Assessing sex differences in childhood mortality

Health care utilization is important factor, which determines the health status and survival chances of children. Girl children suffered more malnutrition and received lesser treatment for various infections especially for diarrheal diseases and for acute-respiratory infection. Where fees are charged or referrals to a higher level of care, families deny these more often in the case of daughters. The study uses primary in 2010, the sample size is 330. The study area comprises of 11 villages from Rajarhat CD block of 24-north Parganas in West Bengal, India. The results show that within three months from the date of survey most of the male and female children suffered from cold and cough, but higher percentage of female children were said to be in severe health condition. For high percentage of male children father and mother were taking active role in seeking medical help as compared to the female children. The time laps in the occurrence of morbidity and treatment was also longer for the female child and the money spent on treatment was less even when severely ill. The distance travel was greater for the female children so that they were taken to the public health facility which was cheaper and lot of time was lost before the treatment was started.

The purpose of this paper is to both quantify women's empowerment in Egyptian context and examine whether any significant improvement in their situation has been achieved since 1995. Further, the association between women's empowerment and child health will be examined. It is argued that women with higher status are better able to make positive investments in their children's chances of living in better health. Data used in the study come from the Egypt Demographic and health surveys in 1995, 2005, and 2008. Women's empowerment is quantified using constructed indices: mobility index, attitude towards gender index, attitude towards domestic violence index, women's involvement in domestic decision making, and media exposure. The evidence suggested that women's status in Egypt is significantly changed in the period between 1995 and 2008. Further, child survival benefit from women's empowerment. Some policy implications of the findings and measurement issues pertaining to women’s empowerment are discussed.

With about 1 percent of the global population, the Democratic Republic of Congo (DRC) has the third highest diarrheal morbidity among under-five children worldwide. This study aimed to describe trends in diarrhea prevalence by selected socioeconomic characteristics; identify the sources of variation, and assess contribution of changes the DRC. The study used information on 9,748 children from the 2001 Multiple Indicators Cluster Survey and 7,987 children from the 2007 Demographic and Health Survey. Statistical techniques include trends analysis, decomposition method and fixed effect regression models.
Findings revealed significant decrease in diarrhea prevalence in all socioeconomic categories considered. Changes in behavior and/or in public health policy seem to be likely the main source of the observed changes, as there were no significant changes in diarrhea prevalence associated with variation of the population structure. However, the decrease in diarrhoea prevalence in the DRC contrasts with the generalized humanitarian crisis, deterioration in environmental conditions and population poverty observed in the country during the same study period. These findings suggest further investigations through district or provincial based studies to validate findings from national surveys.

In the Egyptian context, delayed fertility transition compared to neighboring countries, can be in part ascribed to the delay in the fall of infant mortality rates. Infant mortality was high in Egypt till the 1980s. Since then, infant mortality recorded significant progress: in 2001, the number of deaths per 1000 births was 38 against 97 in 1984. However differences are still significant between governorates: in urban governorates, the 2008 level is 29 deaths per 1,000 births. In rural Upper Egypt, mortality was about 39 ‰. No previous studies had attempted to estimate infant and child mortality in Egypt for small geographical areas. Strong socio-economics differences and inequalities exist between urban and rural setting, Upper and Lower Egypt and even between small area in the same region or city. Those differences justify the need to calculate infant and child mortality rates at the local level. We will account for this problem using a Bayesian hierarchical model for small area: model-based estimators will be derived and their precisions compared with alternative estimators proposed in literature. We use data from Egyptian Demographic and Health Surveys (1995 and 2005), Egyptian population register and Egyptian Population and Housing Census (1996 and 2006).

Despite adolescents (10- 19 year olds) having the lowest mortality compared to older and younger age groups in the country, the mortality rate of this age-group is increasing. Prominent broad- underlying and immediate causes of death have varied very little over the period. What remains unclear is the determinants of these causes of death among South African adolescents. This paper is a study of the determinants of adolescent mortality in South Africa. Data from the South African Death Registry is used (2006- 2009). Cause-specific mortality rates and proportional mortality ratios are used. Logistic regression is then used to infer the odds of adolescent mortality by specific demographic and socioeconomic characteristics. Results paper include that occurrences of mortality due to ‘Tuberculosis’ and ‘ill- defined and unknown causes’ are high among adolescents. Further this paper has found that female adolescents are at greater odds of natural or disease mortality than males. However, females are at lower odds of unnatural and violence related causes of death. Also, marriage decreases the odds of mortality.

Terminal illness in children in developing countries is frequently characterized by the co-occurrence of more than one disease- a phenomenon referred to as Co-morbidity. Using self-reported illness data from the 2005-06 India Demographic and Health survey, we applied a multinomial model to access the risk factors of childhood Co-morbidity of fever, diarrhoea and acute respiratory infection (ARI). Various models were fitted and compared using the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Specifically, risk factors associated with child Co-morbidity included age of the child, birth order, and vitamin A, sex of children, breastfeeding, household water supply, toilet facility, rural-urban place of residence and six regions of India. The result show that age of child, sex, vitamin A, place of residence (urban/rural) and regions are important predictor not only for co-morbidity but also for single disease. The results emphasis the need for interventions targeted at this group, and may include micro-nutrient supplements, e.g. vitamin A, and use of insecticides treated nets, and combined intervention could be cost-effective to implement. Rural areas are particularly vulnerable and deserve attention when scaling up-interventions.

Child nutrition is one of the key components of development. Despite rapid economic growth in India, many states are failing to fight against malnutrition. The paper, utilizing data from NFHS 3 (2005-06) explores the inequalities and determinants of severe stunting by applying concentration index and logistic models. Questions addressed are, why so many children are malnourished in spite of economic growth; what is the regional pattern of malnourishment by sex of the child; whether the extent of economic inequality on child malnutrition differs by child’s background? In India boys are more severely stunted than girls, yet the sex difference is marginal. Burden of severe stunting is higher among children from poor households, irrespective of child sex. However, urban poor are more disadvantaged over their rural counterpart. The burden of severe stunting for girl child among the poor is highest in the western region. Regional heterogeneity is widespread in severe chronic malnutrition which needs policy attention

This paper focuses on percentage of childhood death among Hindu-Muslim (religion) in India and its selected regions. Sex differentials in infant and child death reflect strong son preference in many regions. Most regions exhibit excess male death during the neonatal period but excess female death during childhood. In the country as a whole, female child death is 40 percent higher than male child death. The sex differentials in infant and child death suggest that son preference and discrimination against female children are very strong in northern states but minimal or nonexistent in southern states. Among socioeconomic background characteristics, urban/rural residence, mother’s exposure to mass media, and Mother’s literacy, access to a flush or pit toilet are found to have substantial unadjusted effects on infant and child death, but these effects are much smaller when the effects of other socioeconomic variables and basic demographic factors are controlled. Wealth index, birth interval, women age at first birth, household head’s religion and economic level of the household have substantial and often statistically significant adjusted effects on infant and child mortality. Both unadjusted and adjusted effects of most of these background characteristics are largest for child mortality and smallest for neonatal death.

Though empirical research has established the household wealth and maternal characteristics as significant predictors of child malnutrition, little is known about the role of community and parental attributes in explaining child malnutrition in India. The aim of this paper is to examine the role of community and household factors in explaining malnutrition among children under five in the Empowered Action Group (EAG) states of India. The eight EAG states constitute about half of India’s population and lag behind in key demographic and socioeconomic indicators.
The unit data from National Family Health Survey (NFHS) 3 is used in the analyses. Bi-variate analyses, concentration curves and multilevel models are used to understand the patterning and contextual effects of child malnutrition in the EAG states. The dependent variables, weight-for-age, height-for-age and weight-for-height are analysed with respect to three composite indices; community socioeconomic status (SES), household wealth and household social status. Results indicate that in EAG states half of children in poor communities and households were underweight, stunted

This paper explores Infant mortality gaps between indigenous and non indigenous children in Latin America from a human rights framework. The data provided by population censuses shows that indigenous peoples suffer the greatest inequalities with a persistence of excess mortality. As most of these deaths are preventable with appropriate access to health, the over mortality became an indicator of the human rights violation. Given the persistent inequity and heterogeneity, the challenge is to develop a cross cultural approach considering cultural and geographical diversity in the frame of equity and human rights. The 2010 Census offers a great opportunity for measuring to what extent infant mortality -close to 60 per 1,000 live births in the 2000 censuses- has declined; Also it is an important moment for estimating if the equity gap between indigenous and non indigenous children has increased, decreased or maintained. It is crucial to know the patterns and tendencies to evaluate the impact of cross cultural programs and interventions developed since the 90's in most Latin American countries.