Contributing determinants of overall and wealth-related inequality in under-5 mortality in 13 African countries

J Epidemiol Community Health. 2013 Aug;67(8):667-76. doi: 10.1136/jech-2012-202195. Epub 2013 May 23.

Abstract

Objective: To investigate and compare the main determinants of overall inequality and wealth-related inequality in under-5 mortality in 13 African countries.

Methods: Data from Demographic and Health Surveys conducted in 2007-2010 in African countries were used. The study assessed the contribution of determinants to (1) overall inequality in under-5 mortality measured by the Gini index and (2) wealth-related inequality in under-5 mortality measured by the concentration index. Techniques used were multivariate logistic regression and decomposition of Gini and concentration indexes.

Results: Birth order and interval and region contributed the most to overall inequality in under-5 mortality in a majority of countries. A significant wealth-related inequality was observed in five countries: DRCongo, Egypt, Madagascar, Nigeria and Sao Tome & Principe. Overall, household wealth, father's occupation and mother's education contributed the most to this inequality, though the ranking of the most important determinants differed across countries.

Conclusions: Assessing the contribution of determinants to overall inequality and to wealth-related inequality in under-5 mortality help in prioritising interventions aiming at improving child survival and equity.

Keywords: CHILD HEALTH; INEQUALITIES; INTERNATIONAL HLTH; PUBLIC HEALTH; SOCIO-ECONOMIC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa / epidemiology
  • Child Mortality*
  • Child, Preschool
  • Family Characteristics
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Poverty / statistics & numerical data
  • Risk Factors
  • Social Class*
  • Socioeconomic Factors