Trends and social differentials in child mortality inRwanda 1990–2010: results from three demographicand health surveys

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Musafili, Aimable,1972-Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition (författare)

Trends and social differentials in child mortality inRwanda 1990–2010 : results from three demographicand health surveys

Artikel/kapitelEngelska2015

Förlag, utgivningsår, omfång ...

2015-04-13
BMJ,2015
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-251290
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-251290URI
https://doi.org/10.1136/jech-2014-204657DOI

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Språk:engelska
Sammanfattning på:engelska

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Background Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. Methods We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 and 2010 in Rwanda. These surveys included 34 790 children born between 1990 and 2010 to women aged 15-49 years. The main outcome measures were neonatal mortality rates (NMR) and under-5 mortality rates (U5MR) over time, and in relation to mother's educational level, urban or rural residence and household wealth. Generalised linear mixed effects models and a mixed effects Cox model (frailty model) were used, with adjustments for confounders and cluster sampling method. Results Mortality rates in Rwanda peaked in 1994 at the time of the genocide (NMR 60/1000 live births, 95% CI 51 to 65; U5MR 238/1000 live births, 95% CI 226 to 251). The 1990s and the first half of the 2000s were characterised by a marked rural/urban divide and inequity in child survival between maternal groups with different levels of education. Towards the end of the study period (2005-2010) NMR had been reduced to 26/1000 (95% CI 23 to 29) and U5MR to 65/1000 (95% CI 61 to 70), with little or no difference between urban and rural areas, and household wealth groups, while children of women with no education still had significantly higher U5MR. Conclusions Recent reductions in child mortality in Rwanda have concurred with improved social equity in child survival. Current challenges include the prevention of newborn deaths.

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Biuppslag (personer, institutioner, konferenser, titlar ...)

Essén, Birgitta,1961-Uppsala universitet,Internationell kvinno- och mödrahälsovård och migration(Swepub:uu)bires412 (författare)
Baribwira, CyprienMaternal and Child Health, Pediatric HIV-AIDS, PMTCTRwanda Program of the Institute of Human Virology, School of Medicine, University of Maryland, Kigali, Rwanda (författare)
Binagwaho, AgnesMinistry of Health, Kigali, Rwanda (författare)
Persson, Lars-Åke,1947-Uppsala universitet,Internationell barnhälsa och nutrition(Swepub:uu)laper499 (författare)
Ekholm Selling, Katarina,1976-Uppsala universitet,Internationell barnhälsa och nutrition,Internationell barnhälsa och nutrition/Persson(Swepub:uu)katse272 (författare)
Uppsala universitetInternationell mödra- och barnhälsovård (IMCH) (creator_code:org_t)

Sammanhörande titlar

Ingår i:Journal of Epidemiology and Community Health: BMJ69:9, s. 834-8400143-005X1470-2738

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Folkhälsovetensk ...

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Av lärosätet: Uppsala universitet

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