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Socioeconomic Inequalities in Perinatal Mortality in Bangladesh: A multivariable regression analysis using evidence from the Demographic and Health Survey 2014 of Bangladesh
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Each year almost 4.1 million perinatal deaths are estimated which is notably higher than the total number of global deaths caused by AIDS (2.1 million), tuberculosis (1.6 million) and malaria (1.3 million). In the year of 2006, the World Health Organization (WHO) reported perinatal mortality rate of 47 deaths per 1000 births with more than 98% of these perinatal deaths are occurring in low (61 per 1000 births) and middle-income countries (50 per 1000 births). Likewise, any other low-middle income countries, Bangladesh was also identified to have high perinatal mortality rate (44 deaths per 1000 births) in 2014. Information on how different socioeconomic groups are affected is lacking. Hence, this study aims to assess the socioeconomic inequalities related to perinatal mortality.

Methods: This is a cross sectional study and data from the Bangladesh Demographic and Health Survey (BDHS) from the year of 2014 was used. Data was collected by the DHS program using a two-stages stratified cluster sampling design from 17,863 ever married women aged between 15-49 years. Descriptive analysis was performed to present the frequency of outcome variable and distal and proximate variables. Crude associations between each of the distal variables (socioeconomic indicators) and each of the proximate variables with the outcome variable were assessed by using univariate logistic regression. Subsequently, multivariable logistic regression was performed to adjust the association between each significant independent variable with the outcome variable. The results were expressed as odds ratios (ORs) with a 95% CI; statistical significance was determined at p-value < 0.05. Sampling weights were applied in both the univariate and multi variable regression analysis to generate population estimates. All the analyses were conducted using Stata version 13.

Results: The weighted perinatal mortality rate was 1.16%. The determinant that was found to be significantly increasing the odds of perinatal mortality was the poorest wealth quintile (AOR 1.89, 95% CI: 1.02-3.49).

Conclusion: This study showed that wealth status had a strong association with perinatal mortality in Bangladesh. This finding implies that policies aiming to reduce perinatal mortality should be focused on removing the socio-economic disparities. This study provides a platform for further empirical studies using advanced statistical methods to look for the causality of perinatal mortality in reference to wealth status.

Place, publisher, year, edition, pages
2019. , p. 30
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2019:43
Keywords [en]
Perinatal Mortality, Bangladesh, Socioeconomic Inequalities
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-166116OAI: oai:DiVA.org:umu-166116DiVA, id: diva2:1377381
External cooperation
Bangladesh Demographic and Health Survey (BDHS), U.S. Agency for International Development (USAID)
Educational program
Master's Programme in Public Health
Presentation
2019-10-16, Alicante, Building 5B, 3rd floor, Department of Epidemiology and Global Health, Umeå University, Umeå, 11:00 (English)
Supervisors
Examiners
Available from: 2019-12-11 Created: 2019-12-11 Last updated: 2019-12-11Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
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  • vancouver
  • Other style
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