Assessing sex differences in childhood mortality

Reduction in child malnutrition is central to economic and social development in any country as it has dire ramifications to physical, psychological and mental development of individuals over the life course. Child malnutrition is also associated with higher morbidity and mortality incidence. Therefore, it is imperative to have knowledge of its correlates and determinants. Examination of determinants of child nutrition at different points of its distribution has better policy implications than investigating predictors on average value. Using NFHS-III (2005-06) data, this study investigates determinants of nutritional status -measured by standard anthropometric indicators- of children aged 0-59 months in India using quantile regression approach. Results show that age and birth order is negatively associated with height for age and weight for age z-scores but these are positively associated with the weight-for-height z-scores. Mothers’ nutrition, educational level and better household environment are positively associated with the nutrition z-scores but these factors differential effects at different points of the conditional distribution of the anthropometric z-scores.

Under-five mortality is one of the major health challenges in sub-Saharan Africa. In Nigeria, 1 out of 6 children dies before his or her fifth birthday. There are regional differentials in under-five mortality in the country with Northeast having the highest rate while Southwest has the lowest rate. Little effort has been made to examine the socio-demographic factors that contribute to these differentials. This study shows that 1 in every 10 women in Southwest has higher education while only 1% of women in Northeast have higher education. In terms of wealth index, women in Southwest are better off. This is so because 47% of women in Northeast are found in the poorest category while only 5% of women in Southwest belong to this group. The place of residence shows that 75% of the women from Northeast live in the rural area while 1 in every 2 women in Southwest lives in urban area. The study also shows that the factors responsible for the under-five mortality differentials in Northeast and Southwest include mother’s education, place of residence, antenatal care, wealth index and preceding birth interval.

According to the latest reports submitted to the international community, Southern Cone countries (Argentina, Brazil, Chile and Uruguay) have shown a noticeable decrease in the level of mortality in children under the age of 5, which grants them conditions to fulfill the goals to reduce child mortality set at their adhesion to the Millennium Summit (2000). Notwithstanding these predictions, said reports, in general, do not address in detail the problems of differences inside the countries and of preventable deaths, two issues which are essential to study to what extent the advances linked to development have enabled the joint realization of human rights. In order to give an answer to this, we refer to the information produced by the national vital statistics offices, and we apply several measures to this information which allow for estimation of differences between social, geographical and cultural sectors (and the temporal dynamics they describe). Likewise, we try to identify preventable deaths and their composition in order to determine the role of the population; so as to give continuity to the decreasing trend in the level of deaths occurring during the early years of life.

Fagbamigbe A. F., Adebowale A. S., Alabi O.
Abstract
Infant mortality rate (IMR) is a demographic measure and important health and economic indicator. The Nigeria Demographic and Household Survey (NDHS, 2008) declared wide difference between IMR in North East (NE) and South West (SW). This study assessed the zonal differences and determined factors affecting IMR in the zones.
This is a cross sectional study of nationally representative NDHS, 2008 data using recoded data of 164,209 and 82,744 children from NE and SW Nigeria respectively. We censored and weighted the data and analyzed using descriptive, bivariate statistics and binary logistic regression with p-value=0.05.
Mean age of mothers at first birth was 17.84(3.40) and 20.65(4.25) years respectively (p<0.05) nearly 74% of children from NE are from uneducated mothers compared to 6.88% in the SW (p<0.05). Almost half (46.48%) of children from NE had poorest wealth index compared to 6.50% in SW (p<0.05). The IMR among children from teenager mothers is 21 and 9 per 1000 live births in NE and SW respectively, 10 for urban NE, 6 for urban NE, 12 for rural NE and 9 for rural SW (p<0.05).
Efforts should be directed at in reducing the IMR in NE through education, economic empowerment and delayed childbearing.
Key world: Infant Mortality Rate, NDHS, Wealth index

Three neonates are dying every minute in India and every 4th baby born is low birth weight out of 3.9 million neonatal deaths worldwide, India is accounting 1.2 million or nearly 30 percent of global neonatal mortality. In India 39 % of neonatal death occurs within 24 hour of the birth and 57.5% death occurs within first three days. The purpose of this study is to examine the effect of maternal health care utilization on early neonatal, neonatal and post neonatal mortality in India. Data from the cross –sectional, population based NFHS-3(2005-06) was used. Both bi-variate and multivariate techniques were used to examine the effect of antenatal care, safe delivery and post natal care on early neonatal, neonatal and post neonatal mortality. The result of the logistic regression shows that ante natal care has significant impact on early neonatal and neonatal mortality and it is also found that public hospital less relative risk than private sector deliveries. Those women who had taken the post natal care the risk of early neonatal, neonatal and post neonatal are less likely in comparison to those who not received the post natal care.

This study aimed to investigate the progress in gender differential in child mortality in
India and factors explaining it. Based on the analyses of three rounds of National Family
Health Survey data the findings suggest that there is a positive change in the scenario of
child mortality from 1992 to 2006 where, though, largely female child is at higher risk but
there is a decline in the risk. The decomposition analyses suggest that demographic
variables such as breastfeeding, birth order, antenatal care and mother’s age emerged as
critical contributors for excess female child mortality compared to socioeconomic
variables. Overall, the results foster that the gender discrimination is mainly operating
through provision of breastfeeding and negligence of higher order female births. The study
also foster that discrimination of higher order female birth mainly operates in terms of
health care provisions and allocation of intra-household resources.

Latin American has come a long a long way in reducing child mortality in during the last 60 years, decreasing, as a region, from a Q(5) [probability of dying before age 5] of 191 per thousand in 1950 to 31 per thousand nowadays, according to the latest estimations by CELADE-ECLAC. However, there is evidence of unequal decrease among countries.
As well as differences observed in the decrease rhythm among countries, there are significant differences within countries by regions or by socioeconomic conditions. In this paper, the researchers use census microdata from two Latin American countries (Mexico and Brazil), from the 1980, 1990 and 2000 census rounds, with the aim of estimating a model describing the gap trend in Q(5) by years of study of the mother. Using the estimated model, projections are made for gaps up to the latest census (2010 round) and achievements are evaluated, in terms of gap reduction, establishing whether the rhythm followed the expected trend, whether the rhythm was faster or whether a stalling is observed. Inferences can be made on the gaps evolution comparing population groups, as well as the validity of the variable used to measure more or less vulnerable groups regarding child mortality.

This paper has two objectives: to present a detailed demographic analysis of the changing patterns of neonatal mortality in the rural parishes of Veneto region during the first demographic transition, and to provide a definitive answer to the unresolved debate of impact of baptismal practices on mortality.
The analysis is developed using data related to children born between
1816 and 1866 in rural and urban parishes of the province of Padua. Such unpublished information come from asburgical parochial archives found in reference parishes.
Cox proportional-hazards regression models investigate the risk of dying during the week after baptism. A specific analysis has been computed using data on
baptism, to understand if the risk of dying of a child increases with the rising of
time spend from birth to baptism.
A strong relation between seasonality and death emerges from
models. Neonatal mortality reaches its peaks during winter season. Environmental
factors seem to have an impact on death: the parish of birth clearly confirms differences in the risk of dying. While we can affirm the presence of interaction
between baptismal practices and seasonality on explain risk of dying, we can only provide tentative results on the effect of baptismal practices on risk of death.

The Infant Mortality Rate (IMR) is universally regarded not only as an important indicator of the health status of a community but also of the level of living of people. Infant mortality has decreased worldwide including India. However, the fall has slowed down and the level is yet much above MDG. In this scenario, we have attempted to find the plausible ways to prevent infant mortality using the National Family Health Survey – Round 3 (NFHS-3) data. Taking survival of an infant as the dependent variable and the various types of prenatal and delivery-time care, the economic condition of infant’s parents, birth-spacing, education of mother as independent variables binary logistic regression has been done to find out means of improving infant’s health.

It is evident from our study that taking assistance from doctors during the prenatal period, delivery of the baby at a government hospital/health-center/ maternity center etc or at private hospitals/nursing-home, use of clean blade to cut the umbilical cord and use of disposable delivery kit can reduce the infant mortality significantly. Satisfactory employment status of infant’s father increases chance of infant survival. Birth-spacing of minimum 3 to 4 years and education of mother over 10 years are two other important factors that improve infant survival.

Most of the demographic researches on fertility, reproductive health and contraception focus on females of particular age group especially who are in their reproductive period. Important demographic indicators like fertility, contraception and mortality etc. are estimated on the basis of reporting of the eligible female respondent. But how reliable is the reporting of the wife regarding death of the child? Recently the focus of demographic and health surveys has shifted from being woman centric to couple centric where the couple is taken as a sing unit. The available literature on the subject is also scanty. Hence, this particular study makes an attempt in exploring the matching and mismatch among couples in reporting of the death of the child. The present study analyses the couples information by using a nationally representative sample size of the third round of National Family Health Survey(NFHS-3, 2005-06). Information regarding death is collected both from the husband as well as wife. In India mismatch in reporting of total children died is almost 24 percent of which 14 percent women reported less than their husbands and remaining 10 percent reported higher than their husbands.