Inequalities and trends in Neonatal Mortality Rate (NMR) in Ethiopia: Evidence from the Ethiopia Demographic and Health Surveys, 2000-2016.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
18
12
2019
accepted:
27
05
2020
entrez:
11
6
2020
pubmed:
11
6
2020
medline:
25
8
2020
Statut:
epublish
Résumé
Substantial inequality in neonatal mortality rates (NMR) remains in low- and middle-income countries to the detriment of disadvantaged subpopulations. In Ethiopia, there is a dearth of evidence on the extent and trends of disparity in NMR. This study assessed the socioeconomic, residence and sex-based inequalities in NMR, as well as examined its change over a sixteen year period in Ethiopia. Using the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Ethiopia Demographic and Health Surveys (EDHS) were analyzed between 2000 and 2016. NMR was disaggregated by four equity stratifiers: education, wealth, residence and sex. In addition, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, Relative Concentration Index (RCI) and Slope Index of Inequality (SII) were calculated to understand inequalities from different perspectives. Corresponding 95% Uncertainty Intervals (UIs) were computed to measure statistical significance. Large educational inequalities in NMR were found in 2000, 2005, and 2011, while wealth-driven inequality occurred in 2011. Sex disparity was noted in all the surveys, and urban-rural differentials remained in all the surveys except in 2016. While socioeconomic and area-related inequalities decreased over time, sex related inequality did not change during the period of study. NMR appeared to be concentrated among male newborns, neonates born to illiterate and poor women and those living in rural settings. However, the inequality narrowed over time. Interventions appropriate for different subpopulations need to be designed.
Sections du résumé
BACKGROUND
Substantial inequality in neonatal mortality rates (NMR) remains in low- and middle-income countries to the detriment of disadvantaged subpopulations. In Ethiopia, there is a dearth of evidence on the extent and trends of disparity in NMR. This study assessed the socioeconomic, residence and sex-based inequalities in NMR, as well as examined its change over a sixteen year period in Ethiopia.
METHODS
Using the World Health Organization's (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Ethiopia Demographic and Health Surveys (EDHS) were analyzed between 2000 and 2016. NMR was disaggregated by four equity stratifiers: education, wealth, residence and sex. In addition, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, Relative Concentration Index (RCI) and Slope Index of Inequality (SII) were calculated to understand inequalities from different perspectives. Corresponding 95% Uncertainty Intervals (UIs) were computed to measure statistical significance.
FINDINGS
Large educational inequalities in NMR were found in 2000, 2005, and 2011, while wealth-driven inequality occurred in 2011. Sex disparity was noted in all the surveys, and urban-rural differentials remained in all the surveys except in 2016. While socioeconomic and area-related inequalities decreased over time, sex related inequality did not change during the period of study.
CONCLUSIONS
NMR appeared to be concentrated among male newborns, neonates born to illiterate and poor women and those living in rural settings. However, the inequality narrowed over time. Interventions appropriate for different subpopulations need to be designed.
Identifiants
pubmed: 32520940
doi: 10.1371/journal.pone.0234483
pii: PONE-D-19-35043
pmc: PMC7286487
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0234483Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist
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