANC services experienced about 1.5 times higher infant mortality than those who did (52 vs. 36/1000 LB; p = 0.007). The hazard model shows that rich households experienced about 30% (HR = 0.735; 95% CI = 0.614–0.878) less infant mortality than poor ones. The rural-urban differential in public health services and gender inequities are the underlying causes of the stagnation of infant mortality in Pakistan. The low status of women’s education, poor economic conditions and low level of using public health care services are closely tied to higher infant death rates in Pakistan. Health interventions in Pakistan should be designed to reach the most under-served—women and children—especially in rural areas.

Determinants of Infant Mortality in Bangladesh: A Nationally Surveyed Data Analysis

Background: It is well established that improving human health has direct obvious payoff on enhancing life expectancy along with economic growth. Infant mortality deliberately used to understand a countries overall public health status particularly child bearing mothers. But the prevalence of child mortality continues to be a prime public health concerns in Bangladesh. This study aims to investigate the impact of some geospatial, socioeconomic, demographic and health factors on infant mortality in Bangladesh. Methods: The study modeled infant mortality (aged 0-11 months) as the categorical dependent variable using 11 selected covariates from the 2014 Bangladesh Demographic and Health Survey (BDHS-2014) dataset. The Pearson-Chi square test and Binary Logistic Regression methods were utilized for the bivariate and multivariate analyses. Results: All the selected covariates were significantly associated with infant mortality in bivariate analysis. The results of the logistic regression revealed that illiterate father, household without toilet facility or having hanging toilet, multiple birth and small size at birth appeared at the significant risk factors for infant mortality. In contrast, receiving vitamin A dose and visiting in antenatal care revealed as protective factor for infant deaths. Conclusion: This study is uniquely addressed some several determinants which are the immediate cause of infant deaths. This evidence based empirical study suggests that more attention needs regarding to eliminate all kinds of child mortality in Bangladesh along with infant mortality.

Risk factors of infant mortality in Bangladesh

BackgroundThere exist various studies on the cause and determinants of infant mortality in developing countries. However, to best of our knowledge, none of the studies have seen the effect of institutional delivery and infant's birth size on infant mortality in Bangladesh. MethodsData for this study comes from Bangladesh Demographic and Health survey 2014, which is a nationally representative cross-sectional survey. This study uses information on 7,886 infants to analyze the effect of institutional delivery and birth size on infant mortality. Bi-variate and cox regression technique were applied for analyzing the cross-sectional data drawn from representative survey. ResultsInfant mortality was significantly higher in mothers who did not deliver baby at institutions and did not take any antenatal checkups. A significant high infant mortality was found among mothers who belonged to poor wealth status than middle and rich. In addition, infants who had small and very small birth size at the time of delivery had significantly high mortality. The mortality was significantly high in male than female infants. ConclusionInfant mortality is low among those who delivers baby at institutions, takes antenatal checkups and have higher wealth status. Infants with average birth size and female have less mortality. To reduce the infant mortality in Bangladesh, institutional delivery, antenatal care, baby birth size, child sex and wealth index are important factors. There is urgent need to focus into these factors to reduce infant mortality in the country.

On the Structure of Infant Mortality using Accelerated Failure Time (AFT) Model: A Comparative Study based on National Family Health Survey (NFHS) Data in India

This paper analyzes the effect of socioeconomic and demographic factors on infant mortality in India. The Paper also examines reasonable comparison of the three National Family Health Survey (NFHS), the largest sample survey of India from the 1993–1994, 1998–1999 and 2005–06 with respect to different determinants of infant mortality. Accelerated Failure Time (AFT) model is used to measure the direct effect of the above factors on the survival of infants. On the basis of Akaikes Information Criterion (AIC), the Weibull AFT model fits better to other selected models. In all the three NFHS, Weibull AFT model shows the significant effect of the factors on infant survival.

Determinants of infant mortality in rural India: An ecological study.

Long-term reductions in infant mortality (IM) are possible only by addressing the distal determinants. The objective of the present study was to determine the relationship between IM and its major distal determinants in rural India. The dependent variable used in the study was state wise IM rate (IMR), the values of which were obtained from the Sample Registration System, 2015. State level literacy rate in females, unemployment rates of females, GINI index, and round-the-clock neonatal services in primary health centers in the rural areas and the per capita gross state domestic product at purchasing power parity (GSDP at PPP) of the states, were used as the predictor variables for IM. Relationship between the variables was obtained by the Pearson's correlation coefficient. Bivariate and multivariable linear regressions were used to identify the magnitude and direction of the predictors on IM. Correlation statistics showed none or weak positive correlation between the Gini coefficient and 24 × 7 primary health-care services and IMR. There was a strong negative correlation between female literacy rate and IMR, while the unemployment rates and per capita gross state domestic product (GSDP) were moderately negatively correlated to IMR. Bivariate analysis revealed that, for unit increase in unemployment rates in females, proportion of literate women, and 1000$ increase in the GSDP at current prices, IMR decreased by 0.07, 0.763, and 1.702, respectively. However, after adjustment, only the female literacy rates showed significant association with IMR. Of the major determinants included in the study, rural female literacy is the most important distal determinant of IM in rural areas of India.

Maternal Body Mass Index (BMI) and Mid-Upper Arm Circumference (MUAC) in Early Pregnancy as Predictors of Low Birth Weight Infants

Low birth weight is one of the determinants of infant mortality, morbidity, and disability, which can even have an impact on the future. Several studies have suggested that the condition of low birth weight (LBW) infants is influenced by the lack of maternal nutritional status in early pregnancy. Moreover, the prevalence of malnutrition in Indonesia is still high. Therefore, this study attempted to analyze the relationship of maternal nutritional status in early pregnancy as a predictor of LBW infants. Using a cross-sectional study design, this study involved 62 pregnant patients aged 20–35 years who had antenatal visits and a term delivery at Puskesmas Kecamatan Cakung. The measurements of body mass index (BMI) and mid-upper arm circumference (MUAC) in early pregnancy are used to determine the maternal nutritional status. Pregnant women with BMI &lt;18.5 or MUAC &lt;23.5 cm are considered to have less nutritional status. Meanwhile, LBW infants are defined as babies with birth weight &lt;2500 grams. This study proves that the risk of birth of LBW infants is increased in pregnant women with BMI &lt;18.5 (underweight) (OR 5.37) and less MUAC (OR 20.4).