Assessing sex differences in childhood mortality

Background: Health knowledge is developed through the experiences gathered by an individual, which makes him or her able to understand health problems. In Indian context, the study assess health knowledge of women of age group 15 to 49 years and its association with the prevalence of short-term morbidities, medical care and medical expenditure among children in age group 0-59 months.
Methods:The health knowledge and practice index and other several variables are constructed based on the information available from nationwide data (IHDS, 2005). Principal Component Analysis (PCA) is used to construct health knowledge index. Binary logistic regression and multinomial logistic regression analysis and MCA are used Results: Though, there is positive impact of education on health, still, immaculate health knowledge is required for mother to understand her child’s health problems. Enhanced health knowledge among mothers’ causes reduction in the prevalence of short-term morbidities among their children. Besides medical care, spending on medical care is also dependent on the fact that, to what extent women rationally take decision on taking care of their children’s health. . Willingness to pay for medical care is guided by their health knowledge. Health knowledge is established as a key determinant of prevalence of child morbidities.

On an average, Odisha in India has an alarming 45% children not receiving full immunisation according to Annual Health Survey (AHS), 2010-11; child immunisation ranged from 12% in Rayagada to 82% in Kendrapada district. This paper employs correlation and multiple regression techniques to identify factors contributing to full immunisation using socio-economic and maternal health factors sourcing from AHS and Census, 2011.
Newborns receiving health care within 24 hours of birth is found to be a major determining factor for achieving high immunisation as per correlation analysis. At least 3 ANC visits, post-natal care and newborn care within 24 hours significantly positively correlated to full immunisation. Notably, unmet need of family planning and delivery at home are significantly negatively associated. Further, multivariate analysis indicates strong direct relationship between newborn check up within 24 hours of birth and post-natal care, and full immunisation after controlling other socio-economic factors such as female literacy and urbanisation, and maternal factors. Conversely, analysis also reveals that urbanisation and female literacy do not have significant effect. Study concludes that ensuring MCH services, including in remote areas, leads to improving the minimum level of full immunisation achievement across districts

The study uses data from Kenya Demographic and Health Survey 2008-9 to examine regional differences in under-five mortality. The data is analysed using logistic regression and the findings suggest that there are significant regional differences in under-five mortality. The differences however become less significant when the model controls for demographic variables and there is no significant difference when socio-economic and environmental variables are introduced in the model. This suggests that other than the demographic, socio-economic and environmental factors there are other factors probably population distribution, distribution of basic infrastructure and health care services and ecological or climatic that may have confounding the effects. The findings support the notion that interventions aimed at reducing under-five mortality should be tailored to take into account regional variations. There is need for further research to establish the potential determinants behind the observed differentials in under-five mortality

Reducing child mortality’ is the fourth goal among eight Millennium Development Goals by United Nations and for this child immunization is found to be the best way to reduce the child mortality in developing countries. Child immunization is also a key strategy to ensure global health security. The main objective of this paper is to examine the temporal changes and spatial patterns of child immunization in India and in different states. This study is based on the NFHS (National Family Health Survey) round I, II and III (from the year 1992 to 2006). For fulfilling the objectives, trend analyses and GIS mapping have been used. Although India as a whole is showing improvement in immunization coverage in each successive NFHS rounds, but this trend is not visible at micro level. The state Gujarat is declining in child immunization from NFHS I to III continuously. Southern states of India are showing high level of child immunization. Mizoram is the only state from north- east region which shows high level of immunization in urban areas. Examination of NFHS-3 data also reveals that immunization has very clear spatial patterns in the country. Southern state Tamil Nadu is reflecting high level of child immunization followed by Kerala. Himachal Pradesh is revealing better result in northern states of India. On the other hand, Rajasthan, Ut

This paper examines the differentials in utilization of child health services between the Scheduled Tribes and Non-scheduled populations in the Odisha state of India. Data from the National Family Health Survey-3 (NFHS-3) carried out during 2005-06 are used. Besides, information from the field survey and Focus Group Discussions (FGDs) conducted in Sambalpur and Rayagada districts of Odisha are used. Logistic regression models have been employed to see the net effect of individual socioeconomic factors on utilization of preventive as well as curative child health services. Results show that utilization rate of child health care services is substantially lower among the Scheduled Tribes as compared to non-scheduled populations. Though utilization of child health care services is associated with a range of socioeconomic factors, the social group differences in utilization as revealed by the logistic regression models, is largely explained by the variations in the mother’s level of education. The unexplained differences could be attributed to the health seeking behavior as revealed in FGDs conducted among both the groups. Besides neglect of hospital staff and the feeling of ‘out of place’ at the health centre and lack of social capital are found to be linked with low utilization of child health services among the scheduled tribes.

Background and objective: In Bangladesh 82% deliveries occurred at home. Of them 80% assisted by friends, relatives, neighbors which is one major reason of maternal and neonatal mortality and also indicates lack of skilled health workforce including nurse/midwives at community level to conduct safe delivery at home more in rural areas.

Methodology: Data of births of last 5 years preceding the Demographic and Health Survey 2007 used for study.

Results: Only 3.4% births attended by nurse/midwife at home. Among births attended by nurse/midwife at home neonatal death rate is 2.9% while it is 3.7% among births not attended by nurse/midwife. Findings from bivariate and Cox’s regression analysis revealed following potential factors to reduce neonatal death among birth occurred at home: received ANC, birth attended by nurse/midwife, higher age of mother at birth, urban residence, wealth index, educated mothers and fathers, watch television, give colostrum immediately after birth.

Conclusions: Evidence from study indicate urgent necessity of required skilled workforce at community level to conduct safe delivery at home and counsel and motivate mothers and family members to play role for reducing maternal and neonatal mortality. Hence JPGSPH, BRACU has taken initiatives to develop community based midwives.

Immunization against common childhood diseases has been an integral component of mother and child health services in India since adoption of the primary health care approach in 1978 being reinforced by the Declaration of Health Policy in 1983. The focus of this paper was to examine the dropout rates in Polio and DPT vaccines status and its determinants in regions of Uttar Pradesh. Data sources on immunization coverage used for this study include secondary data from RCH-3 Surveys in U.P. The analyses reveal that a large number of children in different socio-economic contexts are missed out of subsequent services. There are dropouts of the vaccines due to non availability of services providers. Almost every other child in U.P was incompletely protected from full immunization and one out every of three children was a dropout from the immunization programme. Revitalize and strengthen routine immunization services with particular reference to urban areas, Muslims, illiterate parents, populations residing in the plains, and population groups or areas hitherto not reached. The paper recommends ensuring regular immunization services on a fixed day and fixed place basis and addressing poor utilization of immunization services, lack of awareness or motivation, through professionally–designed behavior change communication interventions.

The body of research on the ‘health-wealth gradient’ during childhood in developed country setting is extensive. However, the epidemiologic and nutritional transition profile that characterize developing countries suggest that health-wealth gradient in these setting can vary from current findings.

The aim of this paper is to determine whether there is a health-wealth gradient for children’s nutritional status in rural Malawi, and whether the gradient changes as children get older. This analysis uses anthropometric data collected from children aged 0-5 in 2008 and 2006 and 2008 panel household data. The panel data allows for use of contemporaneous household wealth and change in household wealth measures. The investigation reveals that children in wealthier household have decreased risk of stunting but this is not significant until the oldest age groups (48-59 months old). At the oldest ages, effect of household wealth on stunting risk is robust to parent’s education, an alternative measure of household resources. There is no apparent health wealth gradient across the ages studied here but there is evidence of an emerging wealth gradient as children age.

The availability of safe drinking water and access to basic sanitation play positive role on child heath whereas deterioration in their quality invite the higher risk of mortality.

This paper looks into the effect of drinking water and sanitation used in the household on under-five child mortality in Nepal. The study also assesses whether mortality is affected by urban-rural and eco-belt characteristics. The analysis is based on the data obtained in Population Census conducted in 2011. The binary logistic regression of under-five mortality on sources of drinking water and type of toilet used in the household is fitted to assess the impacts of drinking water and sanitation on under-five mortality.

The preliminary results show that access to safe drinking water contributes to decreases the risk both in national and sub-national levels. Moreover, sanitation is found to have a more noticeable impact on child-mortality than drinking water. The results also disclose the facts that the risk is higher in rural areas than in urban areas. The Mountain and Terai regions face higher risk of under-five mortality than in Hill area. The results suggest that increasing awareness among population relative to health care is equally important to decrease under-five child mortality risk in Nepal.

The child health situation in India has been improving slowly over the past few years and remains a major development challenge for India. Highest number of child deaths in world takes place in India. Nutrition level has not much improved form NFHS-2 to NFHS-3. The main purpose of the study to asses and compare the overall health of children in northern and southern states of India and to examine the relationship between several household and development related environmental factors to the health and survival of children in rural parts of two different northern and southern regions of India. Data from NFHS-3 has used for these purposes. Several indicators of nutrition and morbidity are used. Poor sanitation and electricity facilities significantly reduce the chances of children to secure better health in the both the regions. Poor water condition is also founds to be significant impact on wasting among children. Use of non-solid cooking fuel is also associated with survival and health situation of children. Education status of mother was very important determinants of child health and survival. Non nuclear families are also founds to be better than nuclear families in northern region but opposite is true for southern region.