Assessing sex differences in childhood mortality

Urban residents generally perform better on health indicators, leading to the belief that health conditions are better in urban areas. Urban averages, however, are deceiving. They can mask large differentials by SES and hide the problem of poor health among the impoverished. Uncovering the heterogeneity behind urban averages is crucial to improving health outcomes. This paper attempts to unmask these differentials, in the case of child malnutrition, in 16 Sub-Saharan African countries using data from Demographic and Health Surveys. Specifically, I will compare trends in malnutrition among the urban poor, urban non-poor, and rural residents. I include rural residents to assess how the urban-rural gap has changed. Because urban areas are diverse, I will examine trends in malnutrition by type of urban area (capital city vs. towns and cities). Using multilevel logistic regression, I will also test whether the urban poor have higher odds of malnutrition than the urban non-poor.

Recent demographic and health surveys have demonstrated massive declines in infant mortality in Kenya and Tanzania. This study employed survival analysis in order to demonstrate how various factors are related to infant mortality in Kenya and Tanzania. Level of education of the mother, occupation of the mother, region and birth order/preceding birth interval were found to be common factors explaining infant mortality in the duo. Unlike in Tanzania, old age at maternity was a significant determinant of infant mortality in Kenya. While the usage of well water was less likely to result to the death of a postneonate in Kenya, it was more likely to result to a postneonate death in Tanzania. The study backs up any health policy scheme that seeks to stimulate use of family planning methods to increase on birth spacing and reduce on higher order births that have been found to be significantly related to infant mortality at 0.01 significance levels.

Globally, about 7 million under-five children die every year. Meanwhile, family planning is recognized as the pillar of safe motherhood and improved child health outcomes. Evidence showed that promotion of family planning has the potential of averting 32% of all maternal deaths and 10% of childhood deaths. Thus, the relevant question would seem to suggest whether unmet needs for contraception could lead to increased risk of under-five mortality. The objective of this paper is to examine whether unmet needs for contraception could result in increased risk of under-five mortality in Nigeria. The study draws on 2008 Nigeria Demographic and Health Survey. Cox regression analysis was performed on a nationally representative sample of 28,647 children to examine the effect of contraceptive use and unmet need on child survival; while adjusting for the effects of other important covariates. Findings indicate a significantly lower risk of death for children whose mothers were using contraceptives (hazard ratio: 0.54,p<0.001); and for children whose mothers had no unmet need for contraception (hazard ratio 0.89,p<0.05) compared with those in the reference category. The findings of this study suggest the importance of contraceptive use in the pursuit of the Millennium Development Goal four in Nigeria.

Why is it that children who live with a single mother two cohabiting parents have poorer heath and developmental outcomes than children who live with two biological parents? Differential access to high quality and stable housing circumstances by family structure may be one important factor, especially in countries like the United States where housing costs are high and housing assistance is limited. Because family structure is strongly linked to income, married, two parent families are in a better position to be able to afford appropriate housing. Dissolution, more likely amongst unmarried parents, is likely to be linked to housing instability and moves into lower quality or public housing projects, both of which have been shown to be negatively associated with child outcomes. Using data from the Fragile Families and Child Wellbeing Study, this paper aims to identify whether and how housing and family circumstances are inter-related in the production of child health. Preliminary findings suggest strong links between family structure and housing tenure. For childhood asthma, housing tenure appears to be an important explanatory pathway, and children of social housing tenants appear particularly at risk.

The world population is galloping ahead at the rate of 100,000 births per day.More than two-third of these newborn will suffer from severe malnutrition.Majority of the malnourished will be born in overpopulated and underdeveloped countries.This paper studies the prevalence of malnutrition in India particularly, West Bengal.It shows the effect of demographic and socioeconomic variables on the nutritional condition of the child.Study uses secondary data of NFHS and the indices of child malnutrition are: stunting,wasting, and underweight.Methodology includes cross tabulation,Pearson’s chi-square and Logistic Regression.The prevalence of malnutrition is mainly due to retarded growth of height, (long term insufficient food intake).Children of 36-59months were found worst malnourished.Significant impact of breast feeding was found on underweight children.Sex of the child does not have much effect on the nutritional status.Mothers with higher education have shown better health status of child.It is high among children born within two years of a previous birth and children of higher birth orders.Malnutrition is common for children of underweight and anemic mothers.Interestingly it is found that overweight mothers are more likely to give birth to underweight children.
Keywords: Malnutrition,West Bengal,Regression,Health,Underweight

This study assesses the trends in child malnutrition by older surviving sibling composition during 1992-2007 in three South Asian countries, namely Bangladesh, India and Nepal. This study utilizes data from three rounds of Demographic and Health Surveys and considers weight-for-age as an indicator of child malnutrition based on 2006 WHO Standards. Combinations of sex composition of surviving older siblings were constructed. Cochran-Armitage and Chi squared statistics were applied to test linear and nonlinear trends respectively. Although child malnutrition declined during 1992-2007, result show an unacceptably higher prevalence of malnutrition in India (40%), followed by Bangladesh (37%) and Nepal (35%). Malnutrition has been lowest among boys and girls who did not have any older surviving siblings. However, the highest malnutrition was observed among those boys and girls who had at least one older surviving brother and sister. Findings confirm that not all girls and boys are treated equally, and there is a clear pattern of selective neglect in child malnutrition during 1992-2007.

If the omission/misreporting of ages of male/female children is assumed to be equal, child sex ratio is the result of sex ratio at birth and sex differential in mortality. This study aims to understand the impact of both the sex ratio at birth and sex differential in mortality on the change in child sex ratio during 2001-2011 in India and its major states. The result shows that in 2011, at the national level, the skewed child sex ratio could be explained due to distortion in sex ratio at birth by two-thirds and in high female child mortality by about one-third. Whereas, in 2001, the contribution of sex ratio at birth was two-fifths and the contribution of high female child mortality was three-fifths towards determining the child sex ratio.

Survival status of children is one of the indicators of socio-economic development of any given country. A number of developing countries are, however, unable to tackle causes of child morbidity and mortality due to poor public health measures and lack of access to health care facilities. The MDG4 set by the UN is to reduce child mortality level of 1990 by two-third by 2015. The main objective of this study is to identify determinants of child mortality in Ethiopia, and assess if the aforementioned goal is attainable using three rounds of the Demographic and Health Surveys conducted in 2000, 2005 and 2011. Data were analyzed using tabular and graphical methods, and an event history logistic regression model is fitted to identify factors associated with child survival. Results of the study reveal that Ethiopia is on track to achieve the child mortality goal but requires making extra efforts to reduce the excessive neonatal mortality. Significant differences in child mortality still prevail across the regions though the Health Extension Workers (HEWs) provide vaccination and treat child illnesses in rural Ethiopia. Enhancing the capacity of HEWs to manage obstetric care and ANC would ensure higher chances of survival of children in the future.

Bangladesh is one of the few developing countries that has been experiencing rapid urbanization. The paper examined the factors associated with infant mortality in urban area and health seeking behavior of the urban children. This study used data from the Bangladesh Urban and Health Survey 2006. Households’ socioeconomic status was measured using principal component analysis. Both descriptive and logistic regression analyses were used to assess the infant mortality differential of slum and non-slum areas. Infant mortality was astonishingly higher among the slum dwellers than among non-slum dwellers. The rich-poor gap in infant mortality is also significant. The prevalence of acute respiratory infection among the slum and non-slum children within two weeks preceding the survey was 14.3 percent and 10.8 percent respectively. In slum communities, children were 27 percent less likely to be taken to health facilities for treatment than non-slum communities. Wealth, migration status and the mother’s education are identified as important correlates of infant mortality. The findings of this study reveal that there are large differences in infant mortality rates between slum and non-slum urban areas. It will be difficult to achieve Millennium Development Goals if the government ignored the health care need of the urban poor.

The present study is an attempt to examine the factors affect on mortality of children under age three in Madhya Pradesh (a state in India) based on data collected from NFHS-III 2005-06. The differentials of mortality for children under age of three in Madhya Pradesh are observed as mother’s age at child birth, preceding birth interval, sex of child, birth order, mother’s work status, and economic standard of the household. The result clearly shows that child death increases with increase in birth order. Child death is also higher among the women belonging to household with low wealth index, younger and illiterate women than their counterparts. The multivariate survival analysis technique i.e. Cox proportional hazard model has been used to identify the determinants of children under age three mortality. The interesting finding shows that the relative importance of demographic factors in influencing child mortality supersedes the socio-economic factors. This study may help policy maker to take appropriate action against under-three mortality in the State Madhya Pradesh.