scholarly journals Spending on Health is a Complex Phenomenon in our Country

2018 ◽  
Vol 24 (S) ◽  
pp. 829-830
Author(s):  
Sumair Anwar
Keyword(s):  
Mortality Rate ◽  
Neonatal Period ◽  
Health Indicators ◽  
Complex Phenomenon ◽  
Live Births ◽  
Under Five ◽  
Under Five Children ◽  
The Past

According to WHO statistics 2017, amongst health indicators of countries worldwide, Pakistan’s under five children mortality rate has been recorded up to 81.1 per 1000 live births, which is second highest in the list of SAARC countries.1 In Pakistan, over 57% of deaths under 5 years occur during the neonatal period (42 per 1000 live births) and have not changed over the past 6 years.2

scholarly journals Child malnutrition and mortality in Swaziland: Situation analaysis of the immediate, underlying and basic causes

2012 ◽  
Vol 12 (50) ◽  
pp. 5994-6006
Author(s):  
SKS Masuku-Maseko ◽  
◽  
EE Owaga ◽  
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Urban Areas ◽  
Child Nutrition ◽  
Child Malnutrition ◽  
Live Births ◽  
Under Five ◽  
Childhood Malnutrition ◽  
Under Five Children ◽  
Depth Analysis

Malnutrition is a major confounding factor for child morbidity and mortality in developing countries. In Swaziland, about 31% of the under-five children are stunted in growth, where-as 1% and 6% are wasted and underweight, respectively. Hhohho region has the highest prevalence of underweight children (8.2%) relative to other regions such as Shiselweni (7.3%), Lubombo (6.7%) and Manzini (6.4%). The prevalence of infant and under-five children mortality rate (per 1,000 live births) are 85 and 102 deaths, respectively. Lubombo region has the highest cases of under-five mortality rate (deaths per 1,000 live births) of 115 when compared to rates in other regions, namely; Manzini (112), Shiselweni (100) and Hhohho (96). Despite the several child healthcare programmes, the problem of high child malnutrition places a significant hindrance towards the attainment of the Millennium Development Goals (MDG) 4 on reduction of child mortality. Potential determinants of childhood malnutrition and mortality in Swaziland can be categorized into three levels, namely: (a) immediate causes (inadequate dietary intake of protein, energy and micronutrients; diseases such as pneumonia, diarrhoeal diseases and HIV/AIDS, (b) underlying causes (inadequate access to food due to poverty and decline in food production; inadequate care of children and women, insufficient health services and unhealthy environment), and (c) basic causes (inadequate mother’s education and nutrition knowledge, insufficient human resources in child health care; inadequate policies on child nutrition and health care; inequitable distribution of household and national socioeconomic resources). This paper presents an in-depth analysis of the causal factors of childhood malnutrition and mortality in Swaziland, and further explores opportunities that could be adopted to address the malnutrition and mortality problem. It also aims to reinforce that in order to ensure effectiveness and sustainability of intervention programmes, there is need for multi-dimensional strategies and collaboration between all the stakeholders concerned with child nutrition, health and socio-economic development. However, the interventions must recognize the existing socio-economic differentials between the rural and urban areas, and the administrative regions.

scholarly journals Infant and Child health status ahead of implementation of an integrated intervention to improve nutrition and survival: A difference-in-difference quasi-experimental baseline assessment

2019 ◽  
Author(s):  
Emmanuel Nene Odjidja ◽  
Sonia Hakizimana ◽  
Ghislaine Gatasi ◽  
Jean-Berchmans Masabo ◽  
Gildas Irakoze ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Neonatal Period ◽  
Baseline Assessment ◽  
Difference In Difference ◽  
Chronic Malnutrition ◽  
Live Births ◽  
Under Five ◽  
Quasi Experimental ◽  
Child Health Status

Abstract Background Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children in every 1000 children will not celebrate their first birthday. In response, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model. Ahead of implementation of this initiative, we conduct a baseline assessment using a difference-in-difference design in an effort to measure incremental effects. Methods A quasi-experimental evaluation design (difference-in-difference) was employed. Adopting the methodology of the DHS, a sample of 952 and 990 households comprising of 2675 and 3311 birth histories respectively in the treatment and control areas were reached. Mortality data were analysed with R package for mortality computation, Complex Samples Module of IBM – SPSS for other outcomes and Emergency Nutrition Assessment software for nutrition data. Logistic regression was used to assess strength of associations and cox regression model for assessing risk of mortality Results The incidence of low birth weight (LBW) was 5.7% at the program area compared to 7.2% at the controlled area with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2 – 7.2 p=0.043). Fever incidence was higher in the program area (50.5%) in comparison to 48.4% in the control. Non-consumption of minimum acceptable diet was significantly associated with fever (OR 1.67 95%CI 1.07 – 2.61). Acute and chronic malnutrition was 7.6% and 45.8% respectively with non-receipt of Vitamin A was significantly associated with chronic malnutrition. Under-five mortality rate was 32.1 per 1000 live births in the program area and 33.6 in the control. Infant mortality rate was 25.7 in program area and 20.4 in the control. Risk of under-five mortality was higher in the neonatal period (HR 20.72 95% 8.64 – 49.65 p=0.001). Conclusion Improving child health status is complex and therefore investing into an integrated intervention yields best results. Given that the risk of all under-five was higher at the neonatal period, strengthening the health system to provide quality care is crucial.

Inter-state Disparities of Efficiency in Foreshortening Under-five Mortality Rate in Rural India

2021 ◽  
pp. 097300522110515
Author(s):  
Shrabanti Maity ◽  
Ummey Rummana Barlaskar
Keyword(s):  
Mortality Rate ◽  
Health System ◽  
Rural Health ◽  
Health Sector ◽  
State Level ◽  
Health Indicators ◽  
Health System Performance ◽  
Indian States ◽  
Under Five ◽  
Efficient Management

The present study aims to assess the efficiency of the rural health system to foreshorten the under-five (U5) mortality rates across Indian states. The study further attempts to pinpoint the factors responsible for state-level inefficiency of the rural health system performance. The empirical results reveal that among the Indian states, Kerala is the most-efficient in foreshortening the U5 mortality rate. The results convey that the states with better health indicators may not have efficient health systems. The study concludes that along with investment in the health sector, efficient management of the investment is intrinsic to better health outcomes.

Does population health influence FDI inflows into Ghana?

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mustapha Immurana
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Population Health ◽  
Death Rate ◽  
Health Indicators ◽  
Least Square ◽  
Infant Mortality Rate ◽  
Fdi Inflows ◽  
Content Type ◽  
Under Five

PurposeGhana is one of the countries instituting several measures toward attracting more Foreign Direct Investment (FDI) inflows. This is because, FDI is largely viewed as essential to socioeconomic development. However, while population health can influence FDI inflows, it has received very little attention. This study, therefore, investigates empirically, as to focusing on population health could be a useful tool in Ghana’s attempt to attract more FDI inflows.Design/methodology/approachThe study uses time series data on Ghana from 1980 to 2018 to achieve its objective. Life expectancy, death rate, infant mortality rate, under-five mortality rate and incidence of malaria are used as proxies for population health, while the Ordinary Least Square (OLS) and the Instrumental Variable Two-Stage Least Square (IV2SLS) regressions are employed as empirical estimation techniques.FindingsUsing the OLS regression, except the incidence of malaria, the study finds all the other population health indicators to significantly influence FDI inflows. However, after controlling for endogeneity using the IV2SLS regression, all population health indicators are found to be significant as regards their effects on FDI inflows.Practical implicationsPaying attention to population health could be an effective strategy that can be employed by policymakers in the quest to get more FDI inflows into Ghana.Originality/valueThis study, to the best of our knowledge, is the first study solely devoted to Ghana, which doing so helps in devising country-specific policies with regard to the effect of population health on FDI inflows. Further, this study becomes the first to use death rate, infant mortality rate and under-five mortality rate in examining the effect of population health on FDI inflows. Thus, since there are various causes of deaths, using indicators that capture deaths from all factors helps in giving a much broader picture with regard to the FDI population health nexus. Also, this study is the first to use up to five different population health indicators in examining the effect of population health on FDI inflows, which aids in revealing whether FDI is sensitive to the population health indicator used.

scholarly journals Neonatal mortality and child health in a remote rural area in Nepal: a mixed methods study

2019 ◽  
Vol 3 (1) ◽  
pp. e000519
Author(s):  
Bindu Kumari Karki ◽  
Guenter Kittel
Keyword(s):  
Mixed Methods ◽  
Mortality Rate ◽  
Health Services ◽  
Neonatal Mortality ◽  
Rural Area ◽  
Acute Lower Respiratory Infection ◽  
Cultural Perceptions ◽  
Live Births ◽  
Under Five ◽  
Remote Rural Area

ObjectiveTo assess neonatal and under-five mortality and the health situation for children in Dolpa, a remote rural area of Nepal.Study designMixed methods: quantitative (retrospective cross sectional) and qualitative (semistructured interviews).RationaleProgress in reducing child and newborn mortality in Nepal has reached the remote areas to a limited extent. Furthermore, there may be substantial under-reporting and data may be unreliable.Setting and participantsThe population of Dolpa district is approximately 35 000. We visited 10 randomly selected villages (plus one settlement) with approximately 12 000 inhabitants.MethodologyRecords of the number of deliveries, neonatal and under-five deaths were collected. 100 children (10 different villages) were evaluated for common diseases present during the month prior to the investigation. 20 interviews were conducted about the cultural perceptions of neonatal death and morbidity; in each village at least one interview was undertaken.ResultsThe population of the 10 villages (plus one settlement) under investigation was 12 287. 300 deliveries have taken place during the last 12 months before the study. There were 30 children reported to have died; out of those 20 were in the neonatal period. This reflects an estimated neonatal mortality rate in Dolpa district of 67/1000 live births (95% CI 41-101/1000) and an estimated under-five mortality rate of 100/1000 (95% CI 70-140/1000). In the previous month, out of 100 children surveyed there had been 11 cases of acute lower respiratory infection (ALRI), 7 cases of diarrhoea, 3 cases of isolated malnutrition and 5 cases of malnutrition combined with ALRI or diarrhoea.Based on qualitative interviews traditional beliefs still play a major role, and are partly a hindrance to progress in health. There is also mistrust in the health services and misconceptions about ‘modern’ medicine and treatment facilities.ConclusionDespite progress in child morbidity and mortality in Nepal, some areas remain underserved by health services and neonatal mortality is far above the Nepalese average, which is 29/1000 live births. There is a substantial need to increase and train health staff. Health promotion should be encouraged but cultural perceptions have to be understood if positive behavioural change is to be achieved.

scholarly journals Association of maternal and child health related variables with decline in infant mortality rate in Punjab, India

2017 ◽  
Vol 4 (12) ◽  
pp. 4558
Author(s):  
Harjot Kaur ◽  
Tarundeep Singh ◽  
PVM Lakshmi
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Infant Mortality ◽  
Maternal And Child Health ◽  
Health Indicators ◽  
Infant Mortality Rate ◽  
Rapid Decline ◽  
Live Births ◽  
Children Ever Born ◽  
And Child Health

Background: Infant mortality rate (IMR) is a sensitive indicator for monitoring child health and survival. Punjab state in North India is performing better than most of the other states in various health indicators. Punjab’s IMR has shown a rapid decline from 38/1000 live births in 2008 (Sample registration system (SRS) 2008) to 24/1000 live births in 2014 (SRS 2014). This study was planned to assess which of the maternal and child health services is associated with rapid decline in infant mortality rate. Methods: Association between various components of prenatal care, intranatal care and postnatal care, and child healthcare and socio demographic variables (taken from secondary data of District Level Household Surveys) and Infant Mortality Rate (taken from SRS) of Punjab was studied. Spearman correlation coefficient was calculated to measure the association between the variables. Results: Total fertility rate (TFR), women who had institutional deliveries, safe deliveries and mean children ever born are statistically significantly associated with decline in infant mortality rate. Conclusions: In Punjab, maternal and child health indicators are directly or indirectly associated with decline in infant mortality rate. Findings of the study demonstrate that the recent rapid decline in IMR of Punjab is strongly associated with increase in institutional deliveries and decline in TFR and the mean number of children ever born. 

scholarly journals Associations between cesarean delivery and child mortality: A national record linkage longitudinal study of 17.8 million births in Brazil

PLoS Medicine ◽  
2021 ◽  
Vol 18 (10) ◽  
pp. e1003791
Author(s):  
Enny S. Paixao ◽  
Christian Bottomley ◽  
Julia M. Pescarini ◽  
Kerry L. M. Wong ◽  
Luciana L. Cardim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cesarean Delivery ◽  
Child Mortality ◽  
Neonatal Period ◽  
Relative Rate ◽  
Child Survival ◽  
Routine Data ◽  
Live Births ◽  
Medical Indication ◽  
Vaginal Deliveries

Background There is an increasing use of cesarean delivery (CD) based on preference rather than on medical indication. However, the extent to which nonmedically indicated CD benefits or harms child survival remains unclear. Our hypothesis was that in groups with a low indication for CD, this procedure would be associated with higher child mortality and in groups with a clear medical indication CD would be associated with improved child survival chances. Methods and findings We conducted a population-based cohort study in Brazil by linking routine data on live births between January 1, 2012 and December 31, 2018 and assessing mortality up to 5 years of age. Women with a live birth who contributed records during this period were classified into one of 10 Robson groups based on their pregnancy and delivery characteristics. We used propensity scores to match CD with vaginal deliveries (1:1) and prelabor CD with unscheduled CD (1:1) and estimated associations with child mortality using Cox regressions. A total of 17,838,115 live births were analyzed. After propensity score matching (PSM), we found that live births to women in groups with low expected frequencies of CD (Robson groups 1 to 4) had a higher death rate up to age 5 years if they were born via CD compared with vaginal deliveries (HR = 1.25, 95% CI: 1.22 to 1.28; p < 0.001). The relative rate was greatest in the neonatal period (HR = 1.39, 95% CI: 1.34 to 1.45; p < 0.001). There was no difference in mortality rate when comparing offspring born by a prelabor CD to those born by unscheduled CD. For the live births to women with a CD in a prior pregnancy (Robson group 5), the relative rates for child mortality were similar for those born by CD compared with vaginal deliveries (HR = 1.05, 95% CI: 1.00 to 1.10; p = 0.024). In contrast, for live births to women in groups with high expected rates of CD (Robson groups 6 to 10), the child mortality rate was lower for CD than for vaginal deliveries (HR = 0.90, 95% CI: 0.89 to 0.91; p < 0.001), particularly in the neonatal period (HR = 0.84, 95% CI: 0.83 to 0.85; p < 0.001). Our results should be interpreted with caution in clinical practice, since relevant clinical data on CD indication were not available. Conclusions In this study, we observed that in Robson groups with low expected frequencies of CD, this procedure was associated with a 25% increase in child mortality. However, in groups with high expected frequencies of CD, the findings suggest that clinically indicated CD is associated with a reduction in child mortality.

scholarly journals Household and individual level risk factors associated with declining malaria incidence in Meghalaya, India: implications for malaria elimination in low-endemic settings

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Rajiv Sarkar ◽  
Anne Kessler ◽  
Bandapkupar Mawkhlieng ◽  
Steven A. Sullivan ◽  
Mark L. Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Malaria Elimination ◽  
Malaria Incidence ◽  
Signs And Symptoms ◽  
Individual Level ◽  
Under Five ◽  
Under Five Children ◽  
The Past ◽  
History Of ◽  
Almost All

Abstract Background A detailed analysis of household and individual level Plasmodium infection patterns in two low-endemic districts of Meghalaya was undertaken to better understand the epidemiology of malaria in northeast India. Methods Socio-demographic and behavioural information from residents (aged 1–69 years) of households were collected through pre-tested, questionnaire conducted in 2018 and 2019. Blood samples collected from participants were tested for Plasmodium falciparum and/or Plasmodium vivax infection using rapid diagnostic test, microscopy and PCR. Plasma samples from a subset of participants were analysed for antibodies against thirteen P. falciparum and four P. vivax antigens. Associations between household and individual level risk factors, and Plasmodium infections were evaluated using multilevel logistic regression models. Results A total of 2753 individuals from 827 households were enrolled in 2018, and 834 individuals from 222 households were enrolled in 2019. Of them, 33 (1.2%) were positive by PCR for P. falciparum in 2018 and none were positive for P. vivax. In 2019, no PCR-positive individuals were detected. All, but one, infections were asymptomatic; all 33 infections were sub-microscopic. Reported history of malaria in the past 12 months (OR = 8.84) and history of travel in the past 14 days (OR = 10.06) were significantly associated with Plasmodium infection. A significant trend of increased seropositivity with age was noted for all 17 antigens. Although adults (≥ 18 years) consistently had the highest seropositivity rates, a sizeable proportion of under-five children were also found to be seropositive. Almost all individuals (99.4%) reported sleeping under an insecticide-treated bed-net, and household indoor residual spray coverage in the 12 months preceding the survey was low (23%). Most participants correctly identified common signs and symptoms of malaria, i.e., fever (96.4%), headache (71.2%), chills (83.2%) and body-ache (61.8%). Almost all participants (94.3%) used government-provided services for treatment of malaria. Conclusion This study explored the epidemiology of malaria in two communities in Meghalaya, India, in the context of declining transmission. The presence of widespread asymptomatic infections and seropositivity among under-five children suggest that low-level Plasmodium transmission persists in this region. Implications of the study findings for malaria elimination efforts in low-transmission settings are discussed.

scholarly journals Prevalence of Malnutrition and Associated Factors among Under-Five Children in Pastoral Communities of Afar Regional State, Northeast Ethiopia: A Community-Based Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Abel Gebre ◽  
P. Surender Reddy ◽  
Afework Mulugeta ◽  
Yayo Sedik ◽  
Molla Kahssay
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Prelacteal Feeding ◽  
Community Based ◽  
Cross Sectional ◽  
Under Five ◽  
Under Five Children ◽  
The Past ◽  
Northeast Ethiopia ◽  
Pastoral Communities

Background. Malnutrition among children remains one of the most important causes of morbidity and mortality in the world. In Ethiopia, malnutrition is one of the most serious public health problem and the biggest in the world. This study aimed to assess the prevalence of malnutrition and associated factors among under-five children in pastoral communities of Afar Regional state, Northeast Ethiopia. Methods. A community-based cross-sectional study was conducted on 840 children aged 6–59 months from March 01–25, 2017. A multistage cluster sampling method was used to select the study participants. A structured questionnaire was used and anthropometric measurements were taken to collect data. EPI Data 3.1 and SPSS version 20.0 were used for data entry and analysis, respectively. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was declared at p value < 0.05 with 95% confidence intervals in the final model. Result. The study found the prevalence of wasting, stunting, and underweight was 16.2% (95% CI: 13.8–18.8%), 43.1% (95% CI: 39.8–46.5%), and 24.8% (95% CI: 21.9–27.8%), respectively. Family size (AOR = 2.72, 95% CI: 1.62–4.55), prelacteal feeding (AOR = 3.81, 95% CI: 1.79–5.42), and diarrhoea in the past two weeks (AOR = 4.57, 95% CI: 2.56–8.16) were associated with wasting. And sex of child (AOR = 1.98, 95% CI: 1.46–2.72), age of child ((12–23 months: AOR = 3.44, 95% CI: 2.24–5.29); (24–35 months: AOR = 3.58, 95% CI: 2.25–5.69); and (36–59 months: AOR = 4.42, 95% CI: 2.79–6.94)), and immunization status of child (AOR = 3.34, 95% CI: 1.31–4.81) were predictors for stunting. Moreover, mother’s education (AOR = 4.06, 95% CI: 2.01–8.19), sex of child (AOR = 1.83, 95% CI: 1.29–2.94), prelacteal feeding (AOR = 2.81, 95% CI: 1.64–3.72), and immunization status of child (AOR = 3.17, 95% CI: 2.14–4.99) were significantly associated with underweight. Conclusions. This study indicated that child malnutrition was high among under-five children. Family size of five and above, receiving prelacteal feeding, and diarrhoea in the past two weeks were positively associated with wasting. Male child, increasing age of child, and not fully immunized child were positive predictors for increasing stunting. Maternal illiteracy, male child, prelacteal feeding, and not fully immunized child were factors affecting underweight. Promoting use of family planning, preventing diarrhoeal diseases, and vaccinating children integrated with the access of nutrition education programs are vital interventions to improve nutritional status of the children.

scholarly journals Household factors and under-five mortality in Bankass, Mali: results from a cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David C. Boettiger ◽  
Emily Treleaven ◽  
Kassoum Kayentao ◽  
Mahamadou Guindo ◽  
Mama Coumaré ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Reading Ability ◽  
Cox Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Male Mortality ◽  
Live Births ◽  
Under Five ◽  
Factors Associated ◽  
Household Factors

Abstract Background Rural parts of Mali carry a disproportionate burden of the country’s high under-five mortality rate. A range of household factors are associated with poor under-five health in resource-limited settings. However, it is unknown which most influence the under-five mortality rate in rural Mali. We aimed to describe household factors associated with under-five mortality in Bankass, a remote region in central Mali. Methods We analysed baseline household survey data from a trial being conducted in Bankass. The survey was administered to households between December 2016 and January 2017. Under-five deaths in the five years prior to baseline were documented along with detailed information on household factors and women’s birth histories. Factors associated with under-five mortality were analysed using Cox regression. Results Our study population comprised of 17,408 under-five children from 8322 households. In the five years prior to baseline, the under-five mortality rate was 152.6 per 1000 live births (158.8 and 146.0 per 1000 live births for males and females, respectively). Living a greater distance from a primary health center was associated with a higher probability of under-five mortality for both males (adjusted hazard ratio [aHR] 1.53 for ≥10 km versus < 2 km, 95% confidence interval [CI] 1.25–1.88) and females (aHR 1.59 for ≥10 km versus < 2 km, 95% CI 1.27–1.99). Under-five male mortality was additionally associated with lower household wealth quintile (aHR 1.47 for poorest versus wealthiest, 95%CI 1.21–1.78), lower reading ability among women of reproductive age in the household (aHR 1.73 for cannot read versus can read, 95%CI 1.04–2.86), and living in a household with access to electricity (aHR 1.16 for access versus no access, 95%CI 1.00–1.34). Conclusions U5 mortality is very high in Bankass and is associated with living a greater distance from healthcare and several other household factors that may be amenable to intervention or facilitate program targeting.

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