Background & Objectives: Sustainable Development Goals (SDGs) are set up as a part of the Post Millennium Development Goals (MDGs). Then it becomes essential to review the achievement of the MDGs in India and less...Background & Objectives: Sustainable Development Goals (SDGs) are set up as a part of the Post Millennium Development Goals (MDGs). Then it becomes essential to review the achievement of the MDGs in India and lessons learned to incorporate into the SDGs. The present study reviews and predicts different components of under-five mortality rate beyond 2015 to assess the present situation and to determine the future possibilities of achieving the new targets for SDGs in India. Data and Methods: It uses available time series data on different components of U5MR from the India’s Sample Registration System (SRS). Autoregressive Integrated Moving Averages (ARIMA) model has been taken as the method of time series analysis to forecast the mortality rates beyond 2015. Results: There is a consistent pattern of faster decline in the under-five mortality compared with the neonatal mortality rate across all major states in India although neonatal mortality contributes largest share in under-five mortality. Again, share of neonatal death among under-five death is increasing steadily over the future projected years. This indicates very slow progress of reduction in neonatal mortality. Stimulating efforts with new intervention programmes will be needed to focus more on lowering neonatal mortality particularly in rural India.展开更多
Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documente...Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documented factors of under-five mortality,little evidence exists on the impact of systemic barriers and individual factors(maternal health-seeking behaviour)on under-five mortality in Nigeria.The study used a nationally representative sample from Nigeria Demographic and Health Survey(NDHS)2013 dataset.The target population was 20,192 women aged 15-59 years who had given birth to 31,480 children five years before the survey.Stata software was used for data analysis.The risk of death was estimated using Cox proportional hazard models and results are presented as hazards ratios(HR)with 95%confidence intervals(CI).Findings from the overall Model I-IV revealed individual factors(maternal health-seeking indicators)as significant factors of under-five deaths(p<0.05).Children whose mothers received antenatal care coverage(ANC)outside health care facilities(HCF)(HR:1.60,CI:1.0-2.4,p<0.05);or delivered outside HCF(HR:1.02,CI:0.7-1.5,p<0.05)had elevated hazard risk of death before age five.Conversely,children who were presented for postnatal check within two weeks of delivery(HR:0.60,CI:0.5-0.8,p<0.05),or delivered within the longer birth interval(HR:0.67,CI:0.6-0.8,p<0.001)had significantly lower hazard risk of death before age five.As part of systemic factors,children whose mothers were covered by health insurance scheme had significantly(HR:0.52,CI:0.2-1.2,p<0.001)lower risk of death when compared with their counterparts without health insurance coverage.The study emphasized the need to revitalize strategies and programs to improve women health seeking behaviour and investment in the health sector through health insurance,infrastructure,and supplies.展开更多
Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to ...Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to narrow the gap between different social classes. Therefore, this study focused on the social determinants of under-five mortality inEthiopiausing EDHS 2011 data. Methods: The data source for this analysis was the 2011 EDHS which was undertaken over a five-month period from 27 December, 2010 to 3 June, 2011. The sample was selected using a stratified, two-stage cluster design. Samples of 16,515 women of reproductive age were interviewed. The questionnaire used to collect information from these women who?had among other things such as?background characteristics of women, birth history of these women and the survival of each birth at the time of the interview. Births that had occurred to women in the last 10 years prior to the date of the?interview were extracted for the analysis. Descriptive statistical methods were used to describe the distribution of the characteristics of the data. Kaplan Meier plots and incidence rates per 1000 person years were used to compare survival across different categories of the risk factors. The effect of the risk factors on survival was analyzed using Cox proportional hazards regression. Data management and analysis were carried out using STATA 10. Results: A total of 23,581 under-five children were included in the study. The under-five mortality incidence rate in Ethiopia for the last ten years was 29.6 per 1000 person years. Maternal education beyond primary level of education reduced the risk of under-five mortality by about half. A significant reduction in risk of under-five mortality was observed among births to mothers residing in richest households. The hazard ratio (HR) was higher for under-five mortality among boys than daughters, twins than singleton, teen age mother than higher ages and short births than optimal. Conclusions: Empowering mothers with education 展开更多
Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affec...Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA m展开更多
This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate p...This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate proportional hazard analysis reflects that father’s education, place of residence, region of residence, number of children under five years of age, previous death of sibling, mother’s age and breastfeeding have significant influence on under-five mortality. The proximate determinants are found to have stronger influence on under-five mortality than the socioeconomic factors considered in the study do.展开更多
Introduction: Every year it is estimated that about 14 million adolescent girls give birth globally with the highest rate (143 per 1000 girls aged 15 - 19 years) in the sub-Saharan Africa. Babies born to adolescent mo...Introduction: Every year it is estimated that about 14 million adolescent girls give birth globally with the highest rate (143 per 1000 girls aged 15 - 19 years) in the sub-Saharan Africa. Babies born to adolescent mothers are at greater risk and are far more likely to die than those born to older women. This study therefore sets out to describe the health care seeking behaviors in a cohort of teenage mothers attending an Under-Five Clinic in a densely populated section of Freetown, Sierra Leone with a view of determining the impact of their behavior on the survival of their children. Methodology: This is a descriptively cross sectional and prospective study that involved four hundred and six mothers attending the Under-Five Clinic in the Eastern end of Freetown using semiclosed ended questionnaire which were interviewers administered between 1st and 29th July 2011. Result: The age of the study population ranged between 12 and 45 years, with a mean of 24.8 ± 6.3 years. Of the four hundred and six, eighty nine (21%) were teenagers (less than 20 years) with a majority (60.6%) of them being between 18 and 19 years old. Concerning the 89 teenage mothers in the study population, the majority (95.5%) did not possess the secondary school education, 42.7% were petty traders and more than a half of them (61.8%) were married. The mothers were rated low in all the activities geared towards child survival except immunization. In addition there was a delay in the initiation of complementary feeds which were also of poor quality. Fewer percentages of the mothers who had antenatal care in the hospitals delivered there. Conclusion: This study has revealed that early marriage is still common in Sierra Leone. Also the teenage mothers did not engage fully in a majority of activities that have been proven to contribute to the survival of babies in the Tropics thereby making their children vulnerable to malnutrition, measles and diarrhoeal diseases. It was recommended that the country should use recognised teenage programs aimed at 展开更多
Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and pa...Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and patterns of under-five mortality in the country based on the SPSS （Statistic Package for Social Science） file of the 2005 Ethiopian Demographic and Health Survey （EDHS）. This survey covered a sample of about 4,420 households/housing units of urban Ethiopia. The under-five deaths are computed for women in the age group 15-49 by subtracting the number of children living from children ever born （CEB） and established the proportion dead by dividing deaths by CEB corresponding to the categorical variables of housing structure, facilities, and household durables. The analytical techniques of the study included univariate, bivariate, and multivariate data analysis of the proportional variations of childhood mortality patterns being manifested by ＂bar graphs＂ with respect to housing situations as well as household durables. Amongst the categorical variables of the housing structures, facilities, and household durables with the highest no prevalence of under-five mortality levels are found to be the units of unconventional walls, thatched/leaf/reed roofing, animal dung flooring, shared pit latrine/use of bucket/bush, using kerosene, firewood/straw/charcoal for cooking, unconventional lighting, unprotected water supply, households with no durables.展开更多
Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be diffi...Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be difficult to sustain and may hamper the achievement of Millennium Development Goal 4. Therefore, the main objective of this paper is to discuss and compare the dif- ferent covariates of infant and under-five mortality in the context of overall country, urban and rural levels of Bangladesh using discriminant analysis. For this, the data are taken from Bangladesh Demographic and Health Survey, 2004. In discriminant analysis, the stepwise procedure has been picked up and only the significant variables are ranked according to the rank of Wilk's Lambda val- ues. The canonical discriminant function coefficients (unstandard- ized and standardized) for the predictor variables have also been calculated. Both the results show that breastfeeding is the most important variable in discriminating the two groups of mothers, i.e., mothers experiencing to infant mortality or not and mothers experiencing to under-five mortality or not. The related results of discriminant function also indicate that the discriminant func- tion is statistically significant and discriminates well. Therefore, improvements in the health system are essential for promoting the breastfeeding practices (both inclusive and exclusive), which may be the effective strategies to reach families and communities with targeted messages and information.展开更多
文摘Background & Objectives: Sustainable Development Goals (SDGs) are set up as a part of the Post Millennium Development Goals (MDGs). Then it becomes essential to review the achievement of the MDGs in India and lessons learned to incorporate into the SDGs. The present study reviews and predicts different components of under-five mortality rate beyond 2015 to assess the present situation and to determine the future possibilities of achieving the new targets for SDGs in India. Data and Methods: It uses available time series data on different components of U5MR from the India’s Sample Registration System (SRS). Autoregressive Integrated Moving Averages (ARIMA) model has been taken as the method of time series analysis to forecast the mortality rates beyond 2015. Results: There is a consistent pattern of faster decline in the under-five mortality compared with the neonatal mortality rate across all major states in India although neonatal mortality contributes largest share in under-five mortality. Again, share of neonatal death among under-five death is increasing steadily over the future projected years. This indicates very slow progress of reduction in neonatal mortality. Stimulating efforts with new intervention programmes will be needed to focus more on lowering neonatal mortality particularly in rural India.
文摘Despite considerable efforts to reduce under-five mortality nationwide,Nigeria has fallen short of achieving the Millennium Development Goals(MDGs)target of 67 deaths per 1,000 live births by 2015.Of all the documented factors of under-five mortality,little evidence exists on the impact of systemic barriers and individual factors(maternal health-seeking behaviour)on under-five mortality in Nigeria.The study used a nationally representative sample from Nigeria Demographic and Health Survey(NDHS)2013 dataset.The target population was 20,192 women aged 15-59 years who had given birth to 31,480 children five years before the survey.Stata software was used for data analysis.The risk of death was estimated using Cox proportional hazard models and results are presented as hazards ratios(HR)with 95%confidence intervals(CI).Findings from the overall Model I-IV revealed individual factors(maternal health-seeking indicators)as significant factors of under-five deaths(p<0.05).Children whose mothers received antenatal care coverage(ANC)outside health care facilities(HCF)(HR:1.60,CI:1.0-2.4,p<0.05);or delivered outside HCF(HR:1.02,CI:0.7-1.5,p<0.05)had elevated hazard risk of death before age five.Conversely,children who were presented for postnatal check within two weeks of delivery(HR:0.60,CI:0.5-0.8,p<0.05),or delivered within the longer birth interval(HR:0.67,CI:0.6-0.8,p<0.001)had significantly lower hazard risk of death before age five.As part of systemic factors,children whose mothers were covered by health insurance scheme had significantly(HR:0.52,CI:0.2-1.2,p<0.001)lower risk of death when compared with their counterparts without health insurance coverage.The study emphasized the need to revitalize strategies and programs to improve women health seeking behaviour and investment in the health sector through health insurance,infrastructure,and supplies.
文摘Background: Under-five mortality is one of the indicators of the millennium development goals (MDGs) for the child mortality reduction goal. Understanding the social determinants of under-five mortality is helpful to narrow the gap between different social classes. Therefore, this study focused on the social determinants of under-five mortality inEthiopiausing EDHS 2011 data. Methods: The data source for this analysis was the 2011 EDHS which was undertaken over a five-month period from 27 December, 2010 to 3 June, 2011. The sample was selected using a stratified, two-stage cluster design. Samples of 16,515 women of reproductive age were interviewed. The questionnaire used to collect information from these women who?had among other things such as?background characteristics of women, birth history of these women and the survival of each birth at the time of the interview. Births that had occurred to women in the last 10 years prior to the date of the?interview were extracted for the analysis. Descriptive statistical methods were used to describe the distribution of the characteristics of the data. Kaplan Meier plots and incidence rates per 1000 person years were used to compare survival across different categories of the risk factors. The effect of the risk factors on survival was analyzed using Cox proportional hazards regression. Data management and analysis were carried out using STATA 10. Results: A total of 23,581 under-five children were included in the study. The under-five mortality incidence rate in Ethiopia for the last ten years was 29.6 per 1000 person years. Maternal education beyond primary level of education reduced the risk of under-five mortality by about half. A significant reduction in risk of under-five mortality was observed among births to mothers residing in richest households. The hazard ratio (HR) was higher for under-five mortality among boys than daughters, twins than singleton, teen age mother than higher ages and short births than optimal. Conclusions: Empowering mothers with education
文摘Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA m
文摘This paper examines determinants of under-five mortality in Bangladesh. The study utilizes the data extracted from the 2007 Bangladesh demographic and health survey. Chi-square test for independence and multivariate proportional hazard analysis reflects that father’s education, place of residence, region of residence, number of children under five years of age, previous death of sibling, mother’s age and breastfeeding have significant influence on under-five mortality. The proximate determinants are found to have stronger influence on under-five mortality than the socioeconomic factors considered in the study do.
文摘Introduction: Every year it is estimated that about 14 million adolescent girls give birth globally with the highest rate (143 per 1000 girls aged 15 - 19 years) in the sub-Saharan Africa. Babies born to adolescent mothers are at greater risk and are far more likely to die than those born to older women. This study therefore sets out to describe the health care seeking behaviors in a cohort of teenage mothers attending an Under-Five Clinic in a densely populated section of Freetown, Sierra Leone with a view of determining the impact of their behavior on the survival of their children. Methodology: This is a descriptively cross sectional and prospective study that involved four hundred and six mothers attending the Under-Five Clinic in the Eastern end of Freetown using semiclosed ended questionnaire which were interviewers administered between 1st and 29th July 2011. Result: The age of the study population ranged between 12 and 45 years, with a mean of 24.8 ± 6.3 years. Of the four hundred and six, eighty nine (21%) were teenagers (less than 20 years) with a majority (60.6%) of them being between 18 and 19 years old. Concerning the 89 teenage mothers in the study population, the majority (95.5%) did not possess the secondary school education, 42.7% were petty traders and more than a half of them (61.8%) were married. The mothers were rated low in all the activities geared towards child survival except immunization. In addition there was a delay in the initiation of complementary feeds which were also of poor quality. Fewer percentages of the mothers who had antenatal care in the hospitals delivered there. Conclusion: This study has revealed that early marriage is still common in Sierra Leone. Also the teenage mothers did not engage fully in a majority of activities that have been proven to contribute to the survival of babies in the Tropics thereby making their children vulnerable to malnutrition, measles and diarrhoeal diseases. It was recommended that the country should use recognised teenage programs aimed at
文摘Little studies and analysis have been undertaken to investigate the housing determinants of under-five mortality in Ethiopia. This study, therefore, explores the impacts of urban housing variables on the levels and patterns of under-five mortality in the country based on the SPSS （Statistic Package for Social Science） file of the 2005 Ethiopian Demographic and Health Survey （EDHS）. This survey covered a sample of about 4,420 households/housing units of urban Ethiopia. The under-five deaths are computed for women in the age group 15-49 by subtracting the number of children living from children ever born （CEB） and established the proportion dead by dividing deaths by CEB corresponding to the categorical variables of housing structure, facilities, and household durables. The analytical techniques of the study included univariate, bivariate, and multivariate data analysis of the proportional variations of childhood mortality patterns being manifested by ＂bar graphs＂ with respect to housing situations as well as household durables. Amongst the categorical variables of the housing structures, facilities, and household durables with the highest no prevalence of under-five mortality levels are found to be the units of unconventional walls, thatched/leaf/reed roofing, animal dung flooring, shared pit latrine/use of bucket/bush, using kerosene, firewood/straw/charcoal for cooking, unconventional lighting, unprotected water supply, households with no durables.
文摘Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be difficult to sustain and may hamper the achievement of Millennium Development Goal 4. Therefore, the main objective of this paper is to discuss and compare the dif- ferent covariates of infant and under-five mortality in the context of overall country, urban and rural levels of Bangladesh using discriminant analysis. For this, the data are taken from Bangladesh Demographic and Health Survey, 2004. In discriminant analysis, the stepwise procedure has been picked up and only the significant variables are ranked according to the rank of Wilk's Lambda val- ues. The canonical discriminant function coefficients (unstandard- ized and standardized) for the predictor variables have also been calculated. Both the results show that breastfeeding is the most important variable in discriminating the two groups of mothers, i.e., mothers experiencing to infant mortality or not and mothers experiencing to under-five mortality or not. The related results of discriminant function also indicate that the discriminant func- tion is statistically significant and discriminates well. Therefore, improvements in the health system are essential for promoting the breastfeeding practices (both inclusive and exclusive), which may be the effective strategies to reach families and communities with targeted messages and information.
