Decomposition analysis of the compositional and contextual factors associated with poor-non-poor inequality in diarrhoea among under-five children in low- and middle-income countries

Fagbamigbe, Adeniyi Francis; Ologunwa, Oluyemi Phillips; Afolabi, Esther Kikelomo; Fagbamigbe, Omon Stellamaris; Uthman, Olalekan A.

doi:10.1016/j.puhe.2020.12.009

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…Where is the sample size for group . Other model details have been reported [ 18 , 19 , 31 , 33 , 43 ]. The independent contribution of and to the gap are expressed as follows: …”

Section: Methodsmentioning

confidence: 99%

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

2022

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Background The burden of under-5 deaths is disproportionately high among poor households relative to economically viable ones in developing countries. Despite this, the factors driving this inequality has not been well explored. This study decomposed the contributions of the factors associated with wealth inequalities in under-5 deaths in low- and middle-income countries (LMICs). Methods We analysed data of 856,987 children from 66,495 neighbourhoods across 59 LMICs spanning recent Demographic and Health Surveys (2010-2018). Under-5 mortality was described as deaths among live births within 0 to 59 months of birth and it was treated as a dichotomous variable (dead or alive). The prevalence of under-five deaths was stratified using household wealth status. A Fairlie decomposition analysis was utilized to investigate the relative contribution of the factors associated with household wealth inequality in under-5 deaths at p<0.05. The WHO health equity assessment toolkit Plus was used to assess the differences (D) ratios (R), population attributable risk (PAR), and population attributable fraction (PAF) in household wealth inequalities across the countries. Results The proportion of children from poor households was 45%. The prevalence of under-5 deaths in all samples was 51 per 1000 children, with 60 per 1000 and 44 per 1000 among children from poor and non-poor households (p<0.001). The prevalence of under-5 deaths was higher among children from poor households than those from non-poor households in all countries except in Ethiopia, Tanzania, Zambia, Lesotho, Gambia and Sierra Leone, and in the Maldives. Thirty-four of the 59 countries showed significantly higher under-5 deaths in poor households than in non-poor households (pro-non-poor inequality) and no significant pro-poor inequality. Rural-urban contexts, maternal education, neighborhood socioeconomic status, sex of the child, toilet kinds, birth weight and preceding birth intervals, and sources of drinking water are the most significant drivers of pro-poor inequities in under-5 deaths in these countries. Conclusions Individual-level and neighbourhood-level factors were associated with a high prevalence of under-5 deaths among poor households in LMICs. Interventions in countries should focus on reducing the gap between the poor and the rich as well as improve the education and livelihood of disadvantaged people.

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“…Where is the sample size for group . Other model details have been reported [ 18 , 19 , 31 , 33 , 43 ]. The independent contribution of and to the gap are expressed as follows: …”

Section: Methodsmentioning

confidence: 99%

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

2022

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“…These proportions were categorised into two levels (low and high)using the 50th percentile cut-off to allow for non-linear effects and offer useful results for policy decisions. Similar procedures have been used in the literature [12][13][14].…”

Section: Variablesmentioning

confidence: 99%

“…This brings about the questions: what could be the drivers of high levels of parasitaemia and preventive methods utilisation, especially the LLIN? These are the questions that led to the search for the determinants of LLIN use and malaria parasitaemia in 13 Nigerian States with high malaria burden.…”

Section: Introductionmentioning

confidence: 99%

“…This is a typical scenario in the Nigerian context with a diverse ecological, socioeconomic and health system profile across different States and geopolitical zones. To generate evidence that can be used to design targeted interventions, this study focused on 13 States with a high prevalence of malaria. Four of these states had increased parasitaemia between 2015 and 2018, while the remaining nine experienced a decrease [4,11].…”

Section: Introductionmentioning

confidence: 99%

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Drivers of long-lasting insecticide-treated net utilisation and parasitaemia among under-five children in 13 States with high malaria burden in Nigeria

et al. 2022

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Background Although Nigeria has made some progress in malaria control, there are variations across States. We investigated the factors associated with utilisation of long-lasting insecticide-treated net (LLIN) and parasitaemia among under-five children in 13 States with high malaria burden. Method Data from the 2015 Nigeria Malaria Indicator Survey and 2018 Demographic and Health Survey were obtained and analysed. The 2015 and 2018 data were compared to identify States with increase or reduction in parasitaemia. Analysis was done for all the 13 study States; four States with increased parasitaemia and nine States with reduction. Random-effects logit models were fitted to identify independent predictors of LLIN utilisation and parasitaemia. Results LLIN was used by 53.4% of 2844 children, while parasitaemia prevalence was 26.4% in 2018. Grandchildren (AOR = 5.35, CI: 1.09–26.19) were more likely to use LLIN while other relatives (AOR = 0.33, CI: 0.11–0.94) were less likely compared to children of household-heads. LLIN use was more common in children whose mother opined that only weak children could die from malaria (AOR = 1.83, CI: 1.10–3.10). Children whose mothers obtained net from antenatal or immunisation clinics (AOR = 5.30, CI: 2.32–12.14) and campaigns (AOR = 1.77, CI: 1.03–3.04) were also more likely to use LLIN. In contrast, LLIN utilisation was less likely among children in female-headed households (AOR = 0.51, CI: 0.27–0.99) and those in poor-quality houses (AOR = 0.25, CI: 0.09–0.72). Children aged 24–59 months compared to 0–11 months (AOR = 1.78, CI: 1.28–2.48), those in whom fever was reported (AOR = 1.31, CI: 1.06–1.63) and children of uneducated women (AOR = 1.89, CI: 1.32–2.70) were more likely to have parasitaemia. The likelihood of parasitaemia was higher among children from poor households compared to the rich (AOR = 2.06, CI: 1.24–3.42). The odds of parasitaemia were 98% higher among rural children (AOR = 1.98, CI: 1.37–2.87). Conclusion The key drivers of LLIN utilisation were source of net and socioeconomic characteristics. The latter was also a key factor associated with parasitaemia. These should be targeted as part of integrated malaria elimination efforts.

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“…In addition, animal feces contain microorganisms capable of causing diarrheal disease [22]. According to WHO, about 1.87 million children die each year from causes related to diarrheal diseases, and approximately 88% of these deaths are associated with an unsafe water supply and poor sanitation and hygiene [23], [24].…”

Section: E Influence Of Anthropic Activities On the Water Quality Of The Chumbao Rivermentioning

confidence: 99%

The Influence of Anthropogenic Activities on the Concentration of Pesticides, Physicochemical and Microbiological Properties in the Chumbao River, Andahuaylas, Perú

Ligarda-Samanez¹,

Choque-Quispe²,

Ramos-Pacheco³

et al. 2021

International Journal on Advanced Science, Engineering and Information Technology

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Decomposition analysis of the compositional and contextual factors associated with poor-non-poor inequality in diarrhoea among under-five children in low- and middle-income countries

Cited by 9 publications

References 27 publications

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

Drivers of long-lasting insecticide-treated net utilisation and parasitaemia among under-five children in 13 States with high malaria burden in Nigeria

The Influence of Anthropogenic Activities on the Concentration of Pesticides, Physicochemical and Microbiological Properties in the Chumbao River, Andahuaylas, Perú

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