scholarly journals The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states

2019 ◽  
Author(s):  
Jayanta Kumar Bora ◽  
Rajesh Raushan ◽  
Wolfgang Lutz
Keyword(s):  
Maternal Education ◽  
Positive Impact ◽  
Decomposition Analysis ◽  
Mortality Rates ◽  
Household Wealth ◽  
Mortality Factors ◽  
Binary Logistic Regression Model ◽  
Indian States ◽  
Under Five ◽  
Caste Groups

AbstractObjectiveAlthough under-five mortality (U5M) is declining in India, it is still high in a few selected states and among the scheduled caste (SC) and scheduled tribe (ST) population of the country. This study re-examines the association between castes and U5M in high focus Indian states following the implementation of the country’s National Rural Health Mission (NRHM) program. In addition, we aim to quantify the contribution of socioeconomic determinants in explaining the gap in U5M between the SC/ST population and non-SC/ST population in high focus states in India.Data and methodUsing data from the National Family Health Survey (NFHS), we calculated the under-five mortality rate (U5MR) by applying a synthetic cohort probability approach. We applied a binary logistic regression model to examine the association of U5M with the selected covariates. Further, we used Fairlie’s decomposition technique to understand the relative contribution of socioeconomic variables on U5M risk between the caste groups.FindingsIn high focus Indian states, the parallel gap in U5M between well-off and deprived caste children has disappeared in the post-NRHM period, indicating a positive impact in terms of reducing caste-based inequalities in the high focus states. Despite the reduction in U5M, particularly among children belonging to STs, children belonging to the SC and ST population still experience higher mortality rates than children belonging to the non-SC/ST population from 1992 to 2016. Both macro level (district level mortality rates) and individual (regression analysis) analyses showed that children belonging to SCs experience the highest likelihood of dying before their fifth birthday. A decomposition analysis revealed that 78% of the caste-based gap in U5M is due to the effect of women’s level of educational attainment and household wealth between the SC/ST and non-SC/ST population. Program indicators such as place of delivery and number of antenatal care (ANC) visits also contributed significantly to widening caste-based gaps in U5M.ConclusionThe study indicates that there is still scope to improve access to health facilities for mothers and children belonging to deprived caste groups in India. Continuous efforts to raise the level of maternal education and the economic status of people belonging to deprived caste groups should be pursued simultaneously.

scholarly journals Efficacy of deep learning methods for predicting under-five mortality in 34 low-income and middle-income countries

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034524
Author(s):  
Adeyinka Emmanuel Adegbosin ◽  
Bela Stantic ◽  
Jing Sun
Keyword(s):  
Neural Network ◽  
Deep Learning ◽  
Low Income ◽  
Maternal Education ◽  
Household Wealth ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Middle Income ◽  
Under Five ◽  
Middle Income Countries

ObjectivesTo explore the efficacy of machine learning (ML) techniques in predicting under-five mortality (U5M) in low-income and middle-income countries (LMICs) and to identify significant predictors of U5M.DesignThis is a cross-sectional, proof-of-concept study.Settings and participantsWe analysed data from the Demographic and Health Survey. The data were drawn from 34 LMICs, comprising a total of n=1 520 018 children drawn from 956 995 unique households.Primary and secondary outcome measuresThe primary outcome measure was U5M; secondary outcome was comparing the efficacy of deep learning algorithms: deep neural network (DNN); convolution neural network (CNN); hybrid CNN-DNN with logistic regression (LR) for the prediction of child’s survival.ResultsWe found that duration of breast feeding, number of antenatal visits, household wealth index, postnatal care and the level of maternal education are some of the most important predictors of U5M. We found that deep learning techniques are superior to LR for the classification of child survival: LR sensitivity=0.47, specificity=0.53; DNN sensitivity=0.69, specificity=0.83; CNN sensitivity=0.68, specificity=0.83; CNN-DNN sensitivity=0.71, specificity=0.83.ConclusionOur findings provide an understanding of determinants of U5M in LMICs. It also demonstrates that deep learning models are more efficacious than traditional analytical approach.

scholarly journals Determinants of anaemia among children aged under five years in Assam, India

2020 ◽  
Vol 7 (11) ◽  
pp. 2157
Author(s):  
Sankar Goswami ◽  
Rituparna Acharjee ◽  
Sanku Dey
Keyword(s):  
Health Survey ◽  
Maternal Education ◽  
Haemoglobin Concentration ◽  
Family Health ◽  
Control Measures ◽  
National Family Health Survey ◽  
Binary Logistic Regression Model ◽  
Under Five ◽  
Low Level ◽  
National Family

Background: Childhood anaemia is a major public health threat that can increase susceptibility to infections, risk of mortality together with serious degrading consequences on cognitive and physical development. The aim was to examine the prevalence of anaemia in children aged under-five years in Assam, India, exploring 2015-2016 National Family Health Survey (NFHS-4) data.Methods: Statistical analysis is performed on the cross-sectional data of 10,309 children from 2015-2016 National Family Health Survey (NFHS-4), using binary logistic regression model, to assess the significance of some risk factors of child anaemia. Anaemia was diagnosed by WHO cut-off points on hemoglobin level.Results: The prevalence of child anaemia was 35.7 per cent in Assam, India, with mean haemoglobin concentration 11.36 gm/dl (95% CI, 11.32-11.38); male and female being equaled proportionately anaemic. Out of 27 districts in Assam, the highest prevalence was found in Dibrugarh (52.2 per cent), followed by Nalbari (46.7 per cent) and Darrang (45.6 per cent); and the least prevalence was found in Karbi-Anglong (24.4 per cent). The findings indicate that rural children and lower age-groups were at greater risk of anaemia. Higher birth order, low level of maternal education, low level of maternal nutrition and non-intake of iron supplements during pregnancy increased the risk of anaemia among children (p<0.05).Conclusions: The findings suggest a need for proper preventive measures to combat child anaemia. Rural population should be given special attention. Maternal education, nutrition, and birth control measures should be priorities in the programs.

scholarly journals Trends and Predictors of underweight among under-five children in Ethiopia, based on Ethiopian Demographic and Health Survey 2005 -2016. Multivariable Decomposition analysis

2020 ◽  
Author(s):  
Tilahun Yemanu Birhan ◽  
Dessie Abebaw Angaw
Keyword(s):  
Parental Education ◽  
Research Question ◽  
Decomposition Analysis ◽  
Wealth Index ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Data Set ◽  
Under Five ◽  
Under Five Children ◽  
Duration Of Breastfeeding

Abstract Background Underweight is one of the paramount major worldwide health problems, and it touches a large number of population from infancy to old age. This study aimed to analyze the trends and predictors of change in underweight among under-five children in Ethiopia Method The data for this study were accessed from three Ethiopian Demographic and Health Surveys data set 2005, 2011 and 2016. The trend was examined separately for the periods 2005–2011, 2005-2016, and 2011-2016. Multivariate decomposition analysis of change in underweight was employed to answer the major research question of this study. The technique employed the output from the logistic regression model to parcel out the observed difference in underweight into components, and STATA 14 was utilized for data management and analysis. Result Among children in Ethiopia the prevalence of underweight declined from 38% in 2005 to 25% in 2016. The decomposition analysis indicated that almost half of the overall change in underweight was due to difference in characteristics. Change in the composition of parental education, wealth index, duration of breastfeeding, respondents’ occupation, was the major contributor for the decline of underweight, while the age of child and presence of diarrhea were contributors for the rise of underweight in Ethiopia. Conclusion underweight shows a remarkable decline over the last decades in Ethiopia. Change in composition of Birth size, duration of breastfeeding, household wealth quantile (richer) and husband/partner primary education are attributable to the decline of underweight.

scholarly journals Trends and Determinants of Underweight among Children under Five Years in Ethiopia: Further Analysis with Ethiopian Demographic and Health Survey 2005–2016—Multivariate Decomposition Analysis

2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Tilahun Yemanu Birhan ◽  
Dessie Abebaw Angaw
Keyword(s):  
Health Survey ◽  
Research Question ◽  
Decomposition Analysis ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Population Characteristics ◽  
Children Under Five ◽  
Under Five ◽  
The Difference ◽  
The Government

Background. Underweight is one of the paramount major worldwide health problems, and it traces a big number of populations from infancy to old age. This study aimed to analyze the trends and predictors of change in underweight among children under five years in Ethiopia. Method. The data for this study were accessed from three Ethiopian Demographic and Health Survey data sets 2005, 2011, and 2016. The trend was examined separately for the periods 2005–2011, 2005–2016, and 2011–2016. Multivariate decomposition analysis of change in underweight was employed to answer the major research question of this study. The technique employed the output from the logistic regression model to parcel out the observed difference in underweight into components, and STATA 14 was utilized for data management and analysis. Result. Perceiving the overall trend, the rate of underweight was decreased from 38% in 2005 to 24% in 2016. The decomposition analysis results revealed that, about 12.60% of declines in underweight have been explained by the difference in population characteristics or endowments (E) over the study period. The size of the child at birth, husband’s education, women’s education, and household wealth index contributed significantly to the compositional decline in underweight. Conclusion. The magnitude of underweight among children under five years indicates a remarkable decline over the last ten years in Ethiopia. In this study, two-twelfth of the overall decrease in underweight among children under five years over the decade was due to the difference in characteristics between 2005 and 2016. Continuing to educate the population and boost the population’s economy is needed on the government side in Ethiopia.

scholarly journals Nobody left behind? Equity and the drivers of stunting reduction in Vietnamese ethnic minority populations

Food Security ◽  
2021 ◽  
Author(s):  
Jody Harris ◽  
Phuong Huynh ◽  
Hoa T. Nguyen ◽  
Nga Hoang ◽  
Lan Tran Mai ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Maternal Education ◽  
Minority Groups ◽  
National Development ◽  
Decomposition Analysis ◽  
Household Wealth ◽  
Large Set ◽  
Ethnic Minority Groups ◽  
Minority Communities ◽  
Left Behind

AbstractVietnam has successfully reduced population stunting, but ethnic minority groups are being systematically left behind, limiting progress on national reductions. This mixed methods study aims to understand how policy drivers of stunting reduction differ between ethnic majority and minority communities. We used decomposition analysis to explain key determinants of stunting change between 2000 and 2010; and framework analysis to qualitatively assess changes in policy, actors and narratives that have underpinned these over decades. Our analysis shows that stunting reductions are associated with increased household wealth (accounting for 61% of change), improved access to specific health services (16%), and changes in level of maternal education (12%). Despite multiple actors involved in change and a large set of policies designed to address inequities, many among Vietnam’s defined ethnic minority groups are not finding themselves able to effectively engage with central government plans for their communities, and central policies often do not consider their preferences or limitations. This in turn impacts the nutrition of minority groups through the determinants above. Vietnam has achieved the easier portion of stunting reduction through national economic growth and sustained commitment to socially-oriented policy. In order to tackle the remaining pockets of high malnutrition, more attention, thought and funding will need to focus on marginalised ethnic minority communities. The current national development discourse aims to incorporate minorities into mainstream majority systems. This paper argues that policy should rather take into account their particular needs and preferences to address and overcome the identified determinants of malnutrition.

scholarly journals Mind the gap: what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. F. Fagbamigbe ◽  
F. F. Oyinlola ◽  
O. M. Morakinyo ◽  
A. S. Adebowale ◽  
O. S. Fagbamigbe ◽  
...  
Keyword(s):  
Rural Areas ◽  
Decomposition Analysis ◽  
Household Wealth ◽  
Outcome Variable ◽  
Rural Children ◽  
Recent Experience ◽  
Individual Level ◽  
Under Five ◽  
Under Five Children ◽  
Neighbourhood Level

Abstract Background Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities. Methods Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010–2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package. Results Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education. Conclusions The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.

scholarly journals Prevalence and Risk Factors of Anaemia Among Children Under Five Years in Ghana: Analysis From the Ghana Demographic and Health Survey

2021 ◽  
Author(s):  
Ebenezer Opoku ◽  
Shirley Crankson ◽  
Nana Kwame Anokye
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Survey ◽  
Maternal Education ◽  
Tertiary Education ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Multivariate Logistic Regression Model ◽  
Children Under Five ◽  
Under Five

Abstract Background: Childhood anaemia remains a public health challenge in developing countries, mostly in children under five years in Sub-Sharan Africa. Anaemia in children is a preventable condition; however, it has serious consequences including growth retardation, low cognitive functioning, poor immune system causing an increased susceptibility to diseases, and death. This study determined the prevalence and associated risk factors of anaemia among children under five years in Ghana. Methods: Data from the most recent Ghana Demographic and Health Survey (DHS-VIII) was analysed in this study. Anaemia was examined as a binary variable- anaemic (coded as 1) and non-anaemic (coded as 0). The explanatory variables included age, child’s malaria vaccination status, mother’s number of antenatal visits and household source of drinking water. Bivariate and multivariate logistic regression model were conducted to identify the risk factors of anaemia in the defined population. Results: 2,434 children aged 6-59 months were included in this analysis. The majority were males (50.5%), aged from 24-42 months (36.1%), and had received malaria vaccine (94.3%). The prevalence of anaemia in the population was 58.35% (95%CI=52.72-63.96). The logistic regression indicated that female children under five years in Ghana are less likely to have anaemia than male children under five years [aOR= 0.74, 95% CI=0.62-0.88, p<0.001]. Also, children with malaria had about two times the odds of anaemia than those without malaria [95% CI = 1.28-1.87, p<0.001]. Further, children whose mothers had received tertiary education were less likely to have anaemia [aOR= 0.60, 95% CI=0.38-0.96, p=0.03] than those whose mothers had no formal education.Conclusion: The prevalence of anaemia is high among children under five years in Ghana, and this prevalence is determined by child’s age and malaria status, maternal education, household wealth index, and place of residence. Consequently, anaemia prevention and management strategies must prioritise these factors to reduce the anaemia prevalence in this population.

scholarly journals Socioeconomic, Demographic, and Environmental Associated with Stunting among Children under Five Years old in Ethiopia: Evidence from Ethiopian Demographic and Health Survey, 2016

2020 ◽  
Author(s):  
Getnet Bogale Begashaw ◽  
Yordanos Berihun Yohannes
Keyword(s):  
Random Effects ◽  
Breast Feeding ◽  
Household Head ◽  
Wealth Index ◽  
Household Wealth ◽  
Random Coefficient ◽  
Binary Logistic Regression Model ◽  
Random Coefficient Model ◽  
Children Under Five ◽  
Under Five

Abstract Background : Stunting is one of the most serious but least addressed health problems in the world. Adequate nutrition is essential for children’s health and development. Globally it is estimated that, directly or indirectly, for at least 35% of deaths in children less than five years of age. Under nutrition is also a major cause of disability preventing children who survive from reaching their full development potential. Methods: Statistical models that can treat the categorical response variable like binary logistic regression model will be employed. Beside this study will include Socio –economic and demographic factors; Sex and age of child, age of mother, Educational status, occupation, health status, religion, sex of household head, number of children under five years, Household income, family size, land ownership and time of cultivation, income source of household, wealth index as independent variables. Empty model, random intercept and fixed slope with random coefficient are the method of analyzing the dataset. Result: The prevalence of stunting among children ages under five years old were about 49.3%. Months of breastfeeding, educational level, and wealth index, currently pregnant and child food nutrient are significantly associated with stunting presence. The odds of stunting status of child from women who are pregnant is more likely to be stunted 4.157 compared to non-pregnant women controlling for other variables in the model and random effects at level two. Women who feed nutrient food to their child are 1.239 more likely to be stunted (OR=1.239) than women who didn’t feed nutrient food controlling for other variables in the model and random effects at level two. Conclusions : Age of child, breast feeding, sex, pregnant status, and food nutrient were found to be significantly associated with stunting in multilevel modeling of random coefficient model. Finally random coefficient model best fit the EDHS 2016 dataset. Therefore, interventions that focus on breast feeding, period of next pregnancy, food nutrient taken by children are required for improving child stunting in Ethiopia.

scholarly journals Decomposition of Factors Associated With Housing Material Inequality in Under-Five Deaths in Low and Middle-Income Countries

2021 ◽  
Author(s):  
Oyewale Mayowa Morakinyo ◽  
Adeniyi Francis Fagbamigbe ◽  
Ayo Stephen Adebowale
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Middle Income ◽  
Under Five ◽  
Neighbourhood Level ◽  
Housing Materials ◽  
The Individual

Abstract Background: Low-and Medium-Income Countries (LMIC) continue to record high burden of under-five deaths (U5D). There is a gap in knowledge of the factors contributing to housing materials inequalities in U5D. This study examined the contributions of the individual- and neighbourhood-level factors to housing materials inequalities in influencing U5D in LMIC.Methods: We pooled data from the most recent Demographic and Health Surveys for 56 LMIC conducted between 2010 and 2018. In all, we analysed the data of 798,796 children living in 59,791 neighbourhoods. The outcome variable was U5D among live births within 0 to 59 months of birth. The main determinate variable was housing material types, categorised as unimproved housing materials (UHM) and improved housing materials (IHM) while the individual-level and neighbourhood-level factors are the independent variables. Data were analysed using Fairlie decomposition analysis at α=0.05. Results: The overall U5D rate was 53 per 1000 children, 61 among children from houses built with UHM, and 41 among children from houses built with IHM (p<0.001). This rate was higher among children from houses that were built with UHM in all countries except in Malawi, Zambia, Lesotho, Gambia, Liberia, Sierra Leone, Indonesia, Maldives, Jordan, and Albania. None of these countries had significant pro-IHM inequality. The factors explaining housing inequalities in U5D include household wealth status, residence location, source of drinking water, media access, paternal employment, birth interval, and toilet type.Conclusions: There are variations in individual- and neighbourhood-level factors driving housing materials inequalities as it influences U5D in LMIC. Interventions focusing on reducing the burden of U5D in households built with UHM are urgently needed.

scholarly journals Stories of Change in Nutrition in Ghana: a focus on stunting and anemia among children under-five years (2009 – 2018)

Food Security ◽  
2021 ◽  
Author(s):  
Richmond Aryeetey ◽  
Afua Atuobi-Yeboah ◽  
Lucy Billings ◽  
Nicholas Nisbett ◽  
Mara van den Bold ◽  
...  
Keyword(s):  
Health Care Access ◽  
Maternal Education ◽  
Social Protection ◽  
Care Service ◽  
National Level ◽  
Decomposition Analysis ◽  
Household Wealth ◽  
Quantitative Evidence ◽  
Stakeholder Relationships ◽  
Policies And Programs

AbstractThe current study aimed to understand why child stunting and anemia (CS&A) rates declined in Ghana between 2009 and 2018, and which priority policies and programs will further improve nutrition outcomes. Trends and potential drivers of stunting (height-for-age z-score < -2.0 SD) and anemia (hemoglobin < 11.0 g/dL), and decomposition analysis of DHS data (2003 to 2014) were conducted. The quantitative evidence was triangulated with Net-Map analysis of nutrition stakeholder relationships and influence, desk review of policies and programs 2009–2019, and in-depth interviews with 25 stakeholders who provided additional insights to explain CS&A trends. Declines in stunting (29.6%) and anemia (14.1%) in children were observed at the national level, but with important subgroup variations. Decomposition analyses identified changes in the household, maternal, and child characteristics (including wealth, use of antenatal services, maternal education, and immunization) as correlates of anemia reduction. Stunting reduction was linked with changes in bed-net utilization, household wealth, and pregnancy care service utilization. Additionally, multiple policies and programs initiated/implemented across multiple sectors were considered potentially relevant to CS&A reduction over time, including those focused on infant and young child feeding, water and sanitation, social protection, and health care access. Initiation/strengthening of these interventions was stimulated by awareness creation and subsequently increased prioritization of stunting. However, program delivery was limited by deficits in government funding, perceived low priority of child anemia, low implementation capacity and coverage, and weak coherence across sectors. Reduced CS&A resulted from improved access to services implemented across multiple sectors, albeit limited by implementation scale and capacity. Further reduction in CS&A requires enhanced multi-sectorally coordinated actions and capacity.

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