Cargando…
Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania
BACKGROUND: Disparities in health outcomes between the poor and the better off are increasingly attracting attention from researchers and policy makers. However, policies aimed at reducing inequity need to be based on evidence of their nature, magnitude, and determinants. OBJECTIVES: The study aims...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Co-Action Publishing
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556682/ https://www.ncbi.nlm.nih.gov/pubmed/23364083 http://dx.doi.org/10.3402/gha.v6i0.19278 |
_version_ | 1782257220160847872 |
---|---|
author | Nattey, Cornelius Masanja, Honorati Klipstein-Grobusch, Kerstin |
author_facet | Nattey, Cornelius Masanja, Honorati Klipstein-Grobusch, Kerstin |
author_sort | Nattey, Cornelius |
collection | PubMed |
description | BACKGROUND: Disparities in health outcomes between the poor and the better off are increasingly attracting attention from researchers and policy makers. However, policies aimed at reducing inequity need to be based on evidence of their nature, magnitude, and determinants. OBJECTIVES: The study aims to investigate the relationship between household socio-economic status (SES) and under-five mortality, and to measure health inequality by comparing poorest/least poor quintile mortality rate ratio and the use of a mortality concentration index. It also aims to describe the risk factors associated with under-five mortality at Rufiji Demographic Surveillance Site (RDSS), Tanzania. METHODS: This analytical cross sectional study included 11,189 children under-five residing in 7,298 households in RDSS in 2005. Principal component analysis was used to construct household SES. Kaplan–Meier survival incidence estimates were used for mortality rates. Health inequality was measured by calculating and comparing mortality rates between the poorest and least poor wealth quintile. We also computed a mortality concentration index. Risk factors of child mortality were assessed using Poisson regression taking into account potential confounders. RESULTS: Under-five mortality was 26.9 per 1,000 person-years [95% confidence interval (CI) (23.7–30.4)]. The poorest were 2.4 times more likely to die compared to the least poor. Our mortality concentration index [−0.16; 95% CI (−0.24, −0.08)] indicated considerable health inequality. Least poor households had a 52% reduced mortality risk [incidence rate ratio (IRR) = 0.48; 95% CI 0.30–0.80]. Furthermore, children with mothers who had attained secondary education had a 70% reduced risk of dying compared to mothers with no education [IRR = 0.30; 95% CI (0.22–0.88)]. CONCLUSION: Household socio-economic inequality and maternal education were associated with under-five mortality in the RDSS. Targeted interventions to address these factors may contribute towards accelerating the reduction of child mortality in rural Tanzania. |
format | Online Article Text |
id | pubmed-3556682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Co-Action Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-35566822013-01-28 Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania Nattey, Cornelius Masanja, Honorati Klipstein-Grobusch, Kerstin Glob Health Action Building New Knowledge Supplement BACKGROUND: Disparities in health outcomes between the poor and the better off are increasingly attracting attention from researchers and policy makers. However, policies aimed at reducing inequity need to be based on evidence of their nature, magnitude, and determinants. OBJECTIVES: The study aims to investigate the relationship between household socio-economic status (SES) and under-five mortality, and to measure health inequality by comparing poorest/least poor quintile mortality rate ratio and the use of a mortality concentration index. It also aims to describe the risk factors associated with under-five mortality at Rufiji Demographic Surveillance Site (RDSS), Tanzania. METHODS: This analytical cross sectional study included 11,189 children under-five residing in 7,298 households in RDSS in 2005. Principal component analysis was used to construct household SES. Kaplan–Meier survival incidence estimates were used for mortality rates. Health inequality was measured by calculating and comparing mortality rates between the poorest and least poor wealth quintile. We also computed a mortality concentration index. Risk factors of child mortality were assessed using Poisson regression taking into account potential confounders. RESULTS: Under-five mortality was 26.9 per 1,000 person-years [95% confidence interval (CI) (23.7–30.4)]. The poorest were 2.4 times more likely to die compared to the least poor. Our mortality concentration index [−0.16; 95% CI (−0.24, −0.08)] indicated considerable health inequality. Least poor households had a 52% reduced mortality risk [incidence rate ratio (IRR) = 0.48; 95% CI 0.30–0.80]. Furthermore, children with mothers who had attained secondary education had a 70% reduced risk of dying compared to mothers with no education [IRR = 0.30; 95% CI (0.22–0.88)]. CONCLUSION: Household socio-economic inequality and maternal education were associated with under-five mortality in the RDSS. Targeted interventions to address these factors may contribute towards accelerating the reduction of child mortality in rural Tanzania. Co-Action Publishing 2013-01-24 /pmc/articles/PMC3556682/ /pubmed/23364083 http://dx.doi.org/10.3402/gha.v6i0.19278 Text en © 2013 Cornelius Nattey et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Building New Knowledge Supplement Nattey, Cornelius Masanja, Honorati Klipstein-Grobusch, Kerstin Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title | Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title_full | Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title_fullStr | Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title_full_unstemmed | Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title_short | Relationship between household socio-economic status and under-five mortality in Rufiji DSS, Tanzania |
title_sort | relationship between household socio-economic status and under-five mortality in rufiji dss, tanzania |
topic | Building New Knowledge Supplement |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556682/ https://www.ncbi.nlm.nih.gov/pubmed/23364083 http://dx.doi.org/10.3402/gha.v6i0.19278 |
work_keys_str_mv | AT natteycornelius relationshipbetweenhouseholdsocioeconomicstatusandunderfivemortalityinrufijidsstanzania AT masanjahonorati relationshipbetweenhouseholdsocioeconomicstatusandunderfivemortalityinrufijidsstanzania AT klipsteingrobuschkerstin relationshipbetweenhouseholdsocioeconomicstatusandunderfivemortalityinrufijidsstanzania |