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Distribution of und...
Distribution of under-5 deaths in the neonatal, postneonatal, and childhood periods : a multicountry analysis in 64 low- and middle-income countries
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- Li, Zhihui (författare)
- Tsinghua University
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- Karlsson, Omar (författare)
- Lund University,Lunds universitet,Ekonomisk-historiska institutionen,Ekonomihögskolan,Department of Economic History,Lund University School of Economics and Management, LUSEM,Harvard T.H. Chan School of Public Health
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- Kim, Rockli (författare)
- Harvard Center for Population and Development Studies,Korea University Ansan Hospital
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- Subramanian, SV (författare)
- Harvard T.H. Chan School of Public Health,Harvard Center for Population and Development Studies
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(creator_code:org_t)
- 2021-04-26
- 2021
- Engelska.
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 20:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://equityhealth...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: As under-5 mortality rates declined all over the world, the relative distribution of under-5 deaths during different periods of life changed. To provide information for policymakers to plan for multi-layer health strategies targeting child health, it is essential to quantify the distribution of under-5 deaths by age groups.METHODS: Using 245 Demographic and Health Surveys from 64 low- and middle-income countries conducted between 1986 and 2018, we compiled a database of 2,437,718 children under-5 years old with 173,493 deaths. We examined the share of deaths that occurred in the neonatal (< 1 month), postneonatal (1 month to 1 year old), and childhood (1 to 5 years old) periods to the total number of under-5 deaths at both aggregate- and country-level. We estimated the annual change in share of deaths to track the changes over time. We also assessed the association between share of deaths and Gross Domestic Product (GDP) per capita.RESULTS: Neonatal deaths accounted for 53.1% (95% confidence interval [CI]: 52.7, 53.4) of the total under-5 deaths. The neonatal share of deaths was lower in low-income countries at 44.0% (43.5, 44.5), and higher in lower-middle-income and upper-middle income countries at 57.2% (56.8, 57.6) and 54.7% (53.8, 55.5) respectively. There was substantial heterogeneity in share of deaths across countries; for example, the share of neonatal to total under-5 deaths ranged from 20.9% (14.1, 27.6) in Eswatini to 82.8% (73.0, 92.6) in Dominican Republic. The shares of deaths in all three periods were significantly associated with GDP per capita, but in different directions-as GDP per capita increased by 10%, the neonatal share of deaths would significantly increase by 0.78 percentage points [PPs] (0.43, 1.13), and the postneonatal and childhood shares of deaths would significantly decrease by 0.29 PPs (0.04, 0.54) and 0.49 PPs (0.24, 0.74) respectively.CONCLUSIONS: Along with the countries' economic development, an increasing proportion of under-5 deaths occurs in the neonatal period, suggesting a need for multi-layer health strategies with potentially heavier investment in newborn health.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Low- and middle-income countries
- Distribution of under-5 deaths
- Heterogeneity across countries
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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