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Published on: October 23, 2020
Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis
François Niragire1, Thomas N O Achia, Alexandre Lyambabaje
1Department of Applied Statistics, College of Business and Economics, University of Rwanda, Kigali. fniragire@ur.ac.rw.
Child mortality in Rwanda varies significantly by district, with higher risks in Musanze and Nyabihu. Maternal health factors and economic status are key determinants, guiding targeted child survival programs.
Area of Science:
- * Global Health
- * Demography
- * Epidemiology
Background:
- * Child survival programs are most effective when addressing significant and area-specific factors.
- * Understanding spatial variations in child mortality is crucial for targeted interventions.
Purpose of the Study:
- * To assess the key determinants of child mortality at the district level in Rwanda.
- * To analyze the spatial variation of child mortality across Rwandan districts.
Main Methods:
- * Analysis of data from the 2010 Rwanda Demographic and Health Survey (8817 live births).
- * Application of a full Bayesian geo-additive continuous-time hazard model.
- * Identification of factors associated with child death hazards.
Main Results:
- * Substantial district-level spatial variation in childhood mortality observed.
- * Higher death hazards identified in Musanze and Nyabihu districts.
- * Lower death rates linked to medium/high economic status, four antenatal care visits, facility delivery, prolonged breastfeeding, younger maternal age (<31 years), and longer birth intervals.
Conclusions:
- * Child mortality reduction programs in Rwanda must consider district-specific spatial characteristics and maternal factors.
- * Strengthening access to and utilization of maternal and child healthcare services is essential.
- * Reducing the economic status gap among households is critical for improving child survival.
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