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PubMed1994

Some correlates of child mortality in the refugee populated regions in Tanzania.

Data from the 1988 Tanzania census were used to examine child mortality in three regions populated with Burundi refugees. Logistic and least squares analyses show that for both Tanzanian nationals and refugees low levels of maternal education are associated with high child mortality levels. Children born to mothers who are housewives are associated with low levels of mortality compared to those born to employed mothers, though the results were not statistically significant for the refugees. Maternal demographic status, computed from age and parity, has a strong effect on child survival. Unexpectedly, child mortality was lower where the water source was a well outside the village. Tanzanian mothers who are at highest risk of childbearing are roughly 6.4 times more likely to have a child death than those at lowest risk; the corresponding figure for the refugees is 36.8. This emphasises the need to intensify family planning programmes in these regions.

Adolescent↗
PubMed2004

Parental bargaining, health inputs and child mortality in India.

The primary objective of this paper is to examine the relationship between the status of women in the household, the use of health care (demand for prenatal care and hospital delivery) and child mortality in India. Parents care about the health of their children but cannot directly affect child health by their actions. Instead they can, through their actions, control the use of health inputs. I jointly estimate the decision to use prenatal care, the decision to deliver the baby in hospital and child mortality. The estimation methodology allows us to account for unobserved heterogeneity and self-selection in the use of health inputs. The estimation results show that: (1) a woman's education has a stronger effect on health care usage relative to that of her husband; (2) a woman's control over household resources (ability to keep money aside) has a significant effect on health care usage; (3) both prenatal care and hospital delivery significantly reduces the hazard of child mortality; and (4) not accounting for unobserved heterogeneity and self-selection in the use of health inputs results in under-estimation of the effect of health inputs on child mortality.

Adult↗
PubMed1995

Age patterns of child mortality in the developing world.

"This article uses the data from [a] United Nations database, supplemented in a few cases with information from local studies thought to be of particular accuracy, to examine age patterns of child mortality [in developing countries]. The focus is on the split between infant mortality--that is, mortality before the first birthday, and child mortality, between the exact ages of 1 and 5 years.... The underlying objective of the article is to identify regional patterns, both because the epidemiology and social behaviours underlying child mortality are likely to be similar across regions and because such identified patterns could then be used to guide the selection of a model life-table family when using indirect estimation methods in countries of a region."

Cross-Cultural Comparison↗
PubMed2005

Equitable child health interventions: the impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925.

Today, many of the 10 million childhood deaths each year are caused by diseases of poverty--diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality. In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.

Child↗
PubMed2006

The 2004 annual report of the Regional Infant and Child Mortality Review Committee.

The annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. This Committee has as its mission the review of infant and child deaths so that information can be transformed into action to protect young lives. The 2004 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, and Miner counties. For the first time since the inception of RICMRC in 1997, there were no Sudden Infant Death Syndrome (SIDS) deaths in our region. Nevertheless, within our region we need to continue to promote the "Back to Sleep" campaign message of not only placing infants to sleep on their backs, but also making sure infants are put down to sleep on safe, firm, sleeping surfaces. There were ten deaths due to accidental injury. Four deaths were related to motor vehicle crashes (versus ten in 2003). Six children died in fires (versus three in 2003). There were no child abuse homicides and two teenage suicides. The RICMRC invites other communities to join in its efforts to review deaths to prevent potential life threatening hazards to children in their local environs.

Accidents↗
PubMed1991

Comparison of linear and exponential multivariate models for explaining national infant and child mortality.

Product form multivariate regression models (multiplicative exponential) were developed with infant and child mortality as outcomes, and national economic, health, nutrition, education, and demographic statistics as predictor variables. The models were applied to data from 129 countries, resulting in R-square values for the product form models of infants and child mortality of 0.77 and 0.80. For comparison purposes, more conventional sum form models (additive linear) were also estimated, and yielded R-square values (0.22, 0.29) markedly lower than the product form models. The product form models also had a much more uniform distribution of residuals and provided improved model fit across the different categories of nations. An inherent advantage to the product form models is that they did not predict negative mortality rates, in contrast to the sum form models which did predict negative mortalities for some of the more developed nations. Using a product form model, the correlation between physicians per capita and infant mortality was shown to be negative rather than positive--thus correcting for an anomaly seen in previous studies which showed a positive correlation between physicians per capita and infant mortality.

Child↗
PubMed1995

More recent trends in infant and child mortality in Zimbabwe and possible explanations.

The paper uses published results from the 1992 census to describe more recent trends in infant and child mortality in Zimbabwe. It is shown that the period 1986 to 1988 provided the turning point in the gradual decline in infant and child mortality in the provinces. After this period, several provinces experienced a slow-down in mortality decline while some even experienced reversals. Using correlation analysis, it was suggested that the factors which affected infant mortality could be the same ones affecting child mortality. The paper then proceeds to formulate hypotheses on possible explanations for the slow down in mortality decline.

Birth Rate↗
PubMed2000

Determinants of infant and child mortality in the West Bank and Gaza Strip.

Infant and child mortality in the West Bank and Gaza Strip has steadily reduced since 1967, even though fertility has remained extremely high. In this paper the determinants of infant and child mortality are discussed, with particular emphasis on the role of consanguineous marriages, short birth spacing and maternal education. It is shown that short birth spacings and type of marriage are more important determinants of infant mortality than maternal education. Moreover, the relative role of consanguineous marriages appears to increase with time.

Adolescent↗
PubMed2004

The 2003 annual report of the Regional Infant and Child Mortality Review Committee.

The annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is attached. This Committee has as its mission the review of infant and child deaths so that information can be transformed into action to protect young lives. The 2003 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, and Union Counties. In 2003 there was one death in this region due to Sudden Infant Death Syndrome (SIDS), plus two infant deaths listed as undetermined that could potentially represent SIDS. Two of these three deaths had potential risk factors of soft bedding and prone sleeping. These data reflect the need to remain vigilant in the public campaign to promote "back to sleep" and safe sleeping environments for infants. There were 15 other deaths due to accidental injury, and ten related to motor vehicle crashes. In 2003 there were no child abuse homicides and one teenage suicide. The RICMRC invites other communities to join in its efforts to review deaths to prevent potential life threatening hazards to children in their local environs.

Accident Prevention↗
PubMed1999

Female education and child mortality in Indonesia.

This paper uses a sample of 6620 women from the 1994 Indonesian Demographic and Health Survey to examine the relationship between female education and child mortality in Indonesia. Female education is measured in terms of both years of education and literacy. Both primary education and secondary schooling significantly decrease the probability of child death, while literacy plays an insignificant role. When the sample is divided into urban and rural locations, primary and secondary education are significant in both areas in reducing the likelihood of a mother experiencing child mortality. The benefits of public and private infrastructure appear to differ in rural and urban areas. The results confirm that investment in female human capital lowers the probability of child mortality.

Asia↗
PubMed2006

The 2005 Annual Report of the Regional Infant and Child Mortality Review Committee.

The annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is attached. This Committee has as its mission the review of infant and child deaths so that information can be transformed into action to protect young lives. The 2005 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner, and Brookings counties. Although there was only one death meeting the criteria of the Sudden Infant Death Syndrome (SIDS) in our region, there were four infant deaths associated with soft, unsafe, sleeping surfaces where asphyxia could not be excluded. We need to continue to promote the "Back to Sleep" campaign message of not only placing infants to sleep on their backs, but also making sure infants are put down to sleep on safe, firm, sleeping surfaces. Nine of ten accidental deaths were related to motor vehicle crashes (versus three in 2004). Unlike previous years, there were no fire-related deaths. In 2005 there were two child abuse related homicides and one teenage suicide. The RICMRC invites other communities to join in its efforts to review deaths to prevent potential life threatening hazards to children in their local environs.

Adolescent↗
PubMed2003

Health insurance and child mortality in Costa Rica.

This study uses a natural experiment approach to evaluate the effect of health insurance on infant and child mortality. In the 1970s Costa Rica adopted national health insurance, which expanded children's insurance coverage from 42 percent in 1973 to 73 percent by 1984. Aggregate infant and child mortality rates dropped rapidly during this period, but this trend had begun prior to the insurance expansion, and may be related to other changes during this period. We use county-level vital statistics and census data to isolate the causal insurance effect on mortality using county fixed effects models. We find that insurance increases are strongly related to mortality decreases at the county level before controlling for other time-varying factors. However, after controlling for changes in other correlated maternal, household, and community characteristics, fixed effects models indicate that the insurance expansion could have explained only a small portion of the mortality change. These results question the proposition that health insurance can lead to large improvements in infant and child mortality, and that expanding insurance to the poor can substantially narrow socioeconomic differentials in mortality.

Cause of Death↗
PubMed1993

Regional inequalities of child mortality in peninsular Malaysia with special reference to the differentials between Perlis and Kuala Terengganu.

In Peninsular Malaysia child mortality rates (5q0) vary from 13 to 63 per thousand at district level. The spatial pattern is closely associated with the regional distribution of socio-economic factors. But due to multicollinearity it is difficult to isolate the influence of socio-economic variables from other variables by employing aggregated data. However, individual data collected in a case-control-study that was conducted in Perlis and Kuala Terengganu confirm the important role of socio-economic factors. So it should be possible to achieve a further reduction of child mortality by raising the income and educational level of the under-privileged groups. Apart from that, as the case of Perlis shows, the provision of family planning and preventive medical services may also contribute to lower child mortality independent from socio-economic changes. But, as the comparison with Kuala Terengganu shows, the utilization of family planning and preventive medical services is not only influenced by the accessibility to, but also by the socio-culturally determined acceptability of such services.

Case-Control Studies↗
PubMed1996

Immunization coverage and child mortality in two rural districts of Sierra Leone.

The study, which is based on data from a household level health survey conducted in early 1993 in the rural areas of the districts of Western Area and Port Loko of Sierra Leone, examines the coverage of an Expanded Program on Immunization (EPI), infant and child mortality, and disease symptoms in children who died under age five in the study area. The results of the study indicated that the infant and child mortality rate per thousand live births declined from about 162 in the mid 1980s to about 77 in 1993. This decline was associated with immunization coverage which considerably increased by 1993, reaching as high as above 60% of the eligible children. The study further reveals that the major symptoms of disease at the time of death of an infant or a child were fever, cough, troubled breathing, and diarrhea in that order. While fever and cough could reflect the persistence of malaria and pneumonia-two major causes of infant and child deaths not covered by existing EPI-the study also revealed that many children failed to take full doses of immunization. Similarly, inadequate coverage of domiciliary oral rehydration therapy (ORT) might have been the reason of high incidence of diarrhea-related deaths. Simple medical technologies to eliminate many of the existing major causes of infant and child mortality in rural Sierra Leone are now available. Perhaps, a strengthened primary health care service, including an extensive rural health care network, aimed at eliminating these diseases, would go a long way in reducing infant and child mortality to irreducible minimum.

Cause of Death↗
PubMed1982

Determinants of child mortality, health, and nutrition in a developing country.

The authors investigate the determinants of child mortality and health and nutrition status in Nicaragua using economic models of household behavior. In particular, they examine regional differences by degree of urbanization. Various factors affecting child mortality are considered. The results indicate that "income is not an important factor, there is an inverse relation with number of siblings, and there are positive associations with calorie intake, schooling (except in the relatively low-income areas), the availability of refrigeration, and the quality of sewage systems."

Americas↗
PubMed2004

Modelling determinants of child mortality and poverty in the Comoros.

Based on the Demographic and Health Survey of the Comoros of 1996, the analysis of the determinants of child mortality reaches three conclusions. Firstly, differentiated analytical options generate partially convergent results and provide different dimensions of child mortality. Secondly, the study shows that the low standard of living of households in terms of assets is associated with high child mortality. Thirdly, the determinants of infant and infanto-juvenile mortality are relatively comparable. On the one hand, some common factors to both analytical options affect negatively child health: (i) geographical location in rural zones and/or on the islands of Anjouan and Mohéli; (ii) the low standard of living of households in terms of assets; (iii) some community elements, in particular morbidity, the insufficiency of vaccination and the absence of childbirth assisted by qualified persons. On the other hand, characteristics of mothers and births have an impact on infant and infanto-juvenile survival.

Comoros↗
PubMed2005

Estimating the net effect of HIV on child mortality in African populations affected by generalized HIV epidemics.

For a given prevalence, HIV has a relatively higher impact on child mortality when mortality from other causes is low. To project the effect of the epidemic on child mortality, it is necessary to estimate a realistic schedule of "net" age-specific mortality rates that would operate if HIV were the only cause of child death observable. We assume that this net pattern would be independent of mortality from other causes. We used African studies that measured the survival of HIV-infected children (direct data) or survival of children of HIV-infected mothers (indirect data). We developed a mathematic procedure to estimate the mortality of infected children from indirect data sources and obtained net HIV mortality patterns for each study population. The net age-specific HIV mortality pattern for infected children can be described by a double Weibull curve fitted to empiric data; this gives a functional representation of age-specific mortality rates that decline after infancy and rise in the preteens. The fitted curve that we would expect if HIV were the only effective cause of death shows 67% net survival at 1 year and 39% at 5 years. The curve also predicts 13% net survival at 10 years using constraints based on survival of infected adults.

Adolescent↗
PubMedDate not supplied

Factors influencing child mortality levels in rural Bangladesh: evidence from a micro study.

"This paper examines the factors that affect child mortality [in rural Bangladesh] by using a multivariate technique. The results suggest that mother's access to education and health care facilities are important determinants of child mortality. The access to maternal and child health programs and visit by the health workers were also related to low childhood mortality...." (SUMMARY IN FRE AND ITA)

Asia↗