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Contributing determinants of overall and wealth-related inequality in under-5 mortality in 13 African countries
Authors: Carine Van Malderen, Herman Van Oyen, and Niko Speybroeck
Source: Journal of Epidemiology and Community Health, 67:667-676 doi:10.1136/jech-2012-202195
Topic(s): Child health
Childhood mortality
Children under five
Inequality
Country: Africa
   Multiple African Countries
Published: MAY 2013
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) wealthrelated 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.
Web: http://jech.bmj.com/content/67/8/667.full