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

Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Rakibul M Islam ◽  
Razia Aliani ◽  
Youssef Oulhote

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.

2019 ◽  
Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Razia Aliani ◽  
Rakibul M Islam

AbstractBackgroundIndoor air pollution (IAP) from solid fuels for cooking has been considered as a public health threat, particularly for women and children in low- and lower-middle-income countries (LMICs). We investigated the effects of solid fuel use (SFU) on neonatal, infant and under-five child mortality in Myanmar.Materials and MethodsWe used data from Myanmar’s first Demographic and Health Survey conducted in 2016. The sample consists of ever-married mothers with under-five children in the household (n=3249). We calculated the adjusted odds ratio (aOR) to investigate the effects of SFU on neonatal, infant, and under-five mortality using multivariable logistic regression model accounting for survey weight and clustering. Additional analysis was conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking (high exposure, moderate, and unexposed).ResultsThe prevalence of SFU was 79.0%, and the neonatal, infant and the under-five mortality rates were 26, 45 and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child mortality (aOR 2.22, 95% CI: 1.24, 3.95) were higher in households with SFU compared with households with clean fuel use. When applying an augmented measure of exposure to IAP by incorporating both SFU and the kitchen’s location, the likelihood of infant and under-five mortality was higher among moderately and highly exposed children compared to unexposed children with similar trends. Neonatal mortality was not associated with both SFU and levels of exposure to IAP.ConclusionInfants and under-five children are at higher risk of mortality from exposure to IAP. The findings suggest that the risk of infants and under-five child mortality may be reduced by increasing access to clean cookstoves and clean fuels in LMICs, especially in Myanmar.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Juwel Rana ◽  
Nuruzzaman Khan ◽  
Razia Aliani ◽  
Rakibul Islam

Abstract Background Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered as a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. Hence, this study investigated the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods The cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. The sample consists of 3249 ever-married mothers with under-five children in the household with a 98% response rate. HAP (coal and biomass), and level of exposure to HAP (no exposure, moderate and high exposure) were exposures. Outcomes were self-reported neonatal, infant, and under-five mortality. Results The prevalence of SFU was 79.0%. The neonatal, infant, and the under-five mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child (aOR 2.22, 95% CI: 1.24, 3.95) mortality were higher in households with SFU compared with clean fuel use. When applying an augmented measure of exposure to HAP by incorporating both SFU and the kitchen’s location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children compared with unexposed children with similar trends. Conclusion Infants and under-five children are at higher risk of mortality from exposure to HAP. Key messages Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infants and under-five child mortality in LMICs, including Myanmar.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juwel Rana ◽  
Rakibul M. Islam ◽  
Md Nuruzzaman Khan ◽  
Razia Aliani ◽  
Youssef Oulhote

AbstractHousehold air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 sample of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02; 95% CI 1.01–4.05; p-value = 0.048) and under-five mortality (aRR 2.16; 95% CI 1.07–4.36; p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.


2020 ◽  
Author(s):  
Mesfin Wudu Kassaw ◽  
Aele Mamo ◽  
Biruk Abate ◽  
Ayelign Kassie ◽  
Seteamlak Masresha

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.


2020 ◽  
Author(s):  
Asmamaw Atnafu ◽  
Malede Mequanent Sisay ◽  
Getu Debalkie Demissie ◽  
Zemenu Tadesse Tessema

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


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Solomon Gebretsadik ◽  
Emmanuel Gabreyohannes

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.


2021 ◽  
Author(s):  
Mathewos Alemu Gebremichael ◽  
Melkamu Merid Mengesha ◽  
Samuel Hailegebrea’l ◽  
Hanan Abdulkadir ◽  
Biruk Bogale Wolde

Abstract Background: Childhood overweight and obesity are emerging public health challenges of the 21st century. There was a 24% increase in the number of overweight children under the age of five years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children. Methods: This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019, to June 28, 2019. Both descriptive and analytic findings were produced using STATA version 14. For associated factors, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with 95% confidence interval (CI) was reported to show the strength of association and statistical significance. Results: A total 5,164 under-five children were included in this study. The overall prevalence of overweight/obesity was 2.14 % (95% CI; 1.74-2.53) (more than two standard deviations (+2SD) above the median of the reference population) based on the body mass index (BMI) Z-score. The odds of overweight/obesity was higher among children aged less than 6 months (aOR= 5.19; 95%CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95%CI: 1.18-3.29), delivered by caesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95%CI: 1.59-7.81), Oromia region (aOR = 1.93; 95CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95%CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95%CI: 1.66-10.47), and households headed by male (aOR = 1.71; 95%CI: 1.84-3.48). Conclusion: This study showed that childhood overweight/obesity is the problem in Ethiopia. There was an interplay of several factors that affect childhood obesity including child factors, maternal socio-demography, and healthcare utilization, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider a multitude of contributing factors.


Author(s):  
Abdollah ALMASIAN KIA ◽  
Sahar GOODARZI ◽  
Heshmatollah ASADI ◽  
Ardeshir KHOSRAVI ◽  
Aziz REZAPOUR

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.  


2020 ◽  
Author(s):  
Melkamu Molla Ferede

Abstract Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.


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