Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa: A decomposition analysis

Carine Van Malderen, Agbessi Amouzou, Aluisio J.D. Barros, Bruno Masquelier, Herman Van Oyen, Niko Speybroeck

Research output: Contribution to journalArticle

Abstract

Background: In sub-Saharan Africa, socioeconomic factors such as place of residence, mother's educational level, or household wealth, are strongly associated with risk factors of under-five mortality (U5M) such as health behavior or exposure to diseases and injuries. The aim of the study was to assess the relative contribution of four known socioeconomic factors to the variability in U5M in sub-Saharan countries. Methods: The study was based on birth histories from the Demographic and Health Surveys conducted in 32 sub-Saharan countries in 2010-2016. The relative contribution of sex of the child, place of residence, mother's educational level, and household wealth to the variability in U5M was assessed using a regression-based decomposition of a Gini-type index. Results: The Gini index-measuring the variability in U5M related to the four socioeconomic factors-varied from 0.006 (95%CI: 0.001-0.010) in Liberia 2013 to 0.034 (95%CI: 0.029-0.039) in Côte d'Ivoire 2011/12. The main contributors to the Gini index (with a relative contribution higher than 25%) were different across countries: mother's educational level in 13 countries, sex of the child in 12 countries, household wealth in 11 countries, and place of residence in 8 countries (in some countries, more than one main contributor was identified). Conclusions: Factors related to socioeconomic status exert varied effects on the variability in U5M in sub-Saharan African countries. The findings provide evidence in support of prioritizing intersectoral interventions aiming at improving child survival in all subgroups of a population.

Original languageEnglish (US)
Article number760
JournalBMC public health
Volume19
Issue number1
DOIs
StatePublished - Jun 14 2019

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Africa South of the Sahara
Mothers
Mortality
Liberia
Reproductive History
Health Behavior
Social Class
Demography
Wounds and Injuries
Population

Keywords

  • Gini decomposition
  • Poisson regression
  • Socioeconomic inequalities
  • Sub-Saharan Africa
  • Under-five mortality

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa : A decomposition analysis. / Van Malderen, Carine; Amouzou, Agbessi; Barros, Aluisio J.D.; Masquelier, Bruno; Van Oyen, Herman; Speybroeck, Niko.

In: BMC public health, Vol. 19, No. 1, 760, 14.06.2019.

Research output: Contribution to journalArticle

Van Malderen, Carine ; Amouzou, Agbessi ; Barros, Aluisio J.D. ; Masquelier, Bruno ; Van Oyen, Herman ; Speybroeck, Niko. / Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa : A decomposition analysis. In: BMC public health. 2019 ; Vol. 19, No. 1.
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abstract = "Background: In sub-Saharan Africa, socioeconomic factors such as place of residence, mother's educational level, or household wealth, are strongly associated with risk factors of under-five mortality (U5M) such as health behavior or exposure to diseases and injuries. The aim of the study was to assess the relative contribution of four known socioeconomic factors to the variability in U5M in sub-Saharan countries. Methods: The study was based on birth histories from the Demographic and Health Surveys conducted in 32 sub-Saharan countries in 2010-2016. The relative contribution of sex of the child, place of residence, mother's educational level, and household wealth to the variability in U5M was assessed using a regression-based decomposition of a Gini-type index. Results: The Gini index-measuring the variability in U5M related to the four socioeconomic factors-varied from 0.006 (95{\%}CI: 0.001-0.010) in Liberia 2013 to 0.034 (95{\%}CI: 0.029-0.039) in C{\^o}te d'Ivoire 2011/12. The main contributors to the Gini index (with a relative contribution higher than 25{\%}) were different across countries: mother's educational level in 13 countries, sex of the child in 12 countries, household wealth in 11 countries, and place of residence in 8 countries (in some countries, more than one main contributor was identified). Conclusions: Factors related to socioeconomic status exert varied effects on the variability in U5M in sub-Saharan African countries. The findings provide evidence in support of prioritizing intersectoral interventions aiming at improving child survival in all subgroups of a population.",
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