Infant Mortality In Bangladesh Research Articles

Examining the influence of correlates on different quantile survival times: infant mortality in Bangladesh

BackgroundSeveral studies have identified factors influencing infant mortality, but, to the best of knowledge, no studies assessed the factors considering unequal effects on different survival times of infant mortality in Bangladesh. In this study, it was examined how a set of covariates behaves on different quantile survival times related with the infant mortality.MethodsData obtained from Bangladesh multiple indicator cluster survey (BMICS), 2019 have been used for purpose of the study. A total of 9,183 reproductive women were included in the study who gave their most recent live births within two years preceding the survey. Kaplan–Meier product limit approach has been applied to find the survival probabilities for the infant mortality, and the log-rank test has also been used to observe the unadjusted association between infant mortality and selected covariates. To examine the unequal effects of the covariates on different quantile survival time of infant mortality, the Laplace survival regression model has been fitted. The results obtained from this model have also been compared with the results obtained from the classical accelerated failure time (AFT) and Cox proportional hazard (Cox PH) models.ResultsThe infant mortality in Bangladesh is still high which is around 28 per 1000 live births. In all the selected survival regression models, the directions of regression coefficients were similar, but the heterogenous effects of covariates on survival time were observed in quantile survival model. Several correlates such as maternal age, education, gender of index child, previous birth interval, skilled antenatal care provider, immediate breastfeeding etc. were identified as potential factors having higher impact on initial survival times.ConclusionInfant mortality was significantly influenced by the factors more in the beginning of the infant's life period than at later stages, suggesting that receiving proper care at an early age will raise the likelihood of survival. Policy-making interventions are required to reduce the infant deaths, and the study findings may assist policy makers to revise the programs so that the sustainable development goal 3.2 can be achieved in Bangladesh.

An assessment of random forest technique using simulation study: illustration with infant mortality in Bangladesh.

We aimed to assess different machine learning techniques for predicting infant mortality (<1 year) in Bangladesh. The decision tree (DT), random forest (RF), support vector machine (SVM) and logistic regression (LR) approaches were evaluated through accuracy, sensitivity, specificity, precision, F1-score, receiver operating characteristics curve and k-fold cross-validation via simulations. The Boruta algorithm and chi-square ( ) test were used for features selection of infant mortality. Overall, the RF technique (Boruta: accuracy = 0.8890, sensitivity = 0.0480, specificity = 0.9789, precision = 0.1960, F1-score = 0.0771, AUC = 0.6590; : accuracy = 0.8856, sensitivity = 0.0536, specificity = 0.9745, precision = 0.1837, F1-score = 0.0828, AUC = 0.6480) showed higher predictive performance for infant mortality compared to other approaches. Age at first marriage and birth, body mass index (BMI), birth interval, place of residence, religion, administrative division, parents education, occupation of mother, media-exposure, wealth index, gender of child, birth order, children ever born, toilet facility and cooking fuel were potential determinants of infant mortality in Bangladesh. Study findings may help women, stakeholders and policy-makers to take necessary steps for reducing infant mortality by creating awareness, expanding educational programs at community levels and public health interventions.

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

Revisit the correlates of infant mortality in Bangladesh: findings from two nationwide cross-sectional studies

ObjectiveThe main objective of this study is to investigate how the direction and strength of the association between infant mortality and its predictors are changing over time in Bangladesh using...

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.

Association between Antenatal Care and Infant Mortality in Bangladesh: Multivariate Survival Regression Analysis

Association between Antenatal Care and Infant Mortality in Bangladesh: Multivariate Survival Regression Analysis

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.

Temperature extremes and infant mortality in Bangladesh: Hotter months, lower mortality.

BackgroundOur study aims to obtain estimates of the size effects of temperature extremes on infant mortality in Bangladesh using monthly time series data.MethodsData on temperature, child and infant mortality were obtained for Matlab district of rural Bangladesh for January 1982 to December 2008 encompassing 49,426 infant deaths. To investigate the relationship between mortality and temperature, we adopted a regression with Autoregressive Integrated Moving Average (ARIMA) errors model of seasonally adjusted temperature and mortality data. The relationship between monthly mean and maximum temperature on infant mortality was tested at 0 and 1 month lags respectively. Furthermore, our analysis was stratified to determine if the results differed by gender (boys versus girls) and by age (neonates (≤ 30 days) versus post neonates (>30days and <153days)). Dickey Fuller tests were performed to test for stationarity, and since the time series were non-stationary, we conducted the regression analysis based on the first differences of mortality and temperature.ResultsHotter months were associated with lower infant mortality in Bangladesh. Each degree Celsius increase in mean monthly temperature reduced monthly mortality by 3.672 (SE 1.544, p<0.05) points. A one degree increase in mean monthly temperature one month prior reduced mortality by 0.767 (SE 0.439, p<0.1) for boys and by -0.0764 (SE 0.366, NS) for girls. Beneficial effects of maximum monthly temperature were on the order of 0.623 to -0.712 and statistically significant for girls and boys respectively. Effect sizes of mean monthly temperature were larger for neonates at 1.126 (SE 0.499, p<0.05) than for post-neonates at 0.880 (SE 0.310, p<0.05) reductions in mortality per degree.ConclusionThere is no evidence that infant survival is adversely affected by monthly temperature extremes in Bangladesh. This may reflect a more heightened sensitivity of infants to hypothermia than hyperthermia in this environment.

Prenatal early food and multiple micronutrient supplementation trial reduced infant mortality in Bangladesh, but did not influence morbidity.

A previous maternal and infant nutrition intervention in rural Matlab, Bangladesh, showed that prenatal nutrient supplements improved child survival, but had no effect on size at birth. This secondary analysis examined whether prenatal multiple micronutrient supplements (MMS), on their own or combined with an early invitation to receive prenatal food supplements, affected child morbidity. This randomised trial enrolled 4436 pregnant women from November 2001 to October 2003 and allocated them to early or standard invitations to food supplements, in the ninth and 20th weeks of pregnancy, respectively, and supplements of either the standard 60 mg iron with 400 μg folic acid, 30 mg iron with 400 μg folic acid or MMS. Quasi-Poisson regression was used to analyse morbidity. There were 3560 single live births and 3516 had morbidity data. The incidence rates of fever, diarrhoea and acute lower respiratory tract infection were 15.3, 3.6 and 2.3 episodes per person-year, respectively. The separate or combined interventions had no effect on morbidity up to 24 months. Early invitations to prenatal food supplements or prenatal MMS had no effect on common infections in rural Bangladesh, suggesting that earlier findings on improved child survival were not mediated by an effect on child morbidity.

Log-Logistic Proportional Odds Model for Analyzing Infant Mortality in Bangladesh.

Log-logistic parametric survival regression model has been used to find out the potential determinants of infant mortality in Bangladesh using the data extracted from Bangladesh Demographic and Health Survey, 2011. First, nonparametric product-limit approach has been used to examine the unadjusted association between infant mortality and covariate of interest. It is found that maternal education, membership of nongovernmental organizations, age of mother at birth, sex of child, size of child at birth, and place of delivery play an important role in reducing the infant mortality, adjusting relevant covariates.

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh.

BackgroundEarly and exclusive breastfeeding may improve neonatal survival in low resource settings, but suboptimal breastfeeding still exists in areas with high infant mortality. Prelacteal feeding, the practice of giving a non-breastmilk food as a neonate’s first food, has been associated with suboptimal breastfeeding practices. We examined the association of feeding a non-breastmilk food in the first three days of life (early neonatal food, or ENF) with time from birth to initiation of breastfeeding among 25,286 Bangladeshi mother-neonate pairs, in a secondary analysis of a randomized controlled trial in northwestern rural Bangladesh conducted from 2001–2007.MethodsTrained interviewers assessed the demographic characteristics during pregnancy. At three months postpartum, the interviewers visited participants again and retrospectively assessed demographic and breastfeeding characteristics surrounding the birth. We assessed the relationship between ENF and time to initiation of breastfeeding in hours in both unadjusted and adjusted linear regression analyses. We also calculated reverse cumulative distribution curves for time to initiation of breastfeeding and analyses were stratified by an infant’s ability to breastfeed normally at birth.ResultsThe mean ± SD time from birth to initiation of breastfeeding was 30.6 ± 27.9 hours. Only 2,535 (10.0%) of women reported initiating breastfeeding in the first hour after birth and 10,207 (40.4%) reported initiating breastfeeding in the first 12 hours after birth. In adjusted linear regression analyses, feeding ENF was associated with a significant increase in time, in hours, to breastfeeding initiation both among children not able to breastfeed at birth (37.4; 95% CI 33.3, 41.5) and among children able to breastfeed at birth (13.3; 95% CI 12.7, 14.0).ConclusionsFeeding ENF was strongly associated with delayed initiation of breastfeeding, even after adjusting for other related factors and stratifying on the neonate’s ability to suckle normally after birth. More research is needed to understand the impact of these findings on optimal breastfeeding in this setting. It is possible that ENF feeding and the ability to breastfeed immediately after birth are interrelated in their respective associations to suboptimal breastfeeding initiation. This study in a large population representative of other populations in rural South Asia, demonstrates significantly longer times to breastfeeding initiation than previously appreciated, with a possible important role of ENF feeding.Trial registrationThe randomized controlled trial on which this analysis is based, “Impact of Maternal Vitamin A or Beta-Carotene Supplementation on Maternal and Infant Mortality in Bangladesh”, was registered with ClinicalTrials.gov as trial number ID GHS-A-00-03-00019-00 and identifier NCT00198822. The identifier was first received September 12, 2005 (retrospectively registered). The first participant was enrolled in August 2001.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-016-0090-9) contains supplementary material, which is available to authorized users.

Spatially Revised Estimation of Infant Mortality in Bangladesh

Infant mortality rate is considered as one of the most important indicators of development of the socio-economic and health status of any country. For Bangladesh, the estimates of infant mortality on 64 districts of the country is available, but these regionally disaggregated estimates, based on sample surveys, may give misleading pictures because in reality they do not capture the neighborhood and contextual influences. If any spatial pattern exists in the characteristics of interest, estimates obtained for a particular district must be adjusted for any spatial effect of the neighboring districts, otherwise the unadjusted estimates alone may give a confounded meaning. Policy implication at regional level on the basis of such estimates may lead to both under coverage and redundancy. In this paper, we utilize a small area estimation approach by intrinsic conditional autoregressive model isolating the effect of the key covariates. Our analysis reveals that there exist spatial autocorrelation in infant mortality over the districts. We obtain revised district level estimates of the infant mortality from available data on infant mortality and other covariates from different sources. We believe our estimates would be more accurate than the nationally available infant mortality dataset. This in the long run, can be supportive in policy measures related to reducing infant mortality.

Women empowerment and infant mortality in Bangladesh

This study attempts to investigate the effects of women empowerment on infant mortality in Bangladesh. Four indicators have been considered to measure four dimensions of women empowerment: the level of education, participation in household (HH) decisions, autonomy in movements and employment status. The rotated factor analysis technique is used to construct the last three dimensions. The Weibull parametric survival model has been specified and estimated using the Bangladesh Demographic and Health Survey (BDHS) data of 2011. The results show that three measures of empowerment (the level of education, participation in HH decisions and autonomy in movements) contribute significantly to the reduction of infant mortality. But women employment is associated with increased mortality for infants. The findings of this study have a number of policy implications on this issue for a developing country like Bangladesh.

Short-term nutrition education reduces low birthweight and improves pregnancy outcomes among urban poor women in Bangladesh.

Maternal malnutrition and poor gestational weight gain are the most important causes of low birthweight and infant mortality in Bangladesh. To assess the effect of short-term nutrition education on weight gain in the third trimester of pregnancy, birth outcomes, and breastfeeding. Three hundred pregnant women participated in this randomized, controlled trial during a 3-month intervention period. The study was conducted in two antenatal clinics in urban Dhaka. One group of women was given monthly education sessions during the third trimester of pregnancy to promote consumption of khichuri, while the control group received only routine services from the health facilities. Birthweight was recorded within 24 hours after delivery. Breastfeeding practices were observed for 1 month after delivery. In the intervention group, maternal weight gain in the third trimester was 60% higher (8.60 vs. 5.38 kg, p = .011), mean birthweight was 20% higher (2.98 vs. 2.49 kg, p < .001), the rate of low birthweight was 94% lower (2.7% vs. 44.7%; p < .001), and the rate of initiation of breastfeeding within 1 hour after birth was 52% higher (86.0% vs. 56.7%, p < .001), in comparison with the control group. Birthweight was associated with frequency of intake of khichuri (p < 0.001). Nutrition education with a focus on promoting consumption of khichuri during the third trimester of pregnancy significantly reduced the rate of low birthweight and increased maternal weight gain.

Zinc in Well Water and Infant Mortality in Bangladesh: A Report from Gonoshasthaya Kendra

Zinc supplementation reduces the duration, severity and recurrence of diarrhoea in young children. This study examines whether zinc, found naturally in drinking water, reduced infant deaths from diarrhoea in rural Bangladesh. Information was compiled for births over two calendar years with follow-up for deaths within one year of birth. The study included 29,744 live births and 934 deaths in some 600 villages under the care of Gonoshasthaya Kendra (GK), grouped into 15 health centre regions within 12 upazillas. Individual matching of death to birth data was not possible, but information on exposures through well water and on potential confounders was available for each upazilla. Average concentration of zinc in well water, reported by the British Geological Survey, was grouped into high (>0.07 mg/L), moderate (0.020–0.070 mg/L) and low (<0.020 mg/L) concentrations. Odds ratios (OR) were calculated for zinc by age and cause of death. Zinc concentration was unrelated to all-cause mortality but a decrease in deaths from diarrhoea (N = 50) was seen in areas with high zinc (OR = 0.30; 95% CI 0.13–0.69). No relation to diarrhoeal deaths was found with other well contaminants (arsenic, manganese) having accounted for zinc. Upazillas with a high proportion of women without education had higher rates of death from diarrhea, but the decrease in risk with high zinc remained (OR adjusted = 0.41; 95% CI 0.20–0.84). It is concluded that exposure to zinc through drinking water may reduce risk of diarrhoeal deaths.

Infant death clustering in families: Magnitude, causes, and the influence of better health services, Bangladesh 1982–2005

This analysis of infant mortality in Bangladesh focuses on explaining death clustering within families, using prospective data from a rural region in Bangladesh, split into areas with and without extensive health services (the area covered by the International Centre for Diarrhoeal Disease Research and the comparison area, respectively). The modelling framework distinguishes between two explanations of death clustering: (observed and unobserved) heterogeneity across families and a causal ‘scarring’ effect of the death of one infant on the survival chances of the next to be born. Keeping observed and unobserved characteristics constant, we find scarring in the comparison area only. There the likelihood of infant death is about 29 per cent greater if the previous sibling died in infancy than otherwise. This effect mainly works through birth intervals: infant deaths are followed by shorter birth intervals, which increases the risk of infant death for the next child.

Manganese, Arsenic, and Infant Mortality in Bangladesh: An Ecological Analysis

ABSTRACT Recent studies in Bangladesh indicate that arsenic and manganese in tube-well water may increase the incidence of infant mortality. The study reported here examined whether these findings could be replicated. Data available from some 600 villages under the care of the nongovernmental organization (NGO) Gonoshasthaya Kendra included details of 29744 live births and 934 infant deaths in a 2-year period, with age and cause. These were analyzed by mean well levels of arsenic and manganese as reported by the British Geological Survey for the 12 upazillas. Odds ratios were calculated by age at death and cause. The effect of arsenic on all-cause infant mortality, although small and not significant, was consistent with earlier reports. The previous finding of an increased risk of infant mortality at concentrations of manganese ≥0.4 mg/L was not evident.

Association between manganese exposure through drinking water and infant mortality in Bangladesh.

BackgroundManganese is a common natural contaminant of groundwater in Bangladesh. In this cross-sectional study we assessed the association between water manganese and all-cause infant mortality in the offspring of female participants in the Health Effects of Arsenic Longitudinal Study Cohort.MethodsIn 2001, drinking water samples were collected, a history of well use was obtained, and a history of birth outcomes was ascertained. To avoid misclassification of exposure, women were included only if they had been drinking from the same well for most of their childbearing years (marriage years – well years ≤ 2). Of a total of 26,002 births (among 6,537 mothers), 3,837 children were born to women with this profile. The current analysis was based on the portion of these infants (n = 3,824) with recorded exposure and outcome status, 335 of whom died before reaching 1 year of age.ResultsInfants exposed to water manganese greater than or equal to the 2003 World Health Organization standard of 0.4 mg/L had an elevated mortality risk during the first year of life compared with unexposed infants [odds ratio (OR) = 1.8; 95% confidence interval (CI), 1.2–2.6]. Adjustment for water arsenic, indicators of social class, and other variables did not appreciably alter these results. When the population was restricted to infants born to recently married parents (marriage year 1991 or after), this elevation was more pronounced (OR = 3.4; 95% CI, 1.5–7.9).ConclusionsThese preliminary findings indicate a possible association between manganese exposure and infant mortality. However, given the methodologic limitations of this study, the association needs to be confirmed through future work.

Effect of multiple birth on infant mortality in Bangladesh

Levels of infant and child mortality in many developing countries remain unacceptably high, and they are disproportionably higher among high-risk groups such as newborn and infant of multiple births, particularly in countries where advanced medical cares are available only at regional referral levels with limited access by the poor rural women and children. This study examined the relationship between high-risk infant of multiple birth and infant mortality in Bangladesh. The analysis uses information on 7001 childbirths in 5 years preceding the 2004 Bangladesh Demographic and Health Survey to examine the relationship between multiple birth and infant mortality using multivariate analysis, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results indicate that children born multiple birth were more than six-times as likely to die during infancy as those born singletons (hazard ratio = 6.51; 95% confidence interval: 4.10, 10.36). Controlling for all other risk factors does not change the strength and direction of the relationship (hazard ratio = 6.18; 95% confidence interval: 3.65, 10.46). Receiving prenatal care and access to safe drinking water are associated with lower risk. Multiple births are strongly negatively associated with infant survival in Bangladesh independent of other risk factors. This evidence suggests that improving maternal and child health at the community level, screening for high-risk pregnancies and making referral services for these conditions more accessible to the rural women and children will be key to improving child survival in Bangladesh.

Infant mortality in Bangladesh: a review of recent evidence

Estimates of child mortality are mainly based on reports by mothers on the survival status of their children. Infant mortality estimates from such data do not seem to have declined in recent years. The Bangladesh Bureau of Statistics sample registration infant mortality estimates appear to be suspiciously low.