Assessing sex differences in childhood mortality

It is well known that there are substantial area variations in child mortality rates in the coastal region of Tanzania. Area variations in mortality may be due to characteristics that relate to the area itself (contextual factors) or to characteristics of the individuals who live in these areas (sociodemographic factors). We extend this body of research by hypothesizing that even within rural areas, there exists spatial disparity in child mortality and that this disparity varies by cause of mortality. The objective of this study is to investigate the geographical disparities of cause-specific under-five mortality in Rufiji Health Demographic Surveillance System (HDSS).
We combined all deaths of children under five that occurred between 2007 and 2010 for each village within the Rufiji HDSS and multiple it by the proportion of deaths assigned to each cause to yield the cause-specific under-five mortality rate at the village level. We rank mortality rates and focus on the leading four causes and contributors to geographical disparity: malaria, pneumonia, birth asphyxia and prematurity/low birth weight.
A total 2801 under-five deaths were recorded. We observe geographical disparities of cause-specific under-five mortality in Rufiji HDSS. These disparities may be due to in socioeconomic differences and healthcare accessibility.

More than half of the world’s population resides in urban areas. In developing countries, the vast majority of future population growth will be in cities. In order to address the health needs of this growing population, timely data on within-city differentials in morbidity and mortality is necessary. Mortality rates within cities are typically not available in standard data sources such as the DHS, and thus intra-urban differentials in child mortality are unknown. Using baseline data from the MLE project in urban sites of Kenya, Nigeria, Senegal and Uttar Pradesh, India, we estimate infant, child and under-five mortality rates for slum and non-slum populations in major cities. The representative household samples of the urban populations in 5-6 major cities in each country were drawn to represent slum and non-slum populations, or the urban poor in cities where slum designations were not available (Nigeria and Senegal). These age-specific mortality rates show that mortality is generally higher among the slum populations compared to the non-slum urban populations in all four countries. We then explore the individual, household, community and geographic factors which contribute to higher rates of child mortality among urban slum dwellers as compared to non-slum dwellers.

Overweight and potential obesity among children in the developing world is an increasing concern as the world becomes more developed and urban (Martorell 2000, Popkin 2006, Jones-Smith 2012). Urbanization and economic development can lead to a public health paradox of concurrent under- and over-nutrition in the developing world population. While malnutrition among children remains a substantial concern, and public health priority, the implications of a simultaneous obesity disparity is not to be ignored. Studies have also suggested that the onset of child obesity lags behind that of adult obesity. This study therefore examines these trends in children and teen and adult women India, from 1992/93-2005/06, a period in which India has seen a rapid rate of urbanization and economic development. Using anthropometric data from the National Family and Health Surveys, we examine the trends and determinants of childhood and adult female obesity in a multivariate model.

Our study focuses on the impact of family environment on the health status of 10 year-old children. We distinguish physical and mental health as well as perceived and diagnosed problems. Data come from the Quebec Longitudinal Study of Child Development (QLSCD) that started collecting information in 1998 on a representative cohort of 2120 children aged 5 months. We create an indicator based on information reported by mothers and children at age ten. It consists of three mutually exclusive categories: 1) no health problem; 2) at least one perceived health problem but no diagnosed problem; 3) at least one diagnosed health problem. We use multinomial logistic regression models to assess whether the factors influencing the probability of having a diagnosed problem or a perceived problem are the same. We repeat the same model for three alternative indicators that consider either only physical health problems, only mental health problems, or both types of problems together. We include a range of risk factors drawn for family environment; some are time-invariant (e.g. age of mother at birth) others vary at each survey wave (e.g. poverty status). We expect to find that duration of poverty episodes and age at onset have different effects on perceived or diagnosed health.

We examined the Demographic and Health Surveys (DHS) data from 31 countries over the last 20 years to estimate the levels and trends of first-day mortality rates considering potential differences in socioeconomic and healthcare factors. The trends in first-day mortality rates and 95% confidence intervals were estimated adjusting for potential clustering effects, comparing three successive DHS held across countries covering sub-Saharan Africa, South and Southeast Asia and Latin America. The findings show that first-day mortality rates varied widely from 21 deaths per 1000 live births in Mali and Ethiopia to about 17 per 1000 in Kenya and Nepal to less than 10 per 1000 in Dominican Republic, Philippines, Jordan and Egypt. The absolute change in the rates between DHS2 and DHS3 were not significant in about 24 countries and the levels were stagnantly high or increased in about 8 countries. First-day mortality increased consistently in Zimbabwe, Zambia, Senegal, Cambodia and Philippines. A negative linear relationship was found between skilled birth attendance, per-capita income and first-day mortality rates whereas a negative curvilinear relationship was observed between years of maternal schooling and first-day mortality rates. In countries where there is high medical intervention in births had relatively low first-day mortality.

Malawi just as many other developing countries, continues to be challenged by the problem of child under-nutrition. Recent estimates indicate that in Malawi, 47% of children under the age of five are stunted whilst 13% are underweight (ORC Macro and NSO, 2011). Most of studies, including those conducted in Malawi report of a higher likelihood of stunting and underweight for male children compared to female children (Madise et al., 1999, Chirwa and Ngalawa, 2008). This study uses the 2004 Malawi Demographic and Health Survey data to study if the relationship between sex and child under-nutrition in Malawi depends on the age of child and undertakes age group multivariate analysis to explore factors that are important for child under-nutrition amongst children in different age groups. The findings indicate that although female children have a lower likelihood of stunting and a lower likelihood of underweight compared to male children, there is a significant interaction between age and sex of child. Male children are more likely to be underweight and more likely to be stunted compared to female children during the weaning time when nutritional demands increase as children get introduced to solid foods.

In this paper, an attempt is made to examine the feeding practices of children by religious groups is carried out to know the differences in child mortality of children by religious groups. The Hindu-Muslim gap in neonatal mortality is quite significant. An attempt is made here to compare the breastfeeding and complimentary feeding pattern by religion. Initial breastfeeding and duration of breastfeeding is not significantly different among these religious groups. Moreover, antenatal care, delivery care and postnatal care is better among Hindus in comparison to Muslims (NFHS-3). Intake of micronutrients namely Vitamin A and iron rich food is better among Muslim children in comparison to Hindus. ARI and fever prevalence is found higher among Muslims whereas treatment of these two diseases is better among Hindus. However, management of diarrhea is better among Muslims. Intake of micronutrients and better management of diarrhea may be reducing the child mortality among Muslim in comparison to Hindus.

Objective: The study seeks to test the effects of social and demographic factors on the health status of children under 5 years of age in Iran.

Methodology: For data analysis, the logistic regression was applied. The relations and extent of effects of the selected independent social and demographic variables on the dependent variable of health of children under age 5 .

Results: The survey outcomes confirm that health status of children under 5 years of age is affected by the social and demographic factors. A review of the health of children under 5 revealed that the independent variable of parents' education, particularly when mother steps up from illiterate status to the primary education level, greatly affects improvement of health status and among the children under study.

Undoubtedly urban poor/slum population is deprived a lot facing the maximum brunt of the inequity in the cities. In this light it becomes imperative to find out what effect is cast by the proportion of slum population the inequity with respect to resources within the same slums and the human development index on the infant mortality rate in Mumbai and its 24 administrative wards. The second objective is to determine contribution of socio-economic inequality in infant mortality in Mumbai slums. The data for study has been gleaned from Human Development Report, Mumbai, 2009, Census of India, 2001 and National Family Health Survey-2005-06. The ward wise analysis with respect to three different regions of Greater Mumbai clearly shows that most of the wards of City Island had infant death around below 35 whereas most of the wards of Eastern suburbs had infant deaths more than 55 per 1000 live births. Some wards of Eastern suburbs such as M/E-Chembur East, M/W-Chembur West and L-Kurla call for special attention because these wards are having high concentration of slum population, low level of human development index and high burden of population on available health facilities which resulted into increase in the level of infant mortality rate during eight years time period.

This study attempts to evaluate principal components concomitant to infant mortality. IMR is affected by several factors belonging to maternal characteristics, child characteristics, utilization of health services and socioeconomic status of the people. Each of these factors includes a large number of variables. Categorical Principal Component Analysis (CATPCA) method is applied as a data reduction tool to reduce dimensionality in data. Data for this work have been taken from NFHS III. The analysis produced a three-dimensional solution, which explains 50.47% of the variance with reliability of 89.1% (cronbach’s α 0.891). Total 26.17% variance is explained in dimension one, 12.49% variance in dimension two and 11.81% in third dimension. Maternal factors explain total 26.83% variance and child factors explain total 18.58% variance. Out of ten samples of size n/2 from the same data set, nine samples give similar results.