TY - JOUR
T1 - Socioeconomic factors contributing to under-five mortality in sub-Saharan Africa
T2 - A decomposition analysis
AU - Van Malderen, Carine
AU - Amouzou, Agbessi
AU - Barros, Aluisio J.D.
AU - Masquelier, Bruno
AU - Van Oyen, Herman
AU - Speybroeck, Niko
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/6/14
Y1 - 2019/6/14
N2 - 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.
AB - 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.
KW - Gini decomposition
KW - Poisson regression
KW - Socioeconomic inequalities
KW - Sub-Saharan Africa
KW - Under-five mortality
UR - http://www.scopus.com/inward/record.url?scp=85067304266&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067304266&partnerID=8YFLogxK
U2 - 10.1186/s12889-019-7111-8
DO - 10.1186/s12889-019-7111-8
M3 - Article
C2 - 31200681
AN - SCOPUS:85067304266
SN - 1471-2458
VL - 19
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 760
ER -