Service Quality beyond Access: A Multilevel Analysis of Neonatal, Infant, and Under-Five Child Mortality Using the Indian Demographic and Health Survey 2015~2016

Kim, Rockli; Choi, Narshil; Subramanian, S. V.; Oh, Juhwan

doi:10.16952/pns.2018.15.2.49

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…Tigray region had lower risk of under-five mortality compared to other regions except Addis Ababa city administration. This finding is in agreement with other studies which found that region is determinant factor of infant and under-five mortality in Ethiopia [ 5 , 7 , 9 , 27 , 32 ], Kenya [ 36 ], Nigeria [ 15 , 16 , 37 ], Mozambique [ 38 ], Ghana [ 23 , 39 ], India [ 40 ], and Bangladesh [ 24 ]. This might be because of difference in basic infrastructure distribution like health coverage and regional variations in economic development among regions.…”

Section: Discussionsupporting

confidence: 93%

“…The richest women had significant reduction in under-five mortality compared to the poorest women. This result agrees with various findings [ 14 , 16 , 24 , 26 , 35 , 40 , 42 , 43 ], but it disagrees with the finding of study conducted in Nigeria [ 29 ]. In Ethiopia, many previous related studies also showed that the variable wealth index was not significantly determined under-five mortality [ 31 , 41 , 44 , 45 ].…”

Section: Discussionsupporting

confidence: 78%

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Risk factors of under-five mortality in Ethiopia using count data regression models, 2021

Argawu¹,

Mekebo²

2022

Annals of Medicine &Amp; Surgery

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 78%

Risk factors of under-five mortality in Ethiopia using count data regression models, 2021

Argawu¹,

Mekebo²

2022

Annals of Medicine &Amp; Surgery

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“…And, Addis Ababa city had a lower U5M and higher in other four regions compared with the Tigray region. This finding is in agreement with other studies which found that there were regional variation for infant and under-five mortality in Ethiopia [5,7,9,27], Kenya [36], Nigeria [15,16,37], Mozambique [38], Ghana [23,39], India [40], and Bangladesh [24] showed that regional variation significantly affects U5M. These differences might be because of difference in basic infrastructure distribution like health coverage and regional variations in economic development.…”

Section: Plos Onesupporting

confidence: 92%

“…The richest women had significant reduction in under-five mortality with compared to the poorest women. This result agrees with various findings [14,16,24,26,35,40,[42][43][44]. Whereas, it is not agreed with a study conducted in Nigeria [29].…”

Section: Plos Onesupporting

confidence: 77%

Zero-inflated Poisson regression analysis of factors associated with under-five mortality in Ethiopia using 2019 Ethiopian mini demographic and health survey data

Argawu,

Mekebo

2023

PLoS ONE

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Background Remarkable reduction in global under-five mortality has been seen over the past two decades. However, Ethiopia is among the five countries which account for about half (49%) of all under-five mortality worldwide. This study aimed at identifying factors associated with under-five children mortality in Ethiopia using the 2019 Ethiopia mini demography and health survey data. Methods The most recent national representative demography and health survey data of Ethiopia, 2019 Ethiopia mini demography and health survey data, were used for this study. Count data regression models were applied to identify the factors associated with under-five children mortality. Statistical significance was declared at P-value less than 0.05. Results Zero-Inflated Poisson (ZIP) regression model was found to be the best model compared to other count regression models based on models comparison Criteria. The ZIP model revealed that decreased risk of under-five mortality was associated with mothers aged 25–34 years, unmarried mothers, mothers delivered in health facility, mothers used Pill/IUD, mothers who had larger number of children at home whereas increased risk of under-five mortality was associated with older mothers at their first births, mothers from rural areas, mothers travel for 1–30 min and >30 min to get drinking water, mothers used charcoal and wood, children with higher birth order and multiple births. Conclusions In this study, place of residence, region, place of delivery, religion, age of mother, mother’s age at first birth, marital status, birth order, birth type, current contraceptive type used, type of cooking fuel, time to get drinking water, and number of children at home were statistically significant factors associated with under-five mortality in Ethiopia. Thus, the Ethiopian Ministry of Health and other concerned bodies are recommended to encourage mothers to deliver at health institutions, give awareness for mothers to use Pill/IUD contraceptive type, and facilitate rural areas to have electricity and drinking water near to homes so as to minimize the under-five mortality to achieve the sustainable development goal.

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“…Most previous studies 9 , 10 , 11 on geographic variation of health system performance have focused on health outcomes of care, with process quality being only rarely examined in terms of geographic distribution. A few existing studies 12 , 13 on between-areas variation in process quality have relied on single-level analysis, such as national or state levels, which may conceal inequalities at lower levels.…”

Section: Introductionmentioning

confidence: 99%

Small Area Variation in the Quality of Maternal and Newborn Care in India

et al. 2022

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ImportanceIn India, the district serves as the primary policy unit for implementing and allocating resources for various programs aimed at improving key developmental and health indicators. Recent evidence highlights that high-quality care for mothers and newborns is critical to reduce preventable mortality. However, the geographic variation in maternal and newborn health service quality has never been investigated.ObjectiveTo examine the variation between smaller areas within districts in the quality of maternal and newborn care in India.Design, Setting, and ParticipantsThis cross-sectional study assessed data from women aged 15 to 49 years on the most recent birth (singleton or multiples) in the 5 years that preceded the fifth National Family Health Survey (June 17, 2019, to April 30, 2021).ExposuresMaternal and newborn care in 36 states and union territories (UTs), 707 districts, and 28 113 clusters (small areas) in India.Main Outcomes and MeasuresThe composite quality score of maternal and newborn care was defined as the proportion of components of care received of the total 11 essential components of antenatal and postnatal care. Four-level logistic and linear regression was used for analyses of individual components of care and composite score, respectively. Precision-weighted prevalence of each component of care and mean composite score across districts as well as their between–small area SD were calculated.ResultsThe final analytic sample for the composite score was composed of 123 257 births nested in 28 113 small areas, 707 districts, and 36 states/UTs. For the composite score, 58.3% of the total geographic variance was attributable to small areas, 29.3% to states and UTs, and 12.4% to districts. Of 11 individual components of care, the small areas accounted for the largest proportion of geographic variation for 6 individual components of care (ranging from 42.3% for blood pressure taken to 73.0% for tetanus injection), and the state/UT was the largest contributor for 4 components of care (ranging from 41.7% for being weighed to 52.3% for ultrasound test taken). District-level composite score and prevalence of individual care components and their variation across small areas within the districts showed a consistently strong negative correlation (Spearman rank correlation ρ = −0.981 to −0.886). Low-quality scores and large between–small area disparities were not necessarily concentrated in aspirational districts (mean district composite score [SD within districts], 92.7% [2.1%] among aspirational districts and 93.7% [1.8%] among nonaspirational districts).Conclusions and RelevanceThe findings of this cross-sectional study suggest that the policy around maternal and child health care needs to be designed more precisely to consider district mean and between–small area heterogeneity in India. This study may have implications for other low- and middle-income countries seeking to improve maternal and newborn outcomes, particularly for large countries with geographic heterogeneity.

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Service Quality beyond Access: A Multilevel Analysis of Neonatal, Infant, and Under-Five Child Mortality Using the Indian Demographic and Health Survey 2015~2016

Cited by 6 publications

References 35 publications

Risk factors of under-five mortality in Ethiopia using count data regression models, 2021

Risk factors of under-five mortality in Ethiopia using count data regression models, 2021

Zero-inflated Poisson regression analysis of factors associated with under-five mortality in Ethiopia using 2019 Ethiopian mini demographic and health survey data

Small Area Variation in the Quality of Maternal and Newborn Care in India

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