Dataset Information

Proximity to health services and child survival in low- and middle-income countries: a systematic review and meta-analysis.

ABSTRACT:

Objectives

Few studies have systematically examined the effects of barriers such as distance to health facilities on child survival in low- and middle-income countries. Our primary objective was to estimate the effect of proximity to health facilities on child survival in low- and middle-income countries. The secondary objective was to compare effects in different age categories (perinatal (28 weeks of gestation to 1 week of age), neonatal (0-27 days), infant (0-11 months) and child (0-59 months) mortality).

Design

A systematic review and meta-analysis was conducted of studies published from 1980 to 2012 that assessed the effect of proximity to health facilities on child survival in low- and middle-income countries. Synthesis was by random-effects meta-analysis, and variation between studies was investigated by meta-regression.

Setting

Low- and middle-income countries.

Participants

13 studies were included in the meta-analysis, 11 from low-income and two from middle-income countries and none were from remote areas.

Primary outcome measures

The primary outcome measures of interest were perinatal, neonatal, infant and child mortality.

Results

Overall, children who lived farthest from health facilities were more likely to die compared with those who lived closer (OR 1.32, 95% CI 1.19 to 1.47). This effect appeared stronger during the perinatal (OR 2.76, 95% CI 1.80 to 4.24) and neonatal (OR 1.98, 95% CI 1.43 to 2.72) periods compared with the infant (OR 1.18, 95% CI 1.0 to 1.38) and under-5 (OR 1.20, 95% CI 1.04 to 1.39) periods.

Conclusions

Proximity to health facilities appears to be an important determinant of under-5 mortality in low- and middle-income countries, especially in the perinatal and neonatal periods. Higher quality studies are needed, which examine the effect of access to health services on child survival, especially studies from remote areas and hard to reach populations.

SUBMITTER: Okwaraji YB

PROVIDER: S-EPMC3400076 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Proximity to health services and child survival in low- and middle-income countries: a systematic review and meta-analysis.

Okwaraji Yemisrach Behailu YB Edmond Karen M KM

BMJ open 20120712 4

<h4>Objectives</h4>Few studies have systematically examined the effects of barriers such as distance to health facilities on child survival in low- and middle-income countries. Our primary objective was to estimate the effect of proximity to health facilities on child survival in low- and middle-income countries. The secondary objective was to compare effects in different age categories (perinatal (28 weeks of gestation to 1 week of age), neonatal (0-27 days), infant (0-11 months) and child (0-5 ...[more]

PMID: 22798257

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Dataset Information

Proximity to health services and child survival in low- and middle-income countries: a systematic review and meta-analysis.

Objectives

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Proximity to health services and child survival in low- and middle-income countries: a systematic review and meta-analysis.

Similar Datasets

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