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Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda

AIM: Rwanda has invested heavily in improving maternal and child health, but knowledge is limited regarding social equity in perinatal survival. We analysed whether perinatal mortality risks differed between social groups in hospitals in the country's capital. METHODS: A case–control study was...

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Autores principales: Musafili, Aimable, Essén, Birgitta, Baribwira, Cyprien, Selling, Katarina Ekholm, Persson, Lars‐Åke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680362/
https://www.ncbi.nlm.nih.gov/pubmed/25640733
http://dx.doi.org/10.1111/apa.12951
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author Musafili, Aimable
Essén, Birgitta
Baribwira, Cyprien
Selling, Katarina Ekholm
Persson, Lars‐Åke
author_facet Musafili, Aimable
Essén, Birgitta
Baribwira, Cyprien
Selling, Katarina Ekholm
Persson, Lars‐Åke
author_sort Musafili, Aimable
collection PubMed
description AIM: Rwanda has invested heavily in improving maternal and child health, but knowledge is limited regarding social equity in perinatal survival. We analysed whether perinatal mortality risks differed between social groups in hospitals in the country's capital. METHODS: A case–control study was carried out on singleton births aged at least 22 weeks of gestation and born in district or tertiary referral hospitals in Kigali from July 2013 to May 2014. Perinatal deaths were recorded as they occurred, with the next two surviving neonates born in the same hospital selected as controls. Conditional logistic regression was used to determine social determinants of perinatal death after adjustments for potential confounders. RESULTS: We analysed 234 perinatal deaths and 468 controls. Rural residence was linked to an increased risk of perinatal death (OR = 3.31, 95% CI 1.43–7.61), but maternal education or household asset score levels were not. Having no health insurance (OR = 2.11, 95% CI 0.91–4.89) was associated with an increased risk of perinatal death, compared to having community health insurance. CONCLUSION: Living in a rural area and having no health insurance were associated with an increased risk of perinatal mortality rates in the Rwandan capital, but maternal education and household assets were not.
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spelling pubmed-66803622019-08-09 Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda Musafili, Aimable Essén, Birgitta Baribwira, Cyprien Selling, Katarina Ekholm Persson, Lars‐Åke Acta Paediatr Regular Articles AIM: Rwanda has invested heavily in improving maternal and child health, but knowledge is limited regarding social equity in perinatal survival. We analysed whether perinatal mortality risks differed between social groups in hospitals in the country's capital. METHODS: A case–control study was carried out on singleton births aged at least 22 weeks of gestation and born in district or tertiary referral hospitals in Kigali from July 2013 to May 2014. Perinatal deaths were recorded as they occurred, with the next two surviving neonates born in the same hospital selected as controls. Conditional logistic regression was used to determine social determinants of perinatal death after adjustments for potential confounders. RESULTS: We analysed 234 perinatal deaths and 468 controls. Rural residence was linked to an increased risk of perinatal death (OR = 3.31, 95% CI 1.43–7.61), but maternal education or household asset score levels were not. Having no health insurance (OR = 2.11, 95% CI 0.91–4.89) was associated with an increased risk of perinatal death, compared to having community health insurance. CONCLUSION: Living in a rural area and having no health insurance were associated with an increased risk of perinatal mortality rates in the Rwandan capital, but maternal education and household assets were not. John Wiley and Sons Inc. 2015-03-27 2015-12 /pmc/articles/PMC6680362/ /pubmed/25640733 http://dx.doi.org/10.1111/apa.12951 Text en ©2015 The Authors. Acta Pædiatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Pædiatrica This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Regular Articles
Musafili, Aimable
Essén, Birgitta
Baribwira, Cyprien
Selling, Katarina Ekholm
Persson, Lars‐Åke
Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title_full Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title_fullStr Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title_full_unstemmed Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title_short Social equity in perinatal survival: a case–control study at hospitals in Kigali, Rwanda
title_sort social equity in perinatal survival: a case–control study at hospitals in kigali, rwanda
topic Regular Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680362/
https://www.ncbi.nlm.nih.gov/pubmed/25640733
http://dx.doi.org/10.1111/apa.12951
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