Knowledge into action for child survival

Claeson, Mariam; Gillespie, Duff; Mshinda, Hassan; Troedsson, Hans; Victora, Cesar G

doi:10.1016/s0140-6736(03)13977-3

Cited by 176 publications

(32 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1–5 The UN Commission for Accountability for Women’s and Children’s Health is a further reminder of intensified interest, along with numerous initiatives from donor organisations. 4,6,7 Global interest in child mortality reduction is not new; the child survival revolution, 8 Jim Grant’s pioneering work at UNICEF on child interventions, 9 and the Health for All by the Year 2000 campaign 10 are examples of the worldwide focus on improvement of child survival that began more than three decades ago. Key actors such as the governments of the USA, Ethiopia, and India, together with UNICEF, are arguing for a continued post-2015 focus on further reductions in child mortality to eliminate all child deaths from preventable causes by 2035.…”

Section: Introductionmentioning

confidence: 99%

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

et al. 2014

View full text Add to dashboard Cite

Summary Background Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. Methods We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. Findings We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Interpretation Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 20...

show abstract

Section: Introductionmentioning

confidence: 99%

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Globally, malnutrition (mild to severe) is associated with about 60 percent of all childhood deaths. 4 Poor nutrition during childhood also causes severe cognitive and physical damage. Moreover, poor nutrition and health among children contribute to the general inefficiency of education systems worldwide.…”

Section: Introductionmentioning

confidence: 99%

Analysis on the association among stunting, wasting and underweight in Malawi: an application of a log-linear model for the three-way table

Ngwira

Munthali

Vwalika

2017

J Public Health Afr

View full text Add to dashboard Cite

Childhood undernutrition is an important public health problem. Many studies have investigated the factors of childhood undernutrition, but not the association between the undernutrition indicators. This study aimed at investigating the association between the childhood undernutrition indicators. A loglinear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2010 Malawi demographic health survey data. Interaction terms in the model depicted deviations from independence. A multiple correspondence analysis of undernutrition indicators was also plotted to have a visual impression of association of the undernutrition variables. A loglinear model showed that underweight was associated with both stunting (P<0.001), and wasting (P<0.001). There was no association between stunting and wasting (P=1). Furthermore there was no three way association of stunting, wasting and underweight (P=1). Lack of three way interaction of stunting, wasting and underweight means that childhood undernutrition multidimensional nature is still valid, and no each indicator can represent the other.

show abstract

“…However, there have been few studies which have examined associations between access to health care and child health outcomes in remote areas of Africa. The only data available are imprecise estimates derived from statistical models [7]–[9] and the impact of health system interventions for children under five years in remote African regions with high mortality remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study

et al. 2012

View full text Add to dashboard Cite

BackgroundThere have been few studies that have examined associations between access to health care and child health outcomes in remote populations most in need of health services. This study assessed the effect of travel time and distance to health facilities on mortality in children under five years in a remote area of rural north-western Ethiopia.Methods and FindingsThis study involved a randomly selected cross sectional survey of 2,058 households. Data were collected during home visits to all resident women of reproductive age (15–49 years). A geographic information system (GIS) was used to map all households and the only health centre in the district. The analysis was restricted to 2,206 rural children who were under the age of five years during the five years before the survey. Data were analysed using random effects Poisson regression. 90.4% (1,996/2,206) of children lived more than 1.5 hours walk from the health centre. Children who lived ≥1.5 hrs from the health centre had a two to three fold greater risk of death than children who lived <1.5 hours from the health centre (children with travel time 1.5–<2.5 hrs adjusted relative risk [adjRR] 2.3[0.95–5.6], travel time 2.5–<3.5 hrs adjRR 3.1[1.3–7.4] and travel time 3.5–<6.5 hrs adjRR 2.5[1.1–6.2]).ConclusionDistance to a health centre had a marked influence on under five mortality in a poor, rural, remote area of Ethiopia. This study provides important information for policy makers on the likely impact of new health centres and their most effective location in remote areas.

show abstract

Knowledge into action for child survival

Cited by 176 publications

References 8 publications

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Analysis on the association among stunting, wasting and underweight in Malawi: an application of a log-linear model for the three-way table

Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional Study

Contact Info

Product

Resources

About