Under-Five Child Mortality and Morbidity Associated with Consanguineous Child Marriage in Pakistan: Retrospective Analysis using Pakistan Demographic and Health Surveys, 1990–91, 2006–07, 2012–13

2017 ◽  
Vol 21 (5) ◽  
pp. 1095-1104 ◽  
Author(s):  
Mudasir Mustafa ◽  
Rubeena Zakar ◽  
Muhammad Zakria Zakar ◽  
Ashraf Chaudhry ◽  
Muazzam Nasrullah
Keyword(s):  
Retrospective Analysis ◽  
Child Mortality ◽  
Health Surveys ◽  
Child Marriage ◽  
Demographic And Health Surveys ◽  
Mortality And Morbidity ◽  
Under Five

scholarly journals Understanding the determinants of infant and under-five mortality rates: a multivariate decomposition analysis of Demographic and Health Surveys in Ghana, 2003, 2008 and 2014

2019 ◽  
Vol 4 (4) ◽  
pp. e001658 ◽  
Author(s):  
Duah Dwomoh ◽  
Susan Amuasi ◽  
Kofi Agyabeng ◽  
Gabriel Incoom ◽  
Yakubu Alhassan ◽  
...  
Keyword(s):  
Child Mortality ◽  
Health Surveys ◽  
Child Survival ◽  
Mortality Rates ◽  
Multiple Births ◽  
Demographic And Health Surveys ◽  
Adjusted Relative Risk ◽  
Decomposition Approach ◽  
Development Goal ◽  
Under Five

IntroductionDespite the decline in infant and under-five mortality rates since the last decade, Ghana did not meet the millennium development goal (MDG) 4 target. To implement effective interventions that could fast-track progress towards achieving the sustainable development goal 3 in 2030, factors contributing to the decline in child mortality throughout the MDG period and which factor(s) has/have been consistent in affecting child survival in the last decade need to be understood.MethodsThis study used Demographic and Health Surveys (DHS) from 2003, 2008 and 2014 and data from World Bank Development Indicators (2000–2018). We employed modified Poisson with robust SE and multivariate decomposition approach to assess risk factors of child mortality using DHS data from 2003, 2008 and 2014. Penalised regression was used assess the effect of 25 country-level contextual factors on child survival.ResultsThe risk of infant mortality is approximately five times higher among mothers who had multiple births compared with mothers who had single birth over the last decade (adjusted relative risk 4.6, 95% CI 3.2 to 6.6, p<0.001). An increase in the annual percentage of female labour force participation (FLFP) is associated with the reduction of approximately 10 and 18 infant and under-five annual deaths per 1000 live births, respectively.ConclusionsThis study found that multiple births and shorter birth spacing are associated with increased risk of infant and under-five deaths over the last decade. Increased in FLFP, and the proportion of children sleeping under bed-net are associated with reduced risk of both infants and under-five deaths.

scholarly journals Impact of High-Risk Fertility Behavior on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

2020 ◽  
Author(s):  
Rafi Amir-ud-Din ◽  
Lubna Naz ◽  
Anila Rubi ◽  
Muhammad Usman ◽  
Umesh Ghimire
Keyword(s):  
High Risk ◽  
Birth Order ◽  
Child Mortality ◽  
South Asian ◽  
Birth Interval ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Under Five ◽  
Increased Risk

Abstract Background High-risk fertility behaviors (HRFBs) are common in African and South Asian countries and can potentially affect child survival. This study examines the high-risk fertility behaviors concerning child mortality across the countries. Method Data from a series of Demographic and Health Surveys from the year 1987 to 2016 from 24 South Asian and African countries (N=1,224,832) were included in this study. Four HRFB parameters - women’s age <18 or >=34 years at childbirth, birth spacing <24 months, and child order of birth >3, were categorized into three exposure levels: i) exposure to any HRFBs category (exposure to any of four parameters); ii) exposure to single and multiple HRFB category (a combination of two or more parameters); and iii) the specific type of HRFB category (either single or multiple HRFB categories). Bivariate descriptive analysis and a multivariate logistic regression model were used to examine the association between under-five child mortality and various measures of HRFBs. Results Our pooled data analysis reported that HRFBs was associated with an increased risk of under-five child mortality in Asian and African countries. Children of women exposed to HRFBs were at increased risk of under-five mortality by 77% (Adjusted Odds Ratio (AOR) = 1.771, 95% confidence interval (CI): 1.722 - 1.821). Children born within 24 months’ birth interval were four times more likely to die (AOR = 4.995, 95% CI: 4.842-5.152) than their counterparts. However, a single high-risk category was not associated with under-five mortality, and birth order was found to be a protective factor against under-five mortality. Age of women (<18 or >=34 years) was found to be a risk factor of Under-five child mortality in 16 countries. The association between under-five mortality risk and birth interval of less than 24 months was highly significant in all countries. Conclusion Women’s age at childbirth, birth interval, and birth order were significantly associated with under-five mortality. Quality care for women and newborns need to be ensured through investment in the healthcare system, and by promoting health services with more focus given to the valuable populations through sexual and reproductive health education programs and empowering women.

scholarly journals Trends of inequalities in care seeking behavior for under-five children with suspected pneumonia in Ethiopia: evidence from Ethiopia demographic and health surveys (2005–2016)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Betregiorgis Zegeye ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya
Keyword(s):  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Care Seeking ◽  
Health Seeking ◽  
Under Five ◽  
Under Five Children ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Index Of Inequality ◽  
Suspected Pneumonia

Abstract Background Pneumonia is a leading public health problem in under-five children worldwide and particularly in Africa. Unfortunately, progress in reducing pneumonia related mortality has been slow. The number of children with symptoms of pneumonia taken to health facilities for treatment is low in Ethiopia, and disparities among sub-groups regarding health seeking behavior for pneumonia have not been well explored in the region. This study assessed the trends of inequalities in care seeking behavior for children under five years of age with suspected pneumonia in Ethiopia. Methods Using cross-sectional data from the 2005, 2011 and 2016 Ethiopia Demographic and Health Surveys (DHS) and the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT), this study investigated the inequalities in health seeking behavior for children with suspected pneumonia. Four measures of inequality were calculated: Difference, Ratio, Slope Index of Inequality and Relative Index of Inequality. Results were disaggregated by wealth, education, residence, and sex with computed 95% Uncertainty Intervals for each point estimate to determine significance. Results The percentage of under-five children with symptoms of pneumonia who were taken to a health facility was significantly lower for children in the poorest families, 15.48% (95% UI; 9.77, 23.64) as compared to children in the richest families, 61.72% (95% UI; 45.06, 76.02) in 2011. Substantial absolute (SII = 35.61; 95% UI: 25.31, 45.92) and relative (RII = 4.04%; 95% UI: 2.25, 5.84) economic inequalities were also observed. Both educational and geographic inequalities were observed; (RII = 2.07; 95% UI: 1.08, 3.06) and (D = 28.26; 95% UI: 7.14, 49.37), respectively. Economic inequality decreased from 2011 to 2016. There was no statistically significant difference between male and female under-five children with pneumonia symptoms taken to health facility, in all the studied years. Conclusions Health care seeking behavior for children with pneumonia was lower among the poorest and non-educated families as well as children in rural regions. Policies and strategies need to target subpopulations lagging behind in seeking care for pneumonia treatment as it impedes achievement of key UN sustainable development goals (SDGs).

scholarly journals Impact of High-Risk Fertility Behaviour on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

2020 ◽  
Author(s):  
Rafi Amir-ud-Din ◽  
Lubna Naz ◽  
Anila Rubi ◽  
Muhammad Usman ◽  
Umesh Ghimire
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Birth Order ◽  
Birth Interval ◽  
Health Surveys ◽  
Maternal Age ◽  
Demographic And Health Surveys ◽  
Index Child ◽  
Under Five ◽  
Fertility Behaviour

Abstract Background: Smaller or older maternal age, smaller inter-pregnancy birth interval, and higher birth order of the child are considered to be high-risk fertility behaviour (HRFB). Under-five mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and under-five mortality in selected Asian and African countries. Methods: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in Sub-Saharan Africa, Middle East, North Africa, and South Asia from 1986 to 2017 (N=1,467,728). Previous evidence hints at four markers of HRFB: women's age at the birth of index child <18 years or >34 years, smaller preceding birth interval (PBI) <24 months, and child's birth order >3. Using logistic regression, we analysed the change in the odds of under-five mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors. Results: Mother's age at the birth of index child <18 years and preceding birth interval (PBI) <24 months were significant risk factors of under-five mortality, while a child's birth order >3 was a protective factor against under-five mortality. Presence of any single HRFB was associated with 1.067 times higher risk of under-five mortality (OR = 1.067; 95% CI: 1.042 - 1.090; P < 0.001). Presence of multiple HRFBs was associated with 1.392 times higher risk of under-five mortality (OR = 1.392; 95% CI: 1.355 - 1.431; P < 0.001). Some specific combinations of risky fertility behaviour such as younger maternal age (<18 years) and smaller preceding birth interval (PBI <24) significantly increased the odds of under-five mortality.Conclusion: Younger maternal age and small preceding birth interval significantly increase the risk of under-five mortality. This highlights the need for effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for an optimal interpregnancy interval.

Impact of High-Risk Fertility Behaviour on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

2020 ◽  
Author(s):  
Rafi Amir-ud-Din ◽  
Lubna Naz ◽  
Anila Rubi ◽  
Muhammad Usman ◽  
Umesh Ghimire
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Birth Order ◽  
Birth Interval ◽  
Health Surveys ◽  
Maternal Age ◽  
Demographic And Health Surveys ◽  
Index Child ◽  
Under Five ◽  
Fertility Behaviour

Abstract Background: Younger or older maternal age, short inter-pregnancy birth interval, and higher birth order of the child are considered to be high-risk fertility behaviour (HRFB). Under-five mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and under-five mortality in selected Asian and African countries.Methods: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in Sub-Saharan Africa, Middle East, North Africa, and South Asia from 1986 to 2017 (N=1,467,728). Previous evidence hints at four markers of HRFB: women’s age at the birth of index child <18 years or >34 years, short preceding birth interval (PBI) <24 months, and child’s birth order >3. Using logistic regression, we analysed the change in the odds of under-five mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors. Results: Mother’s age at the birth of index child <18 years and preceding birth interval (PBI) <24 months were significant risk factors of under-five mortality, while a child’s birth order >3 was a protective factor against under-five mortality. Presence of any single HRFB was associated with 1.067 times higher risk of under-five mortality (OR = 1.067; 95% CI: 1.042 - 1.090; P < 0.001). Presence of multiple HRFBs was associated with 1.392 times higher risk of under-five mortality (OR = 1.392; 95% CI: 1.355 - 1.431; P < 0.001). Some specific combinations of risky fertility behaviour such as younger maternal age (<18 years) and short preceding birth interval (PBI <24) significantly increased the odds of under-five mortality.Conclusion: Younger maternal age and short preceding birth interval significantly increase the risk of under-five mortality. This highlights the need for effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for an optimal interpregnancy interval.

scholarly journals Parental Smoking and Under-Five Child Mortality in Southeast Asia: Evidence from Demographic and Health Surveys

2019 ◽  
Vol 16 (23) ◽  
pp. 4756 ◽  
Author(s):  
Andriani ◽  
Putri ◽  
Kosasih ◽  
Kuo
Keyword(s):  
Child Mortality ◽  
Democratic Republic ◽  
Smoking Status ◽  
Early Death ◽  
Parental Smoking ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Under Five ◽  
Timor Leste ◽  
Paternal Smoking

Smoking remains the main cause of preventable early death. However, little is known about the association between parental smoking and child mortality in under-fives in developing countries. This study assesses the association between parental smoking status, smoking amount and smoking frequency with child mortality in under-fives in four Southeast Asian countries (Cambodia, Indonesia, Lao People's Democratic Republic and Timor Leste). We used the Demographic and Health Survey dataset. The information from couples consisting of fathers and mothers (n = 19,301 couples) in the same household were collected. Under-five child mortality was significantly associated with paternal smoking only (odds ratio (OR) = 1.25, 95% confidence interval (CI): 1.14–1.38), maternal smoking only (OR = 2.40, 95% CI: 1.61–3.59) and both parents smoking (OR = 2.60, 2.08–3.26). Paternal, maternal, both parents’ smoking amount and frequency were also assessed. The estimated association decreased after adjusting for covariates but remained highly significant for smoking in both parents, mothers who smoked 1–10 cigarettes/day, when both parents smoked > 20 cigarettes/day, and in mothers who smoked every day. Future behavioural changes and smoking cessation programmes should engage parents as a catalyst for the reduction of child mortality risk in LMICs in the SEA region.

scholarly journals Mortality Decline in Kenya: A Reexamination of Recent Under-Five Mortality Estimate

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
George Odwe ◽  
Anne Khasakhala ◽  
Titus Agwanda ◽  
Andrew Imbwaga ◽  
Zena Lyaga
Keyword(s):  
Mortality Rate ◽  
Health Surveys ◽  
Mortality Decline ◽  
Demographic And Health Surveys ◽  
Under Five ◽  
Survival Status ◽  
Effective Interventions ◽  
Mortality Estimate ◽  
Using Data ◽  
Mortality Estimates

This study examined the extent of birth displacement and its effect on the under-five mortality estimates in Kenya. Using data from 2003 and 2008/09 Kenya Demographic and Health Surveys, we evaluate the variability of birth displacement by region and place of residence based on the survival status of the child. We compute birth ratios for children born in the 5th calendar year preceding each survey and note the possible effect on under-five mortality estimates. Results show that under-five mortality estimates in 2008/09 survey are smaller than that of a similar period in 2003 survey by 17 percent. Overall, birth ratios for the 5th calendar year were below 100 percent suggesting presence of birth displacement. However, there was no variance in the displacement between surviving and dead children, hence modest impact on the under-five mortality rate. Evidence suggests that the remarkable decline in the under-five mortality rate recorded in 2008/09 is a function of both overestimation of mortality rate in 2003 survey and underestimation in 2008/09 survey. We recommend that data from more than one source be used to interpret under-five mortality decline and further research should be conducted linking the observed mortality decline to the delivery of known effective interventions.

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