scholarly journals What does early initiation and duration of breastfeeding have to do with childhood mortality? Analysis of pooled population-based data in 35 sub-Saharan African countries

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Michael Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Infant Mortality ◽  
Early Initiation ◽  
Childhood Mortality ◽  
Breastfeeding Initiation ◽  
African Countries ◽  
Live Births ◽  
Breastfeeding Practices ◽  
Sub Saharan ◽  
Duration Of Breastfeeding ◽  
Pooled Sample

Abstract Background Breastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa. Methods This study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox). Results Early initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d’ Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively. Conclusions The findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.

scholarly journals The effect of the quality of institutions on the relationship between public health expenditure and the infant mortality rate: evidence from the PVAR (X) and PSTR approaches

2021 ◽  
Vol 1 (1) ◽  
pp. 16-35
Author(s):  
Arthur Evariste KOUASSI ◽  
Ya Assanhoun Guillaume KOUASSI ◽  
Nogbou Andetchi Aubin AMANZOU
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Important Indicator ◽  
Institutional Variables ◽  
Public Health Expenditure ◽  
Sub Saharan

Infant mortality is a major health problem in developing countries. It is an important indicator of a country's public health as it goes hand in hand with socio-economic conditions and many others. Public health spending has been committed to reducing this scourge. This has led to the completion of numerous studies which have yielded mixed results. The main objective of this study is to test the effect of public health expenditure (% GDP) on the infant mortality rate, taking into account the role that institutional quality can play. To achieve this, we use two approaches which are the autoregressive vector panel model with exogenous variables (PVAR (X)) and the smooth threshold regression model (PSTR) on annual data covering the period 2002-2016 and covering 37 African countries. Sub-Saharan. Our main results through the PVAR (X) reveal that in the absence of institutional variables, public health expenditure has a negative and significant effect on the infant mortality rate, whereas, in the presence of the various institutional variables, this effect is still negative but is no longer significant. Our results show that the presence of institutions halves the weight of public health expenditure in explaining the infant mortality rate. In addition, our results show through the PSTR that there is a certain level of institutional qualities that these countries must achieve for public health expenditure to positively affect infant mortality rates. These thresholds oscillate for all the institutional variables around 7%. Taking institutional variables into account will help reduce infant mortality in Sub-Saharan African countries.

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

scholarly journals Akses Remaja dengan Komplikasi Kehamilan terhadap Pelayanan Persalinan dan Kelangsungan Hidup Anak di Indonesia

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Tin Afifah ◽  
Novianti Novianti ◽  
Suparmi Suparmi ◽  
Kemal Nazaruddin Siregar ◽  
Nurillah Amaliah ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Adolescent Pregnancy ◽  
Neonatal Mortality ◽  
Pregnancy Complications ◽  
Death Rate ◽  
Health Facilities ◽  
Childhood Mortality ◽  
Pregnant Adolescents ◽  
Live Births ◽  
Under Five

Abstract Age-Specific Death Rate (ASDR) cases of maternal death are highest in the adolescent group (<20 years). Adolescent pregnancy is a risky pregnancy, so it is necessary to deliver at health facilities.   A complication of pregnancy in adolescents is also at risk of childhood mortality. The study aims to assess the access of pregnant adolescents with complications to delivery facilities and the relation with the survival of the child. This study is a secondary data analysis of the 2017 Indonesia Demographic and Health Survey (IDHS). The unit of analysis of live births five years preceding survey, and mother's age birth before 35 years (14,634 live births). There are 2 dependent variables: access to delivery services (skill birth attendant and health facilities); and survival of the child (neonatal, infant and under-five mortality). Interest variables is multiple high-risk category, a combination of morbidity status (complications during pregnancy) and age adolescents (<20 years) compared adults (20-34 years). Covariate variables are parity and characteristics (mother’s education, residence and wealth index). Statistical test with logistic regression, 95%CI. All pregnancies with complications were significant association with neonatal and infant mortality. Specifically adolescent pregnancy with complications is also significantly associated with under-five mortality. In adolescents with pregnancy complications had OR neonatal mortality=7.4, OR infant mortality=4.56 and OR infant mortality=3.73, compared with adults pregnant without complication. Pregnancies ages 20-34 with complications having neonatal OR=1.95 and OR infant mortality=1.64. Pregnant adolescents are significantly associated with facilities of delivery (OR<1). The conclusions are: the access of adolescents with pregnancy complications to childbirth at the health facility is still low; adolescent pregnancy with complications is significantly related to childhood mortality and the highest risk of neonatal mortality. ABSTRAK  Age Spesific Death Rate (ASDR) kasus kematian maternal tertinggi pada kelompok remaja (<20 tahun). Kehamilan pada usia remaja merupakan kehamilan berrisiko, sehingga mereka perlu akses ke fasilitas persalinan yang aman. Kehamilan dengan komplikasi pada remaja juga berisiko terhadap kematian anaknya. Tujuan studi untuk menilai akses remaja yang hamil dengan komplikasi terhadap pelayanan persalinan dan mengetahui status kelangsungan hidup anaknya. Studi ini merupakan analisis data sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) 2017. Unit analisis adalah kelahiran hidup periode lima tahun sebelum survey dan saat dilahirkan usia ibu belum mencapai 35 tahun (14.634 kelahiran hidup). Variabel dependen yang diteliti ada 2: akses ke pelayanan persalinan (tenaga kesehatan dan fasilitas pelayanan kesehatan); dan kelangsungan hidup anak (kematian: neonatal, bayi, dan balita). Variabel interes adalah status ganda yaitu kombinasi status komplikasi kehamilan dan umur risiko remaja dibandingkan umur tidak berisiko (20-34 tahun). Variabel kovariat: paritas dan karakteristik (pendidikan, tempat tinggal dan indeks kekayaan). Uji statistik dengan regresi logistik, 95%CI. Semua kehamilan dengan komplikasi berhubungan signifikan dengan kematian neonatal dan bayi bila dibandingkan dengan kehamilan usia 20-34 tanpa komplikasi. Khusus kehamilan remaja dengan komplikasi juga berhubungan signifikan dengan kematian balita. Pada remaja dengan komplikasi kehamilan mempunyai OR kematian neonatal=7,4, OR kematian bayi=4,56 dan OR kematian balita=3,73. Kehamilan usia 20-34 dengan komplikasi mempunyai OR neonatal=1,95 dan OR kematian bayi=1,64. Remaja hamil berhubungan signifikan dengan persalinan di fasyankes (OR<1). Kesimpulan studi ini adalah akses remaja dengan kehamilan komplikasi terhadap persalinan di fasyankes masih rendah. Kehamilan remaja dengan komplikasi berhubungan signifikan dengan kematian anak, dan risiko paling tinggi terhadap kematian neonatus.   

On African Responsibility for Economic Problems

1997 ◽  
Vol 25 (1) ◽  
pp. 50-53
Author(s):  
Richard E. Mshomba
Keyword(s):  
Developing Countries ◽  
Infant Mortality ◽  
Life Expectancy ◽  
Mortality Rates ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Economic Problems ◽  
High Infant Mortality ◽  
Sub Saharan ◽  
Poor Infrastructure

African countries, like many other developing countries, suffer the problems associated with poverty—malnutrition, poor health services, high infant mortality rates, low life expectancy, high illiteracy rates, poor infrastructure, and inadequate technology. These problems are especially severe in Sub-Saharan Africa.

Infant and early childhood mortality in the Sine-Saloum region of Senegal

1988 ◽  
Vol 20 (4) ◽  
pp. 471-484 ◽  
Author(s):  
Howard I. Goldberg ◽  
Fara G. M'bodji
Keyword(s):  
Early Childhood ◽  
Infant Mortality ◽  
Respiratory Diseases ◽  
Early Mortality ◽  
Childhood Mortality ◽  
Adjustment Factor ◽  
Socioeconomic Groups ◽  
Live Births ◽  
Using Data ◽  
Very High

SummaryUsing data from a 1982–83 survey, infant and early childhood mortality are investigated in a large rural region of Senegal. Because of evidence of under-reporting of early mortality an adjustment factor was applied to the data. Infant mortality was estimated to be about 113 deaths per 1000 live births. Childhood mortality was very high relative to infant mortality. Some noteworthy differentials in mortality between geographic, ethnic, and socioeconomic groups were recorded. It was estimated that diarrhoeal and respiratory diseases accounted for about one-half of reported deaths. Tetanus was an important cause of death during infancy. Measles and malaria were important causes only after the first birthday.

scholarly journals Time to death and its associated factors among infants in sub-Saharan Africa using the recent demographic and health surveys: shared frailty survival analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sofonyas Abebaw Tiruneh ◽  
Ejigu Gebeye Zeleke ◽  
Yaregal Animut
Keyword(s):  
Survival Analysis ◽  
Infant Mortality ◽  
Health Survey ◽  
Associated Factors ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Time To Death ◽  
Live Births ◽  
Shared Frailty ◽  
Sub Saharan

Abstract Background Globally, approximately 4.1 million infants died, accounting for 75% of all under-five deaths. In sub-Saharan Africa (SSA), infant mortality was 52.7/1000 live births in 2018 This study aimed to assess the pooled estimate of infant mortality rate (IMR), time to death, and its associated factors in SSA using the recent demographic and health survey dataset between 2010 and 2018. Methods Data were retrieved from the standard demographic and health survey datasets among 33 SSA countries. A total of 93,765 samples were included. The data were cleaned using Microsoft Excel and STATA software. Data analysis was done using R and STATA software. Parametric shared frailty survival analysis was employed. Statistical significance was declared as a two-side P-value < 0.05. Results The pooled estimate of IMR in SSA was 51 per 1000 live births (95% Confidence Interval (CI): 46.65–55.21). The pooled estimate of the IMR was 53 in Central, 44 in Eastern, 44 in Southern, and 57 in Western Africa per 1000 live births. The cumulative survival probability at the end of 1 year was 56%. Multiple births (Adjusted Hazard ratio (AHR) = 2.68, 95% CI: 2.54–2.82), low birth weight infants (AHR = 1.28, 95% CI: 1.22–1.34), teenage pregnancy (AHR = 1.19, 95 CI: 1.10–1.29), preceding birth interval <  18 months (AHR = 3.27, 95% CI: 3.10–3.45), birth order ≥ four (AHR = 1.14, 95% CI:1.10–1.19), home delivery (AHR = 1.08, 95% CI: 1.04–1.13), and unimproved water source (AHR = 1.07, 95% CI: 1.01–1.13), female sex (AHR = 0.86, 95% CI: 0.83–0.89), immediately breastfeed (AHR = 0.24, 95% CI: 0.23–0.25), and educated mother (AHR = 0.88, 95% CI: 0.82–0. 95) and educated father (AHR = 0.90, 95% CI: 0.85–0.96) were statistically significant factors for infant mortality. Conclusion Significant number of infants died in SSA. The most common cause of infant death is a preventable bio-demographic factor. To reduce infant mortality in the region, policymakers and other stakeholders should pay attention to preventable bio-demographic risk factors, enhance women education and improved water sources.

scholarly journals Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

2020 ◽  
Vol 117 (8) ◽  
pp. 4027-4033 ◽  
Author(s):  
Emily Smith-Greenaway ◽  
Jenny Trinitapoli
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Age Groups ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Sub Saharan ◽  
Offspring Mortality ◽  
Cumulative Prevalence

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.

scholarly journals The Implementation of Early Initiation of Breastfeeding and The Sucking Reflex in Newborns

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Ermiati E ◽  
Restuning Widiasih ◽  
Anita Setyawati
Keyword(s):  
Infant Mortality ◽  
Sampling Technique ◽  
Mortality Rates ◽  
Early Initiation ◽  
Breastfeeding Initiation ◽  
Early Initiation Of Breastfeeding ◽  
Descriptive Approach ◽  
The Government ◽  
Quantitative Descriptive ◽  
Initiation Of Breastfeeding

Early initiation of breastfeeding (IMD) is a program recommended by the government in increasing the breastfeeding success, achieving exclusive breastfeeding and reducing the infant mortality rates. The IMD is a process of mothers initiates breastfeeding within one hour after delivery of their baby. During an hour, the baby looks for his mother's nipples without help. This would be useful to increase the ability of the baby's sucking reflex. The IMD is implemented in the delivery room as part of the APN procedure, however limited study in Indonesia assessed the IMD procedure. This study is aimed to assess the implementation of IMD and the sucking reflect of newborns in a hospital in Bandung city. This design of the study was the quantitative descriptive approach. The samples were 30 newborns. The samples were chosen using the accidental sampling technique. There were two types of instruments which are an observation sheet to check the procedure of IMD, and an instrument to assess babies’ sucking reflex including rooting, sucking, and swallowing reflexes. The study findings described in a frequency distribution. This study found that 100% of deliveries were carried out IMD inappropriately, and 86.7% of babies' sucking reflects were not achieved. The study concluded that the implementation of IMD was not maximal, and would be affected babies had not succeeded in breastfeeding.  It is expected that the hospital would implement IMD as the standard of maternity services.Keywords: Early Breastfeeding Initiation, Reflect

scholarly journals Beyond poverty as a proxy: reducing inequality in infant mortality by identifying and targeting higher risk births

2021 ◽  
Author(s):  
Antonio Ramos ◽  
Chad Hazlett ◽  
Stephen Smith
Keyword(s):  
Infant Mortality ◽  
Premature Mortality ◽  
Sub Saharan Africa ◽  
Risk Scores ◽  
African Countries ◽  
Left Behind ◽  
Machine Learning Methods ◽  
Mortality Burden ◽  
Sub Saharan ◽  
Better Than

Infant mortality remains high and uneven in much of sub-Saharan Africa. Given finite resources, reducing premature mortality requires effective tools to identifying left- behind populations at greatest risk. While countries routinely use income- or poverty- based thresholds to target policies, we examine whether models that consider other factors can substantially improve our ability to target policies to higher-risk births. Using machine learning methods, and 25 commonly available variables that can be observed prior to birth, we construct child-level risk scores for births in 22 sub-Saharan African countries. We find that targeting based on poverty, proxied by income, is only slightly better than random targeting, with the poorest 10 percent of the population experiencing approximately 10 percent of total infant mortality burden. By contrast the 10 percent of the population at highest risk according to our model accounts for 15-30% of infants deaths, depending on country. A hypothetical intervention that can be administered to 10% of the population and prevents just 5% of the deaths that would otherwise occur, for example, would save roughly 841,000 lives if targeted to the poorest decile, but over 1.6 million if targeted using our approach.

scholarly journals Factors Associated with the Implementation of the WHO Breastfeeding Recommendations in Momo Division, North-West Region of Cameroon

2019 ◽  
pp. 114-123
Author(s):  
Nwachan Mirabelle Boh ◽  
Ejoh Aba Richard
Keyword(s):  
Breast Milk ◽  
Maternity Leave ◽  
Cultural Beliefs ◽  
Mode Of Delivery ◽  
Breastfeeding Initiation ◽  
Maternal Knowledge ◽  
North West ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
Duration Of Breastfeeding

Breastfeeding is essential to break the spiteful cycle of malnutrition in children. In spite of the WHO recommendations on optimum breastfeeding practices and their extensively acknowledged benefits, adherence to these recommendations in Cameroon remains incredibly low. The aim of this study was to identify the factors associated with the implementation of the WHO breastfeeding recommendations among mothers whose children are aged 0 to 24 months in Momo Division, Cameroon. To achieve this goal, 540 mothers attending 22 health units in the 5 sub divisions of Momo division completed structured interviewer administered questionnaire. Through this questionnaire, information on their socioeconomic and demographic characteristics, their knowledge and cultural beliefs about breastfeeding practices and the characteristics of their babies were collected. Results show that 51.5% of babies were girls and 46.1% of mothers had secondary education as their highest level of education. The monthly household income of most (80%) of the mothers was less than 100000frs CFA. Factors found to influence pre-lacteal feeding were mode of delivery, mother’s attitude on the type of first food to be given to the baby and birth order. Breastfeeding initiation within one hour following delivery was associated with place of delivery and mode of delivery. Exclusive breastfeeding was influenced by breast problems, mother’s employment status and misconceptions. The only factor associated with frequency of breastfeeding was the infant’s age. Duration of breastfeeding was associated with birth weight, and maternal knowledge on recommended duration of breastfeeding. The main impairments to breastfeeding practices were mistaken ideas based on misinformation, inadequate or no maternity leave, caesarian method of delivery, delayed breast milk secretion, breast problems and non-satiation of the baby after breastfeeding. The misconceptions noticed amongst mothers in this Division was the belief that breast milk alone is not enough to meet the nutritional needs of the baby for up to six months, expressed breast milk should not be fed to the baby and that infants below 6 months need water to quench their thirst. Maternal knowledge on breastfeeding was good as many knew the importance of breast milk.  

Sign in / Sign up

Export Citation Format

Share Document