scholarly journals Geostatistical analysis and mapping: social and environmental determinants of under-five child mortality, evidence from the 2014 Ghana demographic and health survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Justice Moses K. Aheto ◽  
Robert Yankson ◽  
Michael Give Chipeta
Keyword(s):  
Child Mortality ◽  
Health Survey ◽  
Child Survival ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Multiple Births ◽  
Outcome Variable ◽  
Under Five ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Background Under-five mortality (U5M) rates are among the health indicators of utmost importance globally. It is the goal 3 target 2.1 of the Sustainable Development Goals that is expected to be reduced to at least 25 per 1000 livebirths by 2030. Despite a considerable reduction in U5M observed globally, several countries especially those in sub-Saharan Africa (SSA) like Ghana are struggling to meet this target. Evidence-based targeting and utilization of the available limited public health resources are critical for effective design of intervention strategies that will enhance under-five child survival. We aimed to estimate and map U5M risk, with the ultimate goal of identifying communities at high risk where interventions and further research can be targeted. Methods The 2014 Ghana Demographic and Health Survey data was used in this study. Geostatistical analyses were conducted on 5884 children residing in 423 geographical clusters. The outcome variable is child survival status (alive or dead). We employed a geostatistical generalised linear mixed model to investigate both measured and unmeasured child specific and spatial risk factors for child survival. We then visualise child mortality by mapping the predictive probability of survival. Results Of the total sampled under 5 children, 289 (4.91%) experienced the outcome of interest. Children born as multiple births were at increased risk of mortality with an adjusted odds ratio (aOR) (aOR: 8.2532, 95% CI: [5.2608–12.9477]) compared to singletons. Maternal age increased risk of mortality (aOR: 1.0325, 95% CI: [1.0128–1.0527]). Child’s age (aOR: 0.2277, 95% CI: [0.1870–0.2771]) and number of children under 5 within each household (aOR: 0.3166, 95% CI: [0.2614–0.3835]) were shown to have a protective effect. Additionally, mothers with secondary education level (aOR: 0.6258, 95% CI: [0.4298–0.9114]) decreased the risk of U5M. The predicted U5M risk in 2014 was at 5.98%. Substantial residual spatial variations were observed in U5M. Conclusion The analysis found that multiple births is highly associated with increased U5M in Ghana. The high-resolution maps show areas and communities where interventions and further research for U5M can be prioritised to have health impact.

scholarly journals Geostatistical analysis and mapping: Social and environmental determinants of under-five child mortality, evidence from the 2014 Ghana Demographic and Health Survey.

2019 ◽  
Author(s):  
Justice Moses K. Aheto ◽  
Robert Yankson ◽  
Michael Give Chipeta
Keyword(s):  
Health Survey ◽  
Maternal Education ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Multiple Births ◽  
Outcome Variable ◽  
Under Five ◽  
Spatial Risk ◽  
Increased Risk ◽  
Generalised Linear Mixed Model

Abstract Background Under-five mortality (U5M) rates are among the health indicators of utmost importance globally. It is the goal 3 target 2.1 of the Sustainable Development Goals that is expected to be reduced to at least 25 per 1000 livebirths by 2030. Despite a considerable reduction in U5M was observed globally, several countries especially those in sub-Saharan Africa (SSA) like Ghana are struggling to meet this target. Evidence-based targeting and utilization of the available limited public health resources are critical for effective design of intervention strategies that will enhance under-five child survival. We aimed to estimate and map U5M risk, with the ultimate goal of identifying communities at high risk where interventions can be targeted.Methods The 2014 Ghana Demographic and Health Survey data was used in this study. Geostatistical analyses were conducted on 5,801 children residing in 423 geographical clusters. The outcome variable is child survival status (alive or dead). We employed a geostatistical generalised linear mixed model to investigate both measured and unmeasured child specific and spatial risk factors for child survival. We then visualise child mortality by mapping the predictive probability of survival.Results Of the total sampled under 5 children, 280 (4.83%) experienced the outcome of interest. Children born as multiple births were at increased risk of mortality with AOR (9.28, 95% CI: 6.35 – 13.58) compared to singletons. Maternal education AOR (0.80, 95% CI: 0.68 – 0.93) and number of children under 5 within each household AOR (0.34, 95% CI: 0.28 – 0.41) were shown to have a protective effect. The predicted U5M risk in 2014 was at 8.3%. High altitude areas were highly associated with high U5M.Conclusion The analysis found that multiple births and high elevation are highly associated with U5M in Ghana. The high-resolution maps show areas and communities where interventions for U5M can be prioritised to have health impact.

scholarly journals Association Between Household Air Pollution and Infant and Child Mortality in Myanmar: Evidence From The First Demographic and Health Survey

2021 ◽  
Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Rakibul M Islam ◽  
Razia Aliani ◽  
Youssef Oulhote
Keyword(s):  
Air Pollution ◽  
Child Mortality ◽  
Health Survey ◽  
Rural Areas ◽  
Demographic And Health Survey ◽  
Household Air Pollution ◽  
Cluster Sampling ◽  
High Exposure ◽  
Under Five ◽  
Under Five Children

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.

scholarly journals High prevalence of under-five child mortality in the pastoralist communities of Ethiopia: Evidence from the 2016 Ethiopian demographic and health survey data

2020 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Aele Mamo ◽  
Biruk Abate ◽  
Ayelign Kassie ◽  
Seteamlak Masresha
Keyword(s):  
Survey Data ◽  
Child Mortality ◽  
Health Survey ◽  
Wealth Index ◽  
Demographic And Health Survey ◽  
Under Five ◽  
Khat Chewing ◽  
High Prevalence ◽  
Health Survey Data ◽  
The Government

Abstract Objective: The aim of this study was to assess the prevalence and association of child mortality in the pastoralist regions of Ethiopia. The study is a further analysis from 2016 Ethiopian Demographic and Health Survey data. Results: The prevalence of under-five child mortality in the pastoralist’s regions was 23.2%, 95%CI (21.4%, 24.6%). The prevalence of mortality among daughters was 15.4%, 95%CI (14.2, 16.6%), and sons 16.8%, 95%CI (15.6, 18.1%).In logistic regression, wealth index, head of household, Khat chewing, type of child birth, husband education, and child age in months were associated with under-five mortality irrespective of the deceased children’s gender. The prevalence of under-five child mortality in the pastoralist regions of Ethiopia was high, which was far highest in relative to the national under-five mortality prevalence. In assessing the effect of variables on under-five child mortality by gender, almost all the variables that have an effect on female or male child are similar. The government should emphasize on the pastoralists’ regions to decrease the high prevalence of under-five child mortality.

Geographical disparities and determinants of childhood diarrheal illness in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Asmamaw Atnafu ◽  
Malede Mequanent Sisay ◽  
Getu Debalkie Demissie ◽  
Zemenu Tadesse Tessema
Keyword(s):  
Health Survey ◽  
Mixed Model ◽  
Addis Ababa ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Childhood Diarrhea ◽  
Mixed Effect ◽  
Under Five ◽  
Diarrheal Illness ◽  
Under Five Children

Abstract Background: Childhood diarrheal illness is the second leading cause of child mortality in Sub Saharan Africa, including Ethiopia. Studies hypothesized that there are regional variations. Thus, the study aimed to examine the spatial variations and to identify the determinants of childhood diarrhea in Ethiopia. Methods: Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was analyzed. This nationwide survey involved 10,337 children below 5 years old. The survey was carried out using a two-stage stratified sampling design. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Descriptive statistics followed by a mixed-effect logistic regression was used to identify the factors associated with the prevalence of diarrhea. Results: Overall, 11.87% of children were experienced childhood diarrheal illness. The study reveals high-risk areas were Southern and central Ethiopia, while eastern and west were indicated as low-risk regions. Younger children were more likely to suffer from childhood diarrhea than their older counterparts: age 6 to 12, 12 to 23, and 24 to 35 months were (AOR = 2.66, (95% CI 2.01, 3.52)), (AOR = 2.45, (95% CI 1.89, 3.17)), and (AOR = 1.53, (95% CI 1.17, 2.01)), respectively. Children living in Tigray (AOR= 1.69 (95% CI, 1.01, 2.83)), Amhara (AOR = 1.80, (95% CI, 1.06, 3.06), SNNPR (AOR = 2.04, 95% CI 1.22, 3.42), and Gambela (AOR = 2.05, (95% CI 1.22, 3.42)), faced greater risk than Addis Ababa city. The odds of getting diarrhea is decreased by 24% among households having ≥3 under-five children as compared to households having only one under-five child (AOR = 0.76 (95% CI: 0.61, 0.94)). The odds of children getting diarrheal illness among working mothers increase by 19% as compared to not working (AOR = 1.19 (95% CI 1.03, 1.38)). Conclusions: childhood diarrheal illness is highly prevalent among under-five children, particularly in SNNP, Gambella, Oromia, and Benishangul Gumuz regions. Capacity building programs with best experience sharing and better household environment may prove effective in reducing the incidence of childhood diarrhea in Ethiopia. Keywords: Spatial statistics, Ethiopia, under-five children, Diarrhea, Generalized Mixed Model

scholarly journals Under-Five Mortality and Associated Factors: Evidence from the Nepal Demographic and Health Survey (2001–2016)

2019 ◽  
Vol 16 (7) ◽  
pp. 1241
Author(s):  
Pramesh Ghimire ◽  
Kingsley Agho ◽  
Osita Ezeh ◽  
Andre Renzaho ◽  
Michael Dibley ◽  
...  
Keyword(s):  
Sustainable Development ◽  
Health Survey ◽  
Child Survival ◽  
Common Factors ◽  
Demographic And Health Survey ◽  
Sustainable Development Goal ◽  
Development Goal ◽  
Live Births ◽  
Under Five ◽  
Factors Associated

Child mortality in Nepal has reduced, but the rate is still above the Sustainable Development Goal target of 20 deaths per 1000 live births. This study aimed to identify common factors associated with under-five mortality in Nepal. Survival information of 16,802 most recent singleton live births from the Nepal Demographic and Health Survey for the period (2001–2016) were utilized. Survey-based Cox proportional hazard models were used to examine factors associated with under-five mortality. Multivariable analyses revealed the most common factors associated with mortality across all age subgroups included: mothers who reported previous death of a child [adjusted hazard ratio (aHR) 17.33, 95% confidence interval (CI) 11.44, 26.26 for neonatal; aHR 13.05, 95% CI 7.19, 23.67 for post-neonatal; aHR 15.90, 95% CI 11.38, 22.22 for infant; aHR 16.98, 95% CI 6.19, 46.58 for child; and aHR 15.97, 95% CI 11.64, 21.92 for under-five mortality]; nonuse of tetanus toxoids (TT) vaccinations during pregnancy (aHR 2.28, 95% CI 1.68, 3.09 for neonatal; aHR 1.86, 95% CI 1.24, 2.79 for post-neonatal; aHR 2.44, 95% CI 1.89, 3.15 for infant; aHR 2.93, 95% CI 1.51, 5.69 for child; and aHR 2.39, 95% CI 1.89, 3.01 for under-five mortality); and nonuse of contraceptives among mothers (aHR 1.69, 95% CI 1.21, 2.37 for neonatal; aHR 2.69, 95% CI 1.67, 4.32 for post-neonatal; aHR 2.01, 95% CI 1.53, 2.64 for infant; aHR 2.47, 95% CI 1.30, 4.71 for child; and aHR 2.03, 95% CI 1.57, 2.62 for under-five mortality). Family planning intervention as well as promotion of universal coverage of at least two doses of TT vaccine are essential to help achieve child survival Sustainable Development Goal (SDG) targets of <20 under-five deaths and <12 neonatal deaths per 1000 births by the year 2030.

Medical Perspective of Childhood Marriage in Nigeria: Body of Evidence from 2013 Nigeria Demographic and Health Survey

2019 ◽  
Vol 15 (3) ◽  
pp. 188-195
Author(s):  
Audu Alayande ◽  
Bahijjatu Bello-Garko ◽  
Zubaida Abubakar ◽  
Hafsat Kagara ◽  
Islamiyat A. Nuhu
Keyword(s):  
Health Survey ◽  
Female Circumcision ◽  
Child Survival ◽  
Antenatal Clinic ◽  
Skilled Birth Attendance ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Reproductive Health Services ◽  
Birth Attendance

Background: Available data from South Asia and sub-Saharan Africa indicates that 12% and 34% of girls were married at age 15years and 18years respectively. This practice of child marriage may debar countries from achieving the Sustainable Development Goals. Objective: To extract and present disaggregated indices in the 2013 Nigeria Demographic and Health Survey (NDHS) on the effect of child marriage on health. Method: This desk review study extracted disaggregated maternal and child health indices on married females aged 15-19 years from the 2013 NDHS. Results: The result showed that married females aged 15-19 years were short, thin, and least likely to receive prophylactic Vitamin A dose postpartum and deworming medication at last pregnancy. Also, while awareness for Family Planning (FP) was high, its utilization was poor at only 1.2%. Their Antenatal clinic attendance, facility delivery, skilled birth attendance at delivery and post natal service utilization were lowest. Similarly, mortality of children under 5 was highest amongst these mothers. Although violence during pregnancy was highest amongst this group, nevertheless more than 20% of them agreed that the practice of female circumcision should be continued. Conclusion: These findings depict some of the negative outcomes of child marriage on maternal and child survival which require integrated multisectoral interventions to ensure that all girls have access to timely sexual reproductive health services and information.</P>

scholarly journals Determinants of Under-Five Mortality in High Mortality Regions of Ethiopia: An Analysis of the 2011 Ethiopia Demographic and Health Survey Data

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Solomon Gebretsadik ◽  
Emmanuel Gabreyohannes
Keyword(s):  
Survey Data ◽  
Child Mortality ◽  
Health Survey ◽  
Birth Interval ◽  
Secondary Analysis ◽  
Demographic And Health Survey ◽  
Factors Affecting ◽  
Under Five ◽  
Health Survey Data ◽  
Low Probability

The study was a secondary analysis of existing data from the 2011 Ethiopia Demographic and Health Survey data. Of the 2097 live births recorded in Affar, Somali, Benishangul-Gumuz, and Gambela regions of Ethiopia between 2006 and 2011, 366 deaths before the age of five years were reported. The univariable and multivariable Cox proportional regression models were fitted to select the factors affecting under-five mortality in these regions. The model revealed that under-five mortality significantly associated with preceding birth interval, family size, birth type, breastfeeding status, source of drinking water, and income of mother. Children born after a preceding birth interval of 2-3 years and 3 years and above were significantly less likely to have died before their fifth birthday than those born within two years. Children who were breastfed, for any period, were 25.5% (HR 1.255, 1.005–1.567, p = 0.045) less likely to have died before their fifth birthday than those who were not breastfed. Increased birth interval time corresponds to a low probability of child mortality. Thus, mothers should be encouraged to wait for a sufficient number of months after a birth to conceive another child. Furthermore, breastfeeding was of paramount importance in the fight against child mortality.

scholarly journals Neonatal mortality in East Africa and West Africa: a geographic analysis of district-level demographic and health survey data

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Sue C. Grady ◽  
April N. Frake ◽  
Qiong Zhang ◽  
Matlhogonolo Bene ◽  
Demetrice R. Jordan ◽  
...  
Keyword(s):  
High Risk ◽  
West Africa ◽  
East Africa ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Health Survey ◽  
Demographic And Health Survey ◽  
Home Births ◽  
Under Five ◽  
Development Goals

Under-five child mortality declined 47% since 2000 following the implementation of the United Nation’s (UN) Millennium Development Goals. To further reduce under-five child mortality, the UN’s Sustainable Development Goals (SDGs) will focus on interventions to address neonatal mortality, a major contributor of under-five mortality. The African region has the highest neonatal mortality rate (28.0 per 1000 live births), followed by that of the Eastern Mediterranean (26.6) and South-East Asia (24.3). This study used the Demographic and Health Survey Birth Recode data (http://dhsprogram.com/data/File-Types-and-Names.cfm) to identify high-risk districts and countries for neonatal mortality in two sub-regions of Africa – East Africa and West Africa. Geographically weighted Poisson regression models were estimated to capture the spatially varying relationships between neonatal mortality and dimensions of potential need i) <em>care around the time of delivery</em>, ii) <em>maternal education</em>, and iii) <em>women’s empowerment</em>. In East Africa, neonatal mortality was significantly associated with home births, mothers without an education and mothers whose husbands decided on contraceptive practices, controlling for rural residency. In West Africa, neonatal mortality was also significantly associated with home births, mothers with a primary education and mothers who did not want or plan their last child. Importantly, neonatal mortality associated with home deliveries were explained by maternal exposure to unprotected water sources in East Africa and older maternal age and female sex of infants in West Africa. Future SDG-interventions may target these dimensions of need in priority high-risk districts and countries, to further reduce the burden of neonatal mortality in Africa.

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