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 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 Decomposition of factors associated with housing material inequality in under-five deaths in low and middle-income countries

2022 ◽  
Vol 80 (1) ◽  
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 a 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 the 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 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 Spatial Prevalence and Determinants of Malaria among under-five Children in Ghana

2021 ◽  
Author(s):  
Bedilu Alamirie Ejigu ◽  
Eshetu Wencheko
Keyword(s):  
Rural Areas ◽  
Hot Spot ◽  
Control Program ◽  
Wealth Index ◽  
Household Wealth ◽  
Malaria Prevalence ◽  
Vulnerable Groups ◽  
Eastern Region ◽  
Under Five ◽  
Under Five Children

AbstractIn Ghana malaria is an endemic disease and the incidence of malaria still accounts for 38.0% of all outpatient attendance with the most vulnerable groups being children under 5 years of age. In order to alleviate this problem, it is essential to design geographically targeted and cost-effective intervention mechanisms guided by up-to-date and reliable data and maps that show the spatial prevalence of the disease. The 2016 Ghana Malaria Indicator Survey data (N = 2,910 under-five children) were analyzed using model-based geostatistical methods with the two objectives to: (1) explore individual-, household-, and community-level determinant variables associated with malaria illness in U5 children, and (2) produce prevalence maps of malaria across the study locations in the country. The overall weighted prevalence of malaria by microscopy blood smear and rapid diagnostic tests were 20.63% (with 95% CI: 18.85% - 22.53%) and 27.82% (with 95% CI: 25.81% - 29.91%), respectively. Across regions of Ghana, the prevalence of malaria ranges from 5% in Greater Accra to 31% in Eastern region. Malaria prevalence was higher in rural areas, increased with child age, and decreased with better household wealth index and higher level of mother’s education. Given the high prevalence of childhood malaria observed in Ghana, there is an urgent need for effective and efficient public health interventions in hot spot areas. The determinant variables of malaria infection that have been identified in this study as well as the maps of parasitaemia risk could be used in malaria control program implementation to define priority intervention areas.

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 Burden of Acute Respiratory Infections Among Under-Five Children in Relation to Household Wealth and Socioeconomic Status in Bangladesh

2019 ◽  
Vol 4 (1) ◽  
pp. 36 ◽  
Author(s):  
Sanni Yaya ◽  
Ghose Bishwajit
Keyword(s):  
Socioeconomic Status ◽  
Respiratory Infections ◽  
Household Wealth ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
Special Focus ◽  
Acute Respiratory Infections ◽  
Water And Sanitation ◽  
Under Five ◽  
Under Five Children

Acute respiratory infections (ARIs), as a group of diseases and symptoms, are a leading cause of morbidity and mortality among under-five children in tropical countries like Bangladesh. Currently, no clear evidence has been published on the prevalence and socioeconomic correlates of ARIs in Bangladesh. In this regard, we carried out this study with the aim of assessing the prevalence and the socioeconomic predictors of ARIs among children aged 0–59 months, with a special focus on socioeconomic status and wealth-related indicators. Cross-sectional data on 32,998 mother-child (singleton) pairs were collected from six rounds of Bangladesh Demographic and Health Surveys (BDHS 1997–2014). The outcome variable were presence of the common symptoms of ARIs, fever and dyspnea, during the previous two weeks, which were measured based on mothers’ reports about the symptoms of these conditions. Explanatory variables included maternal demographic and socioeconomic factors such as age, education, occupation, wealth quintile, and child’s age and sex. The prevalence and predictors of ARIs were measured using descriptive and multivariate regression methods. The prevalence of both fever (31.00% in 1997 vs. 36.76% in 2014) and dyspnea (39.27% in 1997 vs. 43.27% in 2014) has increased gradually since 1997, and tended to be higher in households in the lower wealth quintiles. Multivariable analysis revealed that higher maternal educational status, access to improved water and sanitation facilities, and living in households in higher wealth quintiles had protective effects against both fever and dyspnea. Findings suggested a significantly negative association between lacking access to improved water and sanitation and use of biomass fuel with ARI symptoms. However, no sex difference was observed in these associations. Based on the findings, childhood ARI prevention strategies should address the risk factors stemming from parental socioeconomic marginalisation, household water and sanitation poverty, and use of unclean fuel.

scholarly journals Bivariate binary analysis on composite index of anthropometric failure of under-five children and household wealth-index

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Demeke Lakew Workie ◽  
Lijalem Melie Tesfaw
Keyword(s):  
Logistic Regression ◽  
Composite Index ◽  
Binary Logistic Regression ◽  
Wealth Index ◽  
Household Wealth ◽  
Education Level ◽  
Multiple Birth ◽  
Under Five ◽  
Under Five Children ◽  
Study Results

Abstract Background Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. Methods In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. Results Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. Conclusion The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.

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 Manuscript title: Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study

2020 ◽  
Author(s):  
Sujata Kapil Murarkar ◽  
Jayashree Sachin Gothankar ◽  
Prakash Doke ◽  
Prasad Pore ◽  
Sanjay Lalwani ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Breast Feeding ◽  
Rural Areas ◽  
Maternal Education ◽  
Economic Status ◽  
Urban Slums ◽  
Cross Sectional ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Under Five Children

Abstract BackgroundUndernutrition among under five children in India is a major public health problem.Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas.Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3,671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. ResultsThe mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37).Overall prevalence of stunting among children under five was 45.9 %, wasting was 17.1% and 35.4% children were underweight.Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area.In the rural areas exclusive breast feeding(p<0.001) and acute diarrhea (p=0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p<0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding(p<0.05) was associated with wasting, sex of the child (p<0.05) and type of family(p<0.05)were associated with stunting,and low income of the family(p<0.05) was associated with underweight.ConclusionsFactors like sex of the child, birth order,exclusive breast feeding ,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.Trial registration-Trial registration number:CTRI/2017/12/010881;Registration date:14/12/2017. Retrospectively registered.

scholarly journals Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study

2020 ◽  
Author(s):  
Sujata Kapil Murarkar ◽  
Jayashree Sachin Gothankar ◽  
Prakash Doke ◽  
Prasad Pore ◽  
Sanjay Lalwani ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Breast Feeding ◽  
Rural Areas ◽  
Maternal Education ◽  
Urban Slums ◽  
Trial Registration ◽  
Cross Sectional ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Under Five Children

Abstract Background Undernutrition among under five children in India is a major public health problem.Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas.Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3,671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. Results The mean age of the children was 2.38years (±SD 1.365) and mean age of mothers was 24.25(± SD6.37) years.Overall prevalence of stunting among children under five was 45.9 %, wasting was 17.1% and 35.4% children were underweight.Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area.In the rural areas exclusive breast feeding(p<0.001) and acute diarrhea (p=0.001)in children underfive were associated with wasting, children with birth order 2 or less than 2 were more affected by stunting and exclusive breast feeding (p<0.05) and low maternal education were associated with underweight.Whereas in the urban slums exclusive breast feeding(p<0.05) was associated with wasting, sex of the child (p<0.05) and type of family(p<0.05)were associated with stunting,and low income of the family(p<0.05) was associated with underweight.Conclusion Factors like sex of the child, birth order,exclusive breast feeding ,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.The trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.

scholarly journals Effect of Improving Housing Conditions on Early Childhood Health in Rural Sudan

2016 ◽  
Vol 9 (4) ◽  
pp. 96
Author(s):  
Obbey A. Elamin
Keyword(s):  
Early Childhood ◽  
Rural Areas ◽  
Strong Impact ◽  
Housing Sector ◽  
Childhood Health ◽  
Under Five ◽  
Under Five Children ◽  
Early Childhood Health ◽  
Percentage Points ◽  
Piped Water

Improving housing sector in rural areas is important to improve health status of under-five children. Propensity score matching using nonparametric kernel estimates is used to examine the effect of improving rural structure of houses in rural Sudan and provide them with services like access to clean piped water, sanitation on improving under-five children health. The prevalence of diarrhoea and cough in rural Sudan are used as measures of health outcome and data from the Sudan Household Health Survey in 2010 is used. Our results show that providing houses with piped water can reduce prevalence of diarrhoea and cough by 22 and 24 percentage points, respectively. Gas cooking fuel reduces the prevalence rates by 26 and 29 percentage points, respectively. Construction materials of walls have strong impact on reducing the prevalence of both illnesses. We recommend that the quality of piped water should be observed and maintained in good standard to ensure that clean water is supplies to the household sector. Developing the housing sector in the rural has many advantages in improving early childhood health in Sudan and it should be one of the priorities of the government.

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