Browsing by Subject "UNDER-5 MORTALITY"

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  • Lohela, Terhi J.; Nesbitt, Robin C.; Pekkanen, Juha; Gabrysch, Sabine (2019)
    Facility delivery should reduce early neonatal mortality. We used the Slope Index of Inequality and logistic regression to quantify absolute and relative socioeconomic inequalities in early neonatal mortality (0 to 6 days) and facility delivery among 679,818 live births from 72 countries with Demographic and Health Surveys. The inequalities in early neonatal mortality were compared with inequalities in postneonatal infant mortality (28 days to 1 year), which is not related to childbirth. Newborns of the richest mothers had a small survival advantage over the poorest in unadjusted analyses (-2.9 deaths/1,000; OR 0.86) and the most educated had a small survival advantage over the least educated (-3.9 deaths/1,000; OR 0.77), while inequalities in postneonatal infant mortality were more than double that in absolute terms. The proportion of births in health facilities was an absolute 43% higher among the richest and 37% higher among the most educated compared to the poorest and least educated mothers. A higher proportion of facility delivery in the sampling cluster (e.g. village) was only associated with a small decrease in early neonatal mortality. In conclusion, while socioeconomically advantaged mothers had much higher use of a health facility at birth, this did not appear to convey a comparable survival advantage.
  • GBD 2019 Under-5 Mortality Collabo; Paulson, Katherine R.; Kamath, Aruna M.; Alam, Tahiya; Meretoja, Atte; Meretoja, Tuomo J.; Shiri, Rahman; Wang, Yuan-Pang (2021)
    Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million [95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% [95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
  • Burstein, Roy; Henry, Nathaniel J.; Collison, Michael L.; Marczak, Laurie B.; Sligar, Amber; Watson, Stefanie; Marquez, Neal; Abbasalizad-Farhangi, Mahdieh; Abbasi, Masoumeh; Abd-Allah, Foad; Abdoli, Amir; Abdollahi, Mohammad; Abdollahpour, Ibrahim; Abdulkader, Rizwan Suliankatchi; Abrigo, Michael R. M.; Acharya, Dilaram; Adebayo, Oladimeji M.; Adekanmbi, Victor; Adham, Davoud; Afshari, Mahdi; Aghaali, Mohammad; Ahmadi, Keivan; Ahmadi, Mehdi; Ahmadpour, Ehsan; Ahmed, Rushdia; Akal, Chalachew Genet; Akinyemi, Joshua O.; Alahdab, Fares; Alam, Noore; Alamene, Genet Melak; Alene, Kefyalew Addis; Alijanzadeh, Mehran; Alinia, Cyrus; Alipour, Vahid; Aljunid, Syed Mohamed; Almalki, Mohammed J.; Al-Mekhlafi, Hesham M.; Altirkawi, Khalid; Alvis-Guzman, Nelson; Amegah, Adeladza Kofi; Amini, Saeed; Amit, Arianna Maever Loreche; Anbari, Zohreh; Androudi, Sofia; Anjomshoa, Mina; Ansari, Fereshteh; Antonio, Carl Abelardo T.; Arabloo, Jalal; Arefi, Zohreh; Aremu, Olatunde; Armoon, Bahram; Arora, Amit; Artaman, Al; Asadi, Anvar; Asadi-Aliabadi, Mehran; Ashraf-Ganjouei, Amir; Assadi, Reza; Ataeinia, Bahar; Atre, Sachin R.; Quintanilla, Beatriz Paulina Ayala; Ayanore, Martin Amogre; Azari, Samad; Babaee, Ebrahim; Babazadeh, Arefeh; Badawi, Alaa; Bagheri, Soghra; Bagherzadeh, Mojtaba; Baheiraei, Nafiseh; Balouchi, Abbas; Barac, Aleksandra; Bassat, Quique; Baune, Bernhard T.; Bayati, Mohsen; Bedi, Neeraj; Beghi, Ettore; Behzadifar, Masoud; Behzadifar, Meysam; Belay, Yared Belete; Bell, Brent; Bell, Michelle L.; Berbada, Dessalegn Ajema; Bernstein, Robert S.; Bhattacharjee, Natalia V.; Bhattarai, Suraj; Bhutta, Zulfiqar A.; Bijani, Ali; Bohlouli, Somayeh; Breitborde, Nicholas J. K.; Britton, Gabrielle; Browne, Annie J.; Nagaraja, Sharath Burugina; Busse, Reinhard; Butt, Zahid A.; Car, Josip; Cardenas, Rosario; Castaneda-Orjuela, Carlos A.; Cerin, Ester; Chanie, Wagaye Fentahun; Chatterjee, Pranab; Chu, Dinh-Toi; Cooper, Cyrus; Costa, Vera M.; Dalal, Koustuv; Dandona, Lalit; Dandona, Rakhi; Daoud, Farah; Daryani, Ahmad; Das Gupta, Rajat; Davis, Ian; Weaver, Nicole Davis; Davitoiu, Dragos Virgil; De Neve, Jan-Walter; Demeke, Feleke Mekonnen; Demoz, Gebre Teklemariam; Deribe, Kebede; Desai, Rupak; Deshpande, Aniruddha; Desyibelew, Hanna Demelash; Dey, Sagnik; Dharmaratne, Samath Dhamminda; Dhimal, Meghnath; Diaz, Daniel; Doshmangir, Leila; Duraes, Andre R.; Dwyer-Lindgren, Laura; Earl, Lucas; Ebrahimi, Roya; Ebrahimpour, Soheil; Effiong, Andem; Eftekhari, Aziz; Ehsani-Chimeh, Elham; El Sayed, Iman; Zaki, Maysaa El Sayed; El Tantawi, Maha; El-Khatib, Ziad; Emamian, Mohammad Hassan; Enany, Shymaa; Eskandarieh, Sharareh; Eyawo, Oghenowede; Ezalarab, Maha; Faramarzi, Mahbobeh; Fareed, Mohammad; Faridnia, Roghiyeh; Faro, Andre; Fazaeli, Ali Akbar; Fazlzadeh, Mehdi; Fentahun, Netsanet; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C.; Filip, Irina; Fischer, Florian; Foigt, Nataliya A.; Foroutan, Masoud; Francis, Joel Msafiri; Fukumoto, Takeshi; Fullman, Nancy; Gallus, Silvano; Gebre, Destallem Gebremedhin; Gebrehiwot, Tsegaye Tewelde; Gebremeskel, Gebreamlak Gebremedhn; Gessner, Bradford D.; Geta, Birhanu; Gething, Peter W.; Ghadimi, Reza; Ghadiri, Keyghobad; Ghajarzadeh, Mahsa; Ghashghaee, Ahmad; Gill, Paramjit Singh; Gill, Tiffany K.; Golding, Nick; Gomes, Nelson G. M.; Gona, Philimon N.; Gopalani, Sameer Vali; Gorini, Giuseppe; Goulart, Barbara Niegia Garcia; Graetz, Nicholas; Greaves, Felix; Green, Manfred S.; Guo, Yuming; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hall, Brian James; Hamidi, Samer; Haririan, Hamidreza; Haro, Josep Maria; Hasankhani, Milad; Hasanpoor, Edris; Hasanzadeh, Amir; Hassankhani, Hadi; Hassen, Hamid Yimam; Hegazy, Mohamed I.; Hendrie, Delia; Heydarpour, Fatemeh; Hird, Thomas R.; Hoang, Chi Linh; Hollerich, Gillian; Rad, Enayatollah Homaie; Hoseini-Ghahfarokhi, Mojtaba; Hossain, Naznin; Hosseini, Mostafa; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Househ, Mowafa; Hsairi, Mohamed; Ilesanmi, Olayinka Stephen; Imani-Nasab, Mohammad Hasan; Iqbal, Usman; Irvani, Seyed Sina Naghibi; Islam, Nazrul; Islam, Sheikh Mohammed Shariful; Jurisson, Mikk; Balalami, Nader Jafari; Jalali, Amir; Javidnia, Javad; Jayatilleke, Achala Upendra; Jenabi, Ensiyeh; Ji, John S.; Jobanputra, Yash B.; Johnson, Kimberly; Jonas, Jost B.; Shushtari, Zahra Jorjoran; Jozwiak, Jacek Jerzy; Kabir, Ali; Kahsay, Amaha; Kalani, Hamed; Kalhor, Rohollah; Karami, Manoochehr; Karki, Surendra; Kasaeian, Amir; Kassebaum, Nicholas J.; Keiyoro, Peter Njenga; Kemp, Grant Rodgers; Khabiri, Roghayeh; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khan, Ejaz Ahmad; Khan, Junaid; Khan, Muhammad Shahzeb; Khang, Young-Ho; Khatab, Khaled; Khater, Amir; Khater, Mona M.; Khatony, Alireza; Khazaei, Mohammad; Khazaei, Salman; Khazaei-Pool, Maryam; Khubchandani, Jagdish; Kianipour, Neda; Kim, Yun Jin; Kimokoti, Ruth W.; Kinyoki, Damaris K.; Kisa, Adnan; Kisa, Sezer; Kolola, Tufa; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Kraemer, Moritz U. G.; Krishan, Kewal; Krohn, Kris J.; Kugbey, Nuworza; Kumar, G. Anil; Kumar, Manasi; Kumar, Pushpendra; Kuupiel, Desmond; Lacey, Ben; Lad, Sheetal D.; Lami, Faris Hasan; Larsson, Anders O.; Lee, Paul H.; Leili, Mostafa; Levine, Aubrey J.; Li, Shanshan; Lim, Lee-Ling; Listl, Stefan; Longbottom, Joshua; Lopez, Jaifred Christian F.; Lorkowski, Stefan; Magdeldin, Sameh; Abd El Razek, Hassan Magdy; Abd El Razek, Muhammed Magdy; Majeed, Azeem; Maleki, Afshin; Malekzadeh, Reza; Malta, Deborah Carvalho; Mamun, Abdullah A.; Manafi, Navid; Manda, Ana-Laura; Mansourian, Morteza; Martins-Melo, Francisco Rogerlandio; Masaka, Anthony; Massenburg, Benjamin Ballard; Maulik, Pallab K.; Mayala, Benjamin K.; Mazidi, Mohsen; Mckee, Martin; Mehrotra, Ravi; Mehta, Kala M.; Meles, Gebrekiros Gebremichael; Mendoza, Walter; Menezes, Ritesh G.; Meretoja, Atte; Meretoja, Tuomo J.; Mestrovic, Tomislav; Miller, Ted R.; Miller-Petrie, Molly K.; Mills, Edward J.; Milne, George J.; Mini, G. K.; Mir, Seyed Mostafa; Mirjalali, Hamed; Mirrakhimov, Erkin M.; Mohamadi, Efat; Mohammad, Dara K.; Darwesh, Aso Mohammad; Mezerji, Naser Mohammad Gholi; Mohammed, Ammas Siraj; Mohammed, Shafiu; Mokdad, Ali H.; Molokhia, Mariam; Monasta, Lorenzo; Moodley, Yoshan; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi, Masoud; Moradi, Yousef; Moradi-Lakeh, Maziar; Moradinazar, Mehdi; Moraga, Paula; Morawska, Lidia; Mosapour, Abbas; Mousavi, Seyyed Meysam; Mueller, Ulrich Otto; Muluneh, Atalay Goshu; Mustafa, Ghulam; Nabavizadeh, Behnam; Naderi, Mehdi; Nagarajan, Ahamarshan Jayaraman; Nahvijou, Azin; Najafi, Farid; Nangia, Vinay; Ndwandwe, Duduzile Edith; Neamati, Nahid; Negoi, Ionut; Negoi, Ruxandra Irina; Ngunjiri, Josephine W.; Huong Lan Thi Nguyen; Long Hoang Nguyen; Son Hoang Nguyen; Nielsen, Katie R.; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Nixon, Molly R.; Nnaji, Chukwudi A.; Nojomi, Marzieh; Noroozi, Mehdi; Nosratnejad, Shirin; Noubiap, Jean Jacques; Motlagh, Soraya Nouraei; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Oladimeji, Kelechi E.; Olagunju, Andrew T.; Olfatifar, Meysam; Olum, Solomon; Olusanya, Bolajoko Olubukunola; Oluwasanu, Mojisola Morenike; Onwujekwe, Obinna E.; Oren, Eyal; Ortega-Altamirano, Doris D. V.; Ortiz, Alberto; Osarenotor, Osayomwanbo; Osei, Frank B.; Osgood-Zimmerman, Aaron E.; Otstavnov, Stanislav S.; Owolabi, Mayowa Ojo; Mahesh, P. A.; Pagheh, Abdol Sattar; Pakhale, Smita; Panda-Jonas, Songhomitra; Pandey, Animika; Park, Eun-Kee; Parsian, Hadi; Pashaei, Tahereh; Patel, Sangram Kishor; Pepito, Veincent Christian Filipino; Pereira, Alexandre; Perkins, Samantha; Pickering, Brandon V.; Pilgrim, Thomas; Pirestani, Majid; Piroozi, Bakhtiar; Pirsaheb, Meghdad; Plana-Ripoll, Oleguer; Pourjafar, Hadi; Puri, Parul; Qorbani, Mostafa; Quintana, Hedley; Rabiee, Mohammad; Rabiee, Navid; Radfar, Amir; Rafiei, Alireza; Rahim, Fakher; Rahimi, Zohreh; Rahimi-Movaghar, Vafa; Rahimzadeh, Shadi; Rajati, Fatemeh; Raju, Sree Bhushan; Ramezankhani, Azra; Ranabhat, Chhabi Lal; Rasella, Davide; Rashedi, Vahid; Rawal, Lal; Reiner, Robert C.; Renzaho, Andre M. N.; Rezaei, Satar; Rezapour, Aziz; Riahi, Seyed Mohammad; Ribeiro, Ana Isabel; Roever, Leonardo; Roro, Elias Merdassa; Roser, Max; Roshandel, Gholamreza; Roshani, Daem; Rostami, Ali; Rubagotti, Enrico; Rubino, Salvatore; Sabour, Siamak; Sadat, Nafis; Sadeghi, Ehsan; Saeedi, Reza; Safari, Yahya; Safari-Faramani, Roya; Safdarian, Mahdi; Sahebkar, Amirhossein; Salahshoor, Mohammad Reza; Salam, Nasir; Salamati, Payman; Salehi, Farkhonde; Zahabi, Saleh Salehi; Salimi, Yahya; Salimzadeh, Hamideh; Salomon, Joshua A.; Sambala, Evanson Zondani; Samy, Abdallah M.; Milicevic, Milena M. Santric; Sao Jose, Bruno Piassi; Saraswathy, Sivan Yegnanarayana Iyer; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Sathian, Brijesh; Saxena, Sonia; Sbarra, Alyssa N.; Schaeffer, Lauren E.; Schwebel, David C.; Sepanlou, Sadaf G.; Seyedmousavi, Seyedmojtaba; Shaahmadi, Faramarz; Shaikh, Masood Ali; Shams-Beyranvand, Mehran; Shamshirian, Amir; Shamsizadeh, Morteza; Sharafi, Kiomars; Sharif, Mehdi; Sharif-Alhoseini, Mahdi; Sharifi, Hamid; Sharma, Jayendra; Sharma, Rajesh; Sheikh, Aziz; Shields, Chloe; Shigematsu, Mika; Shiri, Rahman; Shiue, Ivy; Shuval, Kerem; Siddiqi, Tariq J.; Silva, Joao Pedro; Singh, Jasvinder A.; Sinha, Dhirendra Narain; Sisay, Malede Mequanent; Sisay, Solomon; Sliwa, Karen; Smith, David L.; Somayaji, Ranjani; Soofi, Moslem; Soriano, Joan B.; Sreeramareddy, Chandrashekhar T.; Sudaryanto, Agus; Sufiyan, Mu'awiyyah Babale; Sykes, Bryan L.; Sylaja, P. N.; Tabares-Seisdedos, Rafael; Tabb, Karen M.; Tabuchi, Takahiro; Taveira, Nuno; Temsah, Mohamad-Hani; Terkawi, Abdullah Sulieman; Tessema, Zemenu Tadesse; Thankappan, Kavumpurathu Raman; Thirunavukkarasu, Sathish; To, Quyen G.; Tovani-Palone, Marcos Roberto; Bach Xuan Tran, [No Value]; Khanh Bao Tran; Ullah, Irfan; Usman, Muhammad Shariq; Uthman, Olalekan A.; Vahedian-Azimi, Amir; Valdez, Pascual R.; van Boven, Job F. M.; Vasankari, Tommi Juhani; Vasseghian, Yasser; Veisani, Yousef; Venketasubramanian, Narayanaswamy; Violante, Francesco S.; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Vos, Theo; Giang Thu Vu; Vujcic, Isidora S.; Waheed, Yasir; Wakefield, Jon; Wang, Haidong; Wang, Yafeng; Wang, Yuan-Pang; Ward, Joseph L.; Weintraub, Robert G.; Weldegwergs, Kidu Gidey; Weldesamuel, Girmay Teklay; Westerman, Ronny; Wiysonge, Charles Shey; Wondafrash, Dawit Zewdu; Woyczynski, Lauren; Wu, Ai-Min; Xu, Gelin; Yadegar, Abbas; Yamada, Tomohide; Yazdi-Feyzabadi, Vahid; Yilgwan, Christopher Sabo; Yip, Paul; Yonemoto, Naohiro; Lebni, Javad Yoosefi; Younis, Mustafa Z.; Yousefifard, Mahmoud; Yousof, Hebat-Allah Salah A.; Yu, Chuanhua; Yusefzadeh, Hasan; Zabeh, Erfan; Moghadam, Telma Zahirian; Bin Zaman, Sojib; Zamani, Mohammad; Zandian, Hamed; Zangeneh, Alireza; Zerfu, Taddese Alemu; Zhang, Yunquan; Ziapour, Arash; Zodpey, Sanjay; Murray, Christopher J. L.; Hay, Simon I. (2019)
    Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.