Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Adjuik, Martin; Kanyomse, Ernest; Kondayire, Felix; Wak, George; Hodgson, Abraham

doi:10.3402/gha.v3i0.5233

Cited by 15 publications

(12 citation statements)

References 11 publications

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“…The finding of clustered under‐5 mortality rates (Figure ) is consistent with what has been observed in other HDSSs . It will be important for researchers and public health officials to use HDSS data to monitor how the clustering of mortality changes over time.…”

Section: Discussionsupporting

confidence: 82%

“…Georeferenced longitudinal data from Health and Demographic Surveillance Systems (HDSSs) have the potential to yield important insights into the location and causes of death in low‐income countries. Over the past 4 years, 11 HDSSs in the International Network for Demographic Evaluation of Populations and their Health (INDEPTH) have published studies on the spatial clustering of under‐5, child or infant mortality . The populations resident in these HDSSs range in size from 8000 to 416 000, and the land areas range from 100 to 1800 km 2 .…”

Section: Introductionmentioning

confidence: 99%

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Spatial analysis of under‐5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia

Quattrochi

Jasseh

Mackenzie

et al. 2015

Tropical Med Int Health

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Abstractobjectives To describe the spatial pattern in under-5 mortality rates in the Basse Health and Demographic Surveillance System (BHDSS) and to test for associations between under-5 deaths and biodemographic and socio-economic risk factors.methods Using data on child survival from 2007 to 2011 in the BHDSS, we mapped under-5 mortality by km 2 . We tested for spatial clustering of high or low death rates using Kulldorff's spatial scan statistic. Associations between child death and a variety of biodemographic and socio-economic factors were assessed with Cox proportional hazards models, and deviance residuals from the bestfitting model were tested for spatial clustering.results The overall death rate among children under 5 was 0.0195 deaths per child-year. We found two spatial clusters of high death rates and one spatial cluster of low death rates; children in the two high clusters died at a rate of 0.0264 and 0.0292 deaths per child-year, while in the low cluster, the rate was 0.0144 deaths per child-year. We also found that children born to Fula mothers experienced, on average, a higher hazard of death, whereas children born in the households in the upper two quintiles of asset ownership experienced, on average, a lower hazard of death. After accounting for the spatial distribution of biodemographic and socio-economic characteristics, we found no residual spatial pattern in child mortality risk.conclusion This study demonstrates that significant inequality in under-5 death rates can occur within a relatively small area (1100 km 2 ). Risks of under-5 mortality were associated with mother's ethnicity and household wealth. If high mortality clusters persist, then equity concerns may require additional public health efforts in those areas.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Spatial analysis of under‐5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia

Quattrochi

Jasseh

Mackenzie

et al. 2015

Tropical Med Int Health

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“…Ghana is one of the SSA countries that demonstrated progress in key maternal and neonatal health indicators although it faces challenges to meet the MDG 4 and 5 targets [ 16 – 20 ]. Although Ghana’s under-five mortality ratio fell by 40% from 128 per 1,000 live births in 1990 to 78 per 1,000 live births in 2013, it is still globally ranked among the highest [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors

et al. 2015

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BackgroundSlow progress has been made in achieving the Millennium Development Goals 4 and 5 in Ghana. Ensuring continuum of care (at least four antenatal visits; skilled birth attendance; postnatal care within 48 hours, at two weeks, and six weeks) for mother and newborn is crucial in helping Ghana achieve these goals and beyond. This study examined the levels and factors associated with continuum of care (CoC) completion among Ghanaian women aged 15–49.MethodsA retrospective cross-sectional survey was conducted among women who experienced live births between January 2011 and April 2013 in three regions of Ghana. In a two-stage random sampling method, 1,500 women with infants were selected and interviewed about maternal and newborn service usage in line with CoC. Multiple logistic regression models were used to assess factors associated with CoC completion.ResultsOnly 8.0% had CoC completion; the greatest gap and contributor to the low CoC was detected between delivery and postnatal care within 48 hours postpartum. About 95% of women had a minimum of four antenatal visits and postnatal care at six weeks postpartum. A total of 75% had skilled assisted delivery and 25% received postnatal care within 48 hours. Factors associated with CoC completion at 95% CI were geographical location (OR = 0.35, CI 0.13–0.39), marital status (OR = 0.45; CI 0.22–0.95), education (OR = 2.71; CI 1.11–6.57), transportation (OR = 1.97; CI 1.07–3.62), and beliefs about childhood illnesses (OR = 0.34; CI0.21–0.61).ConclusionThe continuum of care completion rate is low in the study site. Efforts should focus on increasing postnatal care within 48 hours and overcoming the known obstacles to increasing the continuum of care completion rate.

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“…At the community, levels are socio-cultural norms that affect child healthcare and environmental characteristics such as the source of drinking water, sanitation and access to healthcare (Sastry, 1997a;Zenger, 1993). Several authors most of whom analysed data from health and demographic surveillance systems have also reported child death clustering from clusters of communities/villages (Adjuik, Kanyomse, Kondayire, Wak, & Hodgson, 2010;Alabi, Baloye, Doctor, & Oyedokun, 2016;Awini, Mattah, Sankoh, & Gyapong, 2010;Lutambi, Alexander, Charles, Mahutanga, & Nathan, 2010;Van Bodegom, Eriksson, Houwing-Duistermaat, & Westendorp, 2012). Few of these also identified poor infrastructural and environmental characteristics as the main predictors of spatial clustering of child mortality (Alabi et al, 2016;Awini et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Clustering of infant deaths among Nigerian women: investigation of temporal patterns using dynamic random effects model

Akinyemi

Odimegwu

Gbadebo

2019

Genus

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This study was conducted to estimate the magnitude of infant death clustering as well as the mortality risk associated with death of a preceding child and investigate how these have changed over three decades (1980-2013) in Nigeria. Birth history data from the Nigeria Demographic and Health Survey for 1990, 2003, 2008 and 2013 were analysed using dynamic random effects models. The effect of death of an immediate preceding child (sibling mortality correlation) was estimated by controlling for background characteristics and unobserved heterogeneity. A total of 232,090 single births to 56,123 women were analysed. Results showed that 13.2% in the oldest maternal cohort (≤ 1969) experienced death of at least two infants and they accounted for 40.2% of all infant deaths. Among the 1970-1979 maternal cohort, it was 8.6% and 31.6% respectively. In the youngest maternal cohort (≥ 1980), 3. 3% had recorded multiple infant deaths but accounted for 20.3%. Model results revealed that sibling mortality correlation increased the probability of infant death by 0. 080 and 0.061 in the 1980-1989 and 2010 birth cohorts respectively. There is a substantial level of infant death clustering in Nigeria, and this is closely driven by sibling mortality correlation both of which have declined very slowly over time. To achieve desired progress in child survival, death clustering should be addressed alongside other barriers to child survival.

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Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Cited by 15 publications

References 11 publications

Spatial analysis of under‐5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia

Spatial analysis of under‐5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia

Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors

Clustering of infant deaths among Nigerian women: investigation of temporal patterns using dynamic random effects model

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