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Trends in Socioeconomic Disparities in a Rapid Under-Five Mortality Transition: A Longitudinal Study in United Republic of Tanzania

Malick Kanté, A., Nathan, R., Jackson, E. F., Levira, F., Helleringer, S., Masanja, H. and Phillips, a. F. (2016) Trends in Socioeconomic Disparities in a Rapid Under-Five Mortality Transition: A Longitudinal Study in United Republic of Tanzania. Bulletin of the World Health Organization. pp. 1-19. ISSN 0042-9686

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To explore trends in socioeconomic disparities and under-five mortality rates in rural parts of United Republic of Tanzania between 2000 and 2011. We used longitudinal data on births, deaths, migrations, maternal educational attainment and household characteristics from the Ifakara and Rufiji health and demographic surveillance systems. We estimated hazard ratios (HR) for associations between mortality and maternal educational attainment or relative household wealth, using Cox hazard regression models. The under-five mortality rate declined in Ifakara from 132.7 deaths per 1000 live births (95% confidence interval, CI: 119.3–147.4) in 2000 to 66.2 (95%CI: 59.0–74.3) in 2011 and in Rufiji from 118.4 deaths per 1000 live births (95% CI: 107.1–130.7) in 2000 to 76.2 (95% CI: 66.7–86.9) in 2011. Combining both sites, in 2000–2001, the risk of dying for children of uneducated mothers was 1.44 (95% CI: 1.08–1.92) higher than for children of mothers who had received education beyond primary school. In 2010–2011, the HR was 1.18 (95% CI: 0.90–1.55). In contrast mortality disparities between richest and poorest quintiles worsened in Rufiji, from 1.20 (95% CI: 0.99–1.47) in 2000–2001 to 1.48 (95% CI: 1.15–1.89) in 2010–2011, while in Ifakara, disparities narrowed from 1.30 (95% CI: 1.09–1.55) to 1.15 (95% CI: 0.95–1.39) in the same period. While childhood survival has improved, mortality disparities still persist, suggesting a need for policies and programmes that both reduce child mortality and address socioeconomic disparities.

Item Type: Article
Keywords: Mortality Rates, Infant, Under-five, Births, Deaths, Migrations, Maternal Educational Attainment, Tanzania
Subjects: Maternal & Neonatal Health > Maternal Mortality & Morbidity
Maternal & Neonatal Health > Neonatal Health
Divisions: Ifakara Health Institute > Impact Evaluation
Depositing User: Mr Joseph Madata
Date Deposited: 02 Mar 2016 09:00
Last Modified: 02 Mar 2016 09:00

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