Temperature Extreme May Exaggerate the Mortality Risk of COVID-19 in the Low- and Middle-income Countries: A Global Analysis

We performed a global analysis with data from 149 countries to test whether temperature can explain the spatial variability of the spread rate and mortality of COVID-19 at the global scale. We performed partial correlation analysis and linear mixed effect modelling to evaluate the association of the spread rate and motility of COVID-19 with maximum, minimum, average temperatures and temperature extreme (difference between maximum and minimum temperature) and other environmental and socioeconomic parameters. After controlling the effect of the duration after the first positive case, partial correlation analysis revealed that temperature was not related with the spatial variability of the spread rate of COVID-19. Mortality was negatively related with temperature in the countries with high-income economies. In contrast, temperature extreme was significantly and positively correlated with mortality in the low-and middle-income countries. Taking the country heterogeneity into account, mixed effect modelling revealed that inclusion of temperature as a fixed effect in the model significantly improved model skill predicting mortality in the low-and middle-income countries. Our analysis suggest that warm climate may reduce the mortality rate in high-income economies but in low and middle-income countries temperature extreme may increase the mortality risk.

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Inequalities in Antenatal Care Coverage and Quality: an Analysis From 63 Low and Middle-income Countries Using the ANCq Content-qualified Coverage Indicator

10.21203/rs.3.rs-120640/v1 ◽

2020 ◽

Author(s):

Luisa Arroyave ◽

Ghada E Saad ◽

Cesar G Victora ◽

Aluisio J D Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

Abstract Background: Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs.Methods: ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results: We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.Conclusions: Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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Inequalities in antenatal care coverage and quality: an analysis from 63 low and middle-income countries using the ANCq content-qualified coverage indicator

International Journal for Equity in Health ◽

10.1186/s12939-021-01440-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Luisa Arroyave ◽

Ghada E. Saad ◽

Cesar G. Victora ◽

Aluisio J. D. Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

Abstract Background Antenatal care (ANC) is an essential intervention associated with a reduction of maternal and new-born morbidity and mortality. However, evidence suggested substantial inequalities in maternal and child health, mainly in low- and middle-income countries (LMICs). We aimed to conduct a global analysis of socioeconomic inequalities in ANC using national surveys from LMICs. Methods ANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum. Results We analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality. Conclusions Despite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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Inequalities in antenatal care coverage and quality: an analysis from 63 low and middle-income countries using the ANCq content-qualified coverage indicator

10.1101/2020.11.11.20230102 ◽

2020 ◽

Author(s):

Luisa Arroyave ◽

Ghada E Saad ◽

Cesar G Victora ◽

Aluisio J D Barros

Keyword(s):

Antenatal Care ◽

Urban Areas ◽

Global Analysis ◽

Socioeconomic Inequalities ◽

Middle Income ◽

National Surveys ◽

Middle Income Countries ◽

Wide Range ◽

The Difference ◽

Low And Middle Income

AbstractObjectiveto conduct a global analysis of socioeconomic inequalities in antenatal care (ANC) using national surveys from low- and middle-income countries.MethodsANC was measured using the ANCq, a novel content-qualified ANC coverage indicator, created and validated using national surveys, based upon contact with the health services and content of care received. We performed stratified analysis to explore the socioeconomic inequalities in ANCq. We also estimated the slope index of inequality, which measures the difference in coverage along the wealth spectrum.ResultsWe analyzed 63 national surveys carried out from 2010 to 2017. There were large inequalities between and within countries. Higher ANCq scores were observed among women living in urban areas, with secondary or more level of education, belonging to wealthier families and with higher empowerment in nearly all countries. Countries with higher ANCq mean presented lower inequalities; while countries with average ANCq scores presented wide range of inequality, with some managing to achieve very low inequality.ConclusionsDespite all efforts in ANC programs, important inequalities in coverage and quality of ANC services persist. If maternal and child mortality Sustainable Development Goals are to be achieved, those gaps we documented must be bridged.

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