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Inequalities in early childhood mortality in Myanmar: Association between parents’ socioeconomic status and early childhood mortality
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
2018 (engelsk)Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
Abstract [en]

Introduction: Despite substantial global achievements in reducing early childhood mortality, disparitiesremain across and within countries and regions. Reducing these inequalities is important forimproving population health and attaining the Sustainable Development Goals adopted bythe United Nations General Assembly in 2015. There have been some empirical studies ofinequalities in early childhood mortality conducted in developing countries yet very little isknown about these issues in Myanmar. This study aims to fill this knowledge gap byinvestigating association between socioeconomic status and early childhood mortality acrossa ten-year period in Myanmar.

Method: Using cross-sectional data obtained from the Myanmar Demographic Heath Survey (2015-2016), univariate and multivariate logistic regressions were performed to investigateassociations between parents’ education and household wealth, and four age specific earlychildhood mortality outcomes being: under-five (0-4 years); neonatal (0-28 days); postneonatal (1-11 months) and child (1-4 years). Data for 10,081 children born to 4,737 marriedwomen (aged 15-49 years) were analyzed.

Results: Mortality during the first five years of age was associated with household wealth status, andthe association remained robust after adjusting for confounders. Under-five children fromthe richest families had 67% (95% CI 44 to 80%) lower odds of dying compared with childrenin the poorest families after adjusting for individual proximate factors (mothers’ age at birth,mothers’ use of cigarettes or tobacco, birth interval, birth order and sex of the child). Theassociation between mortality and household wealth was strongest for post neonatal deaths.Both mother’s and father’s education were important for early childhood mortality; thehighest benefit from parents’ education was with respect to child mortality in the one to fouryear age bracket. For example, children born to highly educated mothers had 83% (95% CI23 to 96%) lower odds of death in this age group, compared with children born to motherswith primary schooling as their highest educational attainment, after adjusting for individualproximate factors. Similarly in the multivariate analysis, among fathers with highereducation, the odds of child mortality between one and four years of age, were 88% (95% CI16 to 98%) lower than that for fathers for whom the highest educational attainment was atthe primary level.

Conclusion: Socioeconomic indicators, such as household wealth status, mother’s and father’s education,are important for child survival before five years of age. The association between householdwealth and childhood mortality is stronger after the neonatal period, with the benefits ofparents’ education strongest for child mortality in the one to four year age group. Thesefindings provide much needed evidence about association between socioeconomic factorsand age stratified early childhood mortality in Myanmar. Health policy aimed at reducingearly childhood mortality must take socioeconomic determinants into account in order toaddress socioeconomic disparities. This work provides a platform for further empiricalstudies using advanced statistical methods to unpack these and other socially determinedinequalities.

sted, utgiver, år, opplag, sider
2018. , s. 24
Serie
Centre for Public Health Report Series, ISSN 1651-341X ; 2018:1
Emneord [en]
childhood mortality, socioeconomic inequalities, household wealth, parent’s education, distal and proximate determinants, Myanmar
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-152621OAI: oai:DiVA.org:umu-152621DiVA, id: diva2:1256252
Eksternt samarbeid
Myanmar Demographic and Health Survey (MDHS) - Inter City Fund (ICF)
Utdanningsprogram
Master's Programme in Public Health
Presentation
2018-05-23, Caring Science buildning, room B301, Umeå University, Umeå, 10:00 (engelsk)
Veileder
Examiner
Tilgjengelig fra: 2018-10-22 Laget: 2018-10-16 Sist oppdatert: 2018-10-22bibliografisk kontrollert

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