Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data.
Under-five mortality is declining in Ghana and many other countries. Very few studies have measured under-five mortality-and its social and environmental risk factors-at fine spatial resolutions, which is relevant for policy purposes. Our aim was to estimate under-five mortality and its social and e...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-06-01
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| Series: | PLoS Medicine |
| Online Access: | http://europepmc.org/articles/PMC4915620?pdf=render |
| _version_ | 1828847307549835264 |
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| author | Raphael E Arku James E Bennett Marcia C Castro Kofi Agyeman-Duah Samilia E Mintah James H Ware Philomena Nyarko John D Spengler Samuel Agyei-Mensah Majid Ezzati |
| author_facet | Raphael E Arku James E Bennett Marcia C Castro Kofi Agyeman-Duah Samilia E Mintah James H Ware Philomena Nyarko John D Spengler Samuel Agyei-Mensah Majid Ezzati |
| author_sort | Raphael E Arku |
| collection | DOAJ |
| description | Under-five mortality is declining in Ghana and many other countries. Very few studies have measured under-five mortality-and its social and environmental risk factors-at fine spatial resolutions, which is relevant for policy purposes. Our aim was to estimate under-five mortality and its social and environmental risk factors at the district level in Ghana.We used 10% random samples of Ghana's 2000 and 2010 National Population and Housing Censuses. We applied indirect demographic methods and a Bayesian spatial model to the information on total number of children ever born and children surviving to estimate under-five mortality (probability of dying by 5 y of age, 5q0) for each of Ghana's 110 districts. We also used the census data to estimate the distributions of households or persons in each district in terms of fuel used for cooking, sanitation facility, drinking water source, and parental education. Median district 5q0 declined from 99 deaths per 1,000 live births in 2000 to 70 in 2010. The decline ranged from <5% in some northern districts, where 5q0 had been higher in 2000, to >40% in southern districts, where it had been lower in 2000, exacerbating existing inequalities. Primary education increased in men and women, and more households had access to improved water and sanitation and cleaner cooking fuels. Higher use of liquefied petroleum gas for cooking was associated with lower 5q0 in multivariate analysis.Under-five mortality has declined in all of Ghana's districts, but the cross-district inequality in mortality has increased. There is a need for additional data, including on healthcare, and additional environmental and socioeconomic measurements, to understand the reasons for the variations in mortality levels and trends. |
| first_indexed | 2024-12-12T22:05:46Z |
| format | Article |
| id | doaj.art-52c43c65d3d040f0b1ee6d322dec8b47 |
| institution | Directory Open Access Journal |
| issn | 1549-1277 1549-1676 |
| language | English |
| last_indexed | 2024-12-12T22:05:46Z |
| publishDate | 2016-06-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj.art-52c43c65d3d040f0b1ee6d322dec8b472022-12-22T00:10:23ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762016-06-01136e100203810.1371/journal.pmed.1002038Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data.Raphael E ArkuJames E BennettMarcia C CastroKofi Agyeman-DuahSamilia E MintahJames H WarePhilomena NyarkoJohn D SpenglerSamuel Agyei-MensahMajid EzzatiUnder-five mortality is declining in Ghana and many other countries. Very few studies have measured under-five mortality-and its social and environmental risk factors-at fine spatial resolutions, which is relevant for policy purposes. Our aim was to estimate under-five mortality and its social and environmental risk factors at the district level in Ghana.We used 10% random samples of Ghana's 2000 and 2010 National Population and Housing Censuses. We applied indirect demographic methods and a Bayesian spatial model to the information on total number of children ever born and children surviving to estimate under-five mortality (probability of dying by 5 y of age, 5q0) for each of Ghana's 110 districts. We also used the census data to estimate the distributions of households or persons in each district in terms of fuel used for cooking, sanitation facility, drinking water source, and parental education. Median district 5q0 declined from 99 deaths per 1,000 live births in 2000 to 70 in 2010. The decline ranged from <5% in some northern districts, where 5q0 had been higher in 2000, to >40% in southern districts, where it had been lower in 2000, exacerbating existing inequalities. Primary education increased in men and women, and more households had access to improved water and sanitation and cleaner cooking fuels. Higher use of liquefied petroleum gas for cooking was associated with lower 5q0 in multivariate analysis.Under-five mortality has declined in all of Ghana's districts, but the cross-district inequality in mortality has increased. There is a need for additional data, including on healthcare, and additional environmental and socioeconomic measurements, to understand the reasons for the variations in mortality levels and trends.http://europepmc.org/articles/PMC4915620?pdf=render |
| spellingShingle | Raphael E Arku James E Bennett Marcia C Castro Kofi Agyeman-Duah Samilia E Mintah James H Ware Philomena Nyarko John D Spengler Samuel Agyei-Mensah Majid Ezzati Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. PLoS Medicine |
| title | Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. |
| title_full | Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. |
| title_fullStr | Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. |
| title_full_unstemmed | Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. |
| title_short | Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data. |
| title_sort | geographical inequalities and social and environmental risk factors for under five mortality in ghana in 2000 and 2010 bayesian spatial analysis of census data |
| url | http://europepmc.org/articles/PMC4915620?pdf=render |
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