Dataset Information

Under-five mortality in The Gambia: Comparison of the results of the first demographic and health survey with those from existing inquiries.

ABSTRACT:

Background

In The Gambia, national estimates of under-five mortality (U5M) were from censuses and multiple indicator cluster surveys (MICS). The country's first demographic and health survey (DHS) conducted in 2013 provided empirical disaggregated national estimates of neonatal, post-neonatal and child mortality trends.

Objective

To assess the consistency and accuracy of the estimates of U5M from the existing data sources and its age-specific components in rural Gambia and produce reliable up-to-date estimates.

Methods

Available national data on under-five mortality from 2000 onwards were extracted. Additionally, data from two DHS regions were compared to those from two health and demographic surveillance systems (HDSS) located within them. Indirect and direct estimates from the data were compared and flexible parametric survival methods used to predict mortality rates for all empirical data points up to 2015.

Findings

Internal consistency checks on data quality for indirect estimation of U5M suggest that the data were plausible at national level once information from women aged 15-19 years was excluded. The DHS and HDSS data used to make direct U5M estimates were plausible, however HDSS data were of better quality. For 2009-2013, the DHS estimates agreed well with the 2013 census and 2010 MICS reports of U5M but was less accurate about the early births of older women. The most recent estimates from the 2013 DHS, which refer to 2011-12, are an U5M rate of 54/1000 livebirths (95% CI: 43-64) and a neonatal mortality rate of 21/1000 livebirths (95% CI: 15-27), contributing almost 40% of U5M in The Gambia. The DHS showed that for the decade prior to the survey, child mortality dropped by 55% and neonatal mortality by 31%. This indicates the importance of neonatal mortality in The Gambia, and the need to focus on neonatal survival, while maintaining currently successful strategies to further reduce U5M.

SUBMITTER: Rerimoi AJ

PROVIDER: S-EPMC6650053 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Under-five mortality in The Gambia: Comparison of the results of the first demographic and health survey with those from existing inquiries.

Rerimoi Anne J AJ Jasseh Momodou M Agbla Schadrac C SC Reniers Georges G Roca Anna A Timæus Ian M IM

PloS one 20190723 7

<h4>Background</h4>In The Gambia, national estimates of under-five mortality (U5M) were from censuses and multiple indicator cluster surveys (MICS). The country's first demographic and health survey (DHS) conducted in 2013 provided empirical disaggregated national estimates of neonatal, post-neonatal and child mortality trends.<h4>Objective</h4>To assess the consistency and accuracy of the estimates of U5M from the existing data sources and its age-specific components in rural Gambia and produce ...[more]

PMID: 31335884

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Project description:BackgroundGlobally, millions of children aged below 5 years die every year and some of these deaths could have been prevented. Though a global problem, under-five mortality is also a major public health problem in Ghana with a rate of 60 deaths per 1000 live births. Identification of drivers of mortality among children aged below 5 years is an important problem that needs to be addressed because it could help inform health policy and intervention strategies aimed at achieving the United Nations SDG Goal 3 target 2. The aim of this study is to develop a predictive model and to identify determinants of under-five mortality.MethodThe 2014 Ghana Demographic and Health Survey data was used in this study. Analyses were conducted on 5884 children. The outcome variable is child survival status (alive or dead). Single level binary logistic and multilevel logistic regression models were employed to investigate determinants of under-five mortality. The fit of the model was checked using Variance Inflation Factor and Likelihood Ratio tests. The Receiver Operating Characteristic curve was used to assess the predictive ability of the models. A p-value< 0.05 was used to declare statistical significance.ResultsThe study observed 289 (4.91%) deaths among children aged below 5 years. The study produced a good predictive model and identified increase in number of total children ever born, number of births in last 5 years, and mothers who did not intend to use contraceptive as critical risk factors that increase the odds of under-five mortality. Also, children who were born multiple and residing in certain geographical regions of Ghana is associated with increased odds of under-five mortality. Maternal education and being a female child decreased the odds of under-five mortality. No significant unobserved household-level variations in under-five mortality were found. The spatial map revealed regional differences in crude under-five mortality rate in the country.ConclusionThis study identified critical risk factors for under-five mortality and strongly highlights the need for family planning, improvement in maternal education and addressing regional disparities in child health which could help inform health policy and intervention strategies aimed at improving child survival.

Project description:BackgroundAppropriate disposal of child stool is vital in preventing the spread of faecal-oral diseases. According to WHO/ UNICEF Joint Monitoring Program, Safe child stool disposal includes disposing a stool in a Flush or pour-flush toilet/latrine (to a piped sewer system, septic tank, pit latrine), Ventilated improved pit (VIP) latrine or a Pit latrine with slab.ObjectiveThe study aimed to assess safe child stool disposal practice and associated factors among mothers with children aged under-two years in Gambia.MethodsThis study was based on a large community-based cross-sectional survey, conducted from 21 November 2019 to 30 March 2020 in Gambia. The survey employed a two-staged stratified cluster sampling technique to recruit study participants. Descriptive statistics and logistic regression models were used to summarize descriptive data and identify factors associated with safe waste disposal, respectively. A p-value of less than 0.05 and 95% confidence interval were used to determine statistical significance.ResultsThe prevalence of safe stool disposal among mothers with children aged under-two years were 56.3% (95% CI: 54.6%, 58.1%). Mothers aged 25-34 (AOR = 0.78 (95%CI: 0.62, 0.98)), the highest wealth quintile (AOR = 0.43 (95%CI: 0.33, 0.56)), being exposed to media (AOR = 1.37 (95%CI: 1.07, 1.76)), increasing age of children (AOR = 1.06 (1.05, 1.07)), Being employed (AOR = 1.31 (1.11, 1.55)) and Geographic region were significantly associated with safe child disposal practice.ConclusionThe prevalence of safe child stool disposal was low in Gambia. Age of the mother, age of the child, region, wealth index, media exposure and occupational status of the mother were significantly associated with safe child stool disposal. Public health intervention strategies designed to promote safe child stools disposal need to conduct thorough community assessments to identify community-specific facilitators, needs and barriers. Additionally, public health experts and policy makers should take into consideration the geographical and wealth inequalities when designing programs aimed to improve safe child stool disposal practice.

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Project description:BackgroundThe distribution of under-five mortality (U5M) worldwide is uneven and the burden is higher in Sub-Saharan African countries, which account for more than 53% of the global under-five mortality. In Ethiopia, though U5M decreased substantially between 1990 and 2019, it remains excessively high and unevenly distributed. Therefore, this study aimed to assess geographic variation and factors associated with under-five mortality (U5M) in Ethiopia.MethodsWe sourced data from the most recent nationally representative 2019 Ethiopian Mini-Demographic and Health Survey for this study. A sample size of 5,695 total births was considered. Descriptive, analytical analysis and spatial analysis were conducted using STATA version 16. Both multilevel and spatial analyses were employed to ascertain the factors associated with U5M in Ethiopia.ResultsThe U5M was 5.9% with a 95% CI 5.4% to 6.6%. Based on the multivariable multilevel logistic regression model results, the following characteristics were associated with under-five mortality: family size (AOR = 0.92, 95% CI: 0.84,0.99), number of under-five children in the family (AOR = 0.17, 95% CI: 0.14, 0.21), multiple birth (AOR = 14.4, 95% CI: 8.5, 24.3), children who were breastfed for less than 6 months (AOR = 5.04, 95% CI: 3.81, 6.67), people whose main roof is palm (AOR = 0.57, 95% CI: 0.34, 0.96), under-five children who are the sixth or more child to be born (AOR = 2.46, 95% CI: 1.49, 4.06), institutional delivery (AOR = 0.57, 95% CI: 0.41, 0.81), resident of Somali and Afar region (AOR = 3.46, 95% CI: 1.58, 7.55) and (AOR = 2.54, 95% CI: 1.10, 5.85), respectively. Spatial analysis revealed that hot spot areas of under-five mortality were located in the Dire Dawa and Somali regions.ConclusionUnder-five mortality in Ethiopia is high and unacceptable when compared to the 2030 sustainable development target, which aims for 25 per 1000 live births. Breastfeeding for less than 6 months, twin births, institutional delivery and high-risk areas of under-five mortality (Somali and Dire Dawa) are modifiable risk factors. Therefore, maternal and community education on the advantages of breastfeeding and institutional delivery is highly recommended. Women who deliver twins should be given special attention. An effective strategy should be designed for intervention in under-five mortality hot spot areas such as Somali and Dire Dawa.

Project description:BackgroundRural 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.MethodsWe 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.ResultsOur 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).ConclusionsU5 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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Project description:BackgroundDiarrhea in children under five years of age remains a challenge in reducing child mortality in Nepal. Understanding the spatiotemporal patterns and influencing factors of the disease is important for control and intervention.MethodsData regarding diarrhea prevalence and its potential influencing factors were extracted from the Demographic and Health Surveys in Nepal and other open-access databases. A Bayesian logistic regression model with district-specific spatio-temporal random effects was applied to explore the space and time patterns of diarrhea risk, as well as the relationships between the risk and the potential influencing factors.ResultsBoth the observed prevalence and the estimated spatiotemporal effects show a decreasing diarrhea risk trend from 2006 to 2016 in most districts of Nepal, with a few exceptions, such as Achham and Rasuwa. The disease risk decreased with mothers' years of education (OR 0.93, 95% Bayesian Credible Interval (BCI) 0.87, 0.997). Compared to spring, autumn and winter had lower risks of diarrhea. The risk firstly increased and then decreased with age and children under 12-24 months old were the highest risk group (OR 1.20, 95% BCI 1.04, 1.38). Boys had higher risk than girls (OR 1.24, 95% BCI 1.13, 1.39). Even though improved sanitation wasn't found significant within a 95% BCI, there was 93.2% of chance of it being a protective factor. There were no obvious spatiotemporal clusters among districts and each district tended to have its own spatiotemporal diarrhea prevalence pattern.ConclusionsThe important risk factors identified by our Bayesian spatial-temporal modeling provide insights for control and intervention on children diarrhea in Nepal. Special attention should be paid to high risk groups of children and high risk seasons, as well as districts with high risk or increased trend of risk. Effective actions should be implemented to improve sanitation and women's education level. District-specific control planning is recommended for local governments for effective control of children diarrhea in Nepal.

Dataset Information

Under-five mortality in The Gambia: Comparison of the results of the first demographic and health survey with those from existing inquiries.

Background

Objective

Methods

Findings

Publications

Under-five mortality in The Gambia: Comparison of the results of the first demographic and health survey with those from existing inquiries.

Similar Datasets

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