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How does progress towards the MDG 4 affect inequalities between different subpopulations? Evidence from Nepal
Kim-Huong Nguyen1, Eliana Jimenez-Soto, Alison Morgan
1School of Population Health, The University of Queensland, Brisbane, Queensland, Australia. kim.h.nguyen@uq.edu.au
Journal of Epidemiology and Community Health
|January 17, 2013
Summary
Child mortality in Nepal has declined, reducing absolute inequalities. However, relative inequalities persist, especially for neonatal deaths, requiring health system improvements for mothers and newborns.
Area of Science:
- Child Health
- Public Health
- Health Equity
Background:
- Limited research exists on non-wealth-based child mortality inequalities in developing nations.
- This study examines under-5 and neonatal mortality trends in Nepal.
- Assesses equity in progress towards Millennium Development Goal 4.
Purpose of the Study:
- To estimate changes in under-5 and neonatal mortality rates in Nepal from 1990-2005.
- To analyze these changes across various subnational levels (rural/urban, region, ethnicity, wealth).
- To measure absolute and relative inequalities in child mortality.
Main Methods:
- Utilized Demographic and Health Surveys and Living Standards Surveys.
- Calculated under-5 and neonatal death rates at national and subnational levels.
- Measured inequalities using rate differences, rate ratios, and concentration indices.
Main Results:
- Both under-5 and neonatal mortality rates declined, reducing absolute inequalities.
- Relative inequalities in child mortality remained largely stable.
- Neonatal mortality showed no significant trend in absolute or relative inequalities, with higher rates in the mid-western region.
Conclusions:
- By 2015, over 65% of under-5 deaths are projected to be neonatal.
- Equitable reductions in child mortality necessitate strengthening health systems, focusing on maternal and newborn care.
- Vulnerable populations require targeted interventions to address social exclusion and financial barriers to care.
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