Journal
HEALTH POLICY
Volume 65, Issue 3, Pages 277-299Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/S0168-8510(03)00039-3
Keywords
under-five mortality; infant mortality; health inequality
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Empirical studies on child mortality at the disaggregated level-by social-economic group or geographic location-arc more informative for designing health polices. Using Demographic and Health Survey data from over 60 low-income countries, this Study (1) presents global patterns of the level and inequality in child mortality and (2) investigates the determinants of child mortality, both at the national level and separately Cor urban and rural areas. The global patterns of health outcomes reveal two interesting observations. First, as child mortality declines, the gap ill mortality between the poor and the better-off widens. Second, while child mortality in rural areas is substantially higher than in urban areas, the reduction ill child mortality is much slower in rural areas where the poor are concentrated. This suggests that health interventions implemented in the past decade may not have been as effective as intended in reaching the poor. The analysis on mortality determination shows that at the national level access to electricity, incomes, vaccination in the first year of birth, and public health expenditure significantly reduce child mortality. The electricity effect is large and independent of the income effect. While in urban areas, access to electricity is the only significant mortality determinant, ill rural areas, vaccination in the first year of birth is the only significant factor. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.
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