R Peña1, S Wall, L A Persson. 1. Department of Preventive Medicine, Universidad Nacional Autónoma, León, Nicaragua. rodolfo.pena@epiph.umu.se
Abstract
OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.
OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.
Authors: John C Phuka; Melissa Gladstone; Kenneth Maleta; Chrissie Thakwalakwa; Yin Bun Cheung; André Briend; Mark J Manary; Per Ashorn Journal: Matern Child Nutr Date: 2011-02-22 Impact factor: 3.092
Authors: Elwyn Chomba; Wally A Carlo; Shivaprasad S Goudar; Imtiaz Jehan; Antoinette Tshefu; Ana Garces; Sailajandan Parida; Fernando Althabe; Elizabeth M McClure; Richard J Derman; Robert L Goldenberg; Carl Bose; Nancy F Krebs; Pinaki Panigrahi; Pierre Buekens; Dennis Wallace; Janet Moore; Marion Koso-Thomas; Linda L Wright Journal: Neonatology Date: 2016-08-20 Impact factor: 4.035