标题：Association between coverage of maternal and child health interventions, and under-5 mortality: a repeated cross-sectional analysis of 35 sub-Saharan African countries
摘要：Background: Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH) interventions in contributing to declines in child mortality in sub-Saharan Africa.Design: Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ecological time-series and child-level regression models, we estimated the effect of MNCH interventions (summarized by the percent composite coverage index, or CCI) on child mortality with in the first 5 years of life net of temporal trends and covariates at the household, maternal, and child levels.Results: At the ecologic level, a unit increase in standardized CCI was associated with a reduction in under-5 child mortality rate (U5MR) of 29.0 per 1,000 (95% CI: −43.2, −14.7) after adjustment for survey period effects and country-level per capita gross domestic product (pcGDP). At the child level, a unit increase in standardized CCI was associated with an odds ratio of 0.86 for child mortality (95% CI: 0.82–0.90) after adjustment for survey period effect, country-level pcGDP, and a set of household-, maternal-, and child-level covariates.Conclusions: MNCH interventions are important in reducing U5MR, while the effects of economic growth in sub-Saharan Africa remain weak and inconsistent. Improved coverage of proven life-saving interventions will likely contribute to further reductions in U5MR in sub-Saharan Africa.Keywords: Africa; child mortality; child health; maternal and child health interventions; low-income countries; trends; socioeconomic factors(Published: 3 September 2014)Citation: Glob Health Action 2014, 7: 24765 - http://dx.doi.org/10.3402/gha.v7.24765
关键词：Global Health; Population Health;;Africa; child mortality; child health; maternal and child health interventions; low-income countries; trends; socioeconomic factors;RJ
