Do hot-spots of maternal mortality ratio exist in india? A district-level spatial analysis

Puranik, Amitha; Nair, Suma; Biju, Seena

doi:10.47203/ijch.2017.v29i04.006

Cited by 3 publications

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“…Regarding the number of ANC visits during pregnancy as a significantly associated factor of infant mortality, the odds of infant mortality among infants born to mothers who had no ANC visit during pregnancy were higher when compared to those who have four and above ANC visits. This was supported by other studies [ 21 , 28 , 29 ]. It could be due to the reason that ANC utilization is an input for the other maternal health services, and mothers who had no ANC contact with a skilled health professional are not aware of danger signs of pregnancy and underlying medical conditions that could cause low birth weight, prematurity and congenital anomalies which may intern lead to the death of their infant [ 30 ].…”

Section: Discussionsupporting

confidence: 90%

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey

et al. 2023

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Introduction Infant mortality declined globally in the last three decades. However, it is still a major public health concern in Ethiopia. The burden of infant mortality varies geographically with the highest rate in Sub-Saharan Africa. Although different kinds of literature are available regarding infant mortality in Ethiopia, an up to date information is needed to design strategies against the problem. Thus, this study aimed to determine the prevalence, show the spatial variations and identify determinants of infant mortality in Ethiopia. Methods The prevalence, spatial distribution, and predictors of infant mortality among 5,687 weighted live births were investigated using secondary data from the Ethiopian Demographic and Health Survey 2019. Spatial autocorrelation analysis was used to determine the spatial dependency of infant mortality. The spatial clustering of infant mortality was studied using hotspot analyses. In an unsampled area, ordinary interpolation was employed to forecast infant mortality. A mixed multilevel logistic regression model was used to find determinants of infant mortality. Variables with a p-value less than 0.05 were judged statistically significant and adjusted odds ratios with 95 percent confidence intervals were calculated. Result The prevalence of infant mortality in Ethiopia was 44.5 infant deaths per 1000 live births with significant spatial variations across the country. The highest rate of infant mortality was observed in Eastern, Northwestern, and Southwestern parts of Ethiopia. Maternal age between 15&19 (adjusted odds ratio (AOR) = 2.51, 95% Confidence Interval (CI): 1.37, 4.61) and 45&49(AOR = 5.72, 95% CI: 2.81, 11.67), having no antenatal care follow-up (AOR = 1.71, 95% CI: 1.05, 2.79) and Somali region (AOR = 2.78, 95% CI: 1.05, 7.36) were significantly associated with infant mortality in Ethiopia. Conclusion In Ethiopia, infant mortality was higher than the worldwide objective with significant spatial variations. As a result, policy measures and strategies aimed at lowering infant mortality should be devised and strengthened in clustered areas of the country. Special attention should be also given to infants born to mothers in the age groups of 15–19 and 45–49, infants of mothers with no antenatal care checkups, and infants born to mothers living in the Somali region.

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Section: Discussionsupporting

confidence: 90%

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey

et al. 2023

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“…Experts have acknowledged that reproductive health, child health and nutrition are some of the greatest challenges for India 14 . Strong evidence of district-level inequality in maternal mortality rates 15 and under-five child and infant mortality rates [16][17][18][19] exists. Similar evidence of high inequality across districts exists for maternal health care utilization that includes indicators like antenatal and post natal care, institutional birth or delivery in the presence of skilled birth attendants 14,[20][21][22][23][24][25][26] .…”

Section: Introductionmentioning

confidence: 99%

Health Impact Evaluation of Aspirational Districts Program in India: Evidence from National Family Health Survey

Agarwal,

Mishra

2023

Preprint

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Background: Aspirational Districts (ADs) initiative was launched by Government of India in 2018 with the objective of reducing inter-district economic and social inequalities with health and nutrition, education, agriculture and water resources, financial inclusion and skill development and infrastructure as the focus areas for development. 117 most backward districts across the country were identified as aspirational districts (ADs) which received priority in funding and scheme implementation so that these districts can catch up with the rest of the districts. We conduct an impact evaluation of the AD initiative on the health and nutrition outcomes. Methods: The research employed a quasi-experimental approach, utilizing the difference-in-differences (DID) method and another method that combined propensity score matching with DID. Findings: The research found a positive impact of the AD program on maternal health through an increase in the percentage of home births attended by Skilled Birth Attendants (SBA) in the Aspirational Districts (ADs) by on an average 1.26% in the ADs. In addition, with respect to family planning an increase of 0.44% was found in percent of male sterilization. Additionally, weak evidence suggests a 3% improvement in ADs for immunization against the first dose of measles vaccine and three doses of penta or hepatitis B vaccine was observed. No strong evidence of adverse impacts of the AD initiative exist. Interpretation The Aspirational District (AD) initiative, a flagship program of the Indian government, aims to address inter-district economic and social inequalities. Our research evaluated the impact of AD on health and nutrition outcomes. Using PSM-DID, we found significant improvements in home births attended by skilled birth attendants and an increase in percentage of male sterilization in ADs. No strong evidence of any adverse impact of AD was observed. Covid-19 pandemic and inter-sector competition for resources within a district might have undermined the performance of ADs on health and nutrition outcomes. Future research efforts should be put for a holistic impact evaluation of all the targeted sectors and outcomes of the AD initiative. Funding: None Keywords: Aspirational Districts Programme, Inequality, Difference-in-differences (DID), Propensity score matching (PSM) PSM-DID, Full matching method, Average Treatment Effect in Treated (ATT), National Family Health Survey

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“…It reflects the effect of economic and social conditions on the health of mothers and newborn babies, as well as the effectiveness of the health systems in a country/region. [ 1 ] Infant mortality, measured as Infant Mortality Rate (IMR) is the probability of a child born in a specific year or period dying before reaching the age of one year. Infant Mortality Rate is expressed mathematically as the number of children dying before one year of age per 1000 of live births during a fixed time period.…”

Section: Introductionmentioning

confidence: 99%

“…The ability of the spatial analysis to identify the existing and potential clusters aids in better allocation of resources and intervention to such areas for effective utilization of available resources improving cost-effectiveness of the policy or program. [ 1 , 7 ]…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Profile and Spatio-Temporal Pattern of Infant Deaths in a District of North India during 2016-2019

Sachdeva

Verma

Agrawal

et al. 2023

Indian Journal of Community Medicine

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Background: Infant mortality is an important health indicator of a population given its strong link to socioeconomic status, health service access, and quality and maternal health. The declining trend of Infant Mortality Rate has been observed in India where it reduced from 89 deaths per 1000 live births in 1990 to 28 deaths per 1000d live births in 2019. Most of the studies regarding the trend of infant mortality are state-based, however, state-level infant mortality has masked the intradistrict clustering of individual infant deaths. Hence, this study was planned with an objective to study the trend of infant mortality at the district level. Material and Methods: A retrospective study was conducted in the district Rohtak of Haryana using the data collected regarding infant deaths. The collected data regarding addresses were geocoded. The resulting layer was then analyzed using QGIS v3.10. The descriptive data was analyzed using SPSS v20.0. Result: In total, 1336 infant deaths during the study period were included. A declining trend of infant mortality was observed over the study period. The number of grids (25 km 2 ) reduced from 18 in 2016 to 10 in 2019 depicting a reduction in the areas with more than expected count. Conclusion: This study emphasizes on the importance of using the geographic information science technique in identifying local hotspots within the district so as to find areas that need more support and observation.

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Do hot-spots of maternal mortality ratio exist in india? A district-level spatial analysis

Cited by 3 publications

References 0 publications

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey

Prevalence, spatial distribution and determinants of infant mortality in Ethiopia: Findings from the 2019 Ethiopian Demographic and Health Survey

Health Impact Evaluation of Aspirational Districts Program in India: Evidence from National Family Health Survey

Epidemiological Profile and Spatio-Temporal Pattern of Infant Deaths in a District of North India during 2016-2019

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