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dc.contributor.authorKraft, Aleli D
dc.contributor.authorNguyen, Kim-Huong
dc.contributor.authorJimenez-Soto, Eliana
dc.contributor.authorHodge, Andrew
dc.date.accessioned2017-05-03T14:21:05Z
dc.date.available2017-05-03T14:21:05Z
dc.date.issued2013
dc.date.modified2014-02-20T22:38:41Z
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0053696
dc.identifier.urihttp://hdl.handle.net/10072/55603
dc.description.abstractBackground: The probability of survival through childhood continues to be unequal in middle-income countries. This study uses data from the Philippines to assess trends in the prevalence and distribution of child mortality and to evaluate the country's socioeconomic-related child health inequality. Methodology: Using data from four Demographic and Health Surveys we estimated levels and trends of neonatal, infant, and under-five mortality from 1990 to 2007. Mortality estimates at national and subnational levels were produced using both direct and indirect methods. Concentration indices were computed to measure child health inequality by wealth status. Multivariate regression analyses were used to assess the contribution of interventions and socioeconomic factors to wealth-related inequality. Findings: Despite substantial reductions in national under-five and infant mortality rates in the early 1990s, the rates of declines have slowed in recent years and neonatal mortality rates remain stubbornly high. Substantial variations across urban-rural, regional, and wealth equity-markers are evident, and suggest that the gaps between the best and worst performing sub-populations will either be maintained or widen in the future. Of the variables tested, recent wealth-related inequalities are found to be strongly associated with social factors (e.g. maternal education), regional location, and access to health services, such as facility-based delivery. Conclusion: The Philippines has achieved substantial progress towards Millennium Development Goal 4, but this success masks substantial inequalities and stagnating neonatal mortality trends. This analysis supports a focus on health interventions of high quality - that is, not just facility-based delivery, but delivery by trained staff at well-functioning facilities and supported by a strong referral system - to re-start the long term decline in neonatal mortality and to reduce persistent within-country inequalities in child health.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent582652 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoeng
dc.publisherPublic Library of Science
dc.publisher.placeUnited States
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrome53696-1
dc.relation.ispartofpagetoe53696-12
dc.relation.ispartofissue1
dc.relation.ispartofjournalPloS One
dc.relation.ispartofvolume8
dc.rights.retentionY
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchcode119999
dc.titleStagnant neonatal mortality and persistent health inequality in middle-income countries: A case study of the Philippines
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://www.plos.org/journals/license.html
gro.rights.copyright© 2013 Kraft et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License CCAL. (http://www.plos.org/journals/license.html)
gro.date.issued2013
gro.hasfulltextFull Text
gro.griffith.authorNguyen, Kim-Huong


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