Background
Methods
The countries
The database and variables
Outreach services | Clinical services | Community/family services | Contextual factors |
---|---|---|---|
BCG vaccination | Delivered by skilled birth attendant | Underweight | TV at home |
DTP3 vaccination | Delivered in health facility | Stunting | Electricity at home |
Measles vaccination | Delivered by a doctor | Wasting | Education of women 15-19 years |
Maternal tetanus vaccination | Delivered by C-section | Exclusive breastfeeding for 6 months | Sanitation |
Fully vaccinated | Sought care for ARI symptoms | Breastfeeding within an hour of birth | Water supply |
Possesses vaccine card | Diarrhea episode treated with oral rehydration | Total fertility rate | Gross domestic product |
At least 4 antenatal care visits | therapy or recommended home fluids | Availability of toilet | Adult HIV prevalence |
At least 1 antenatal care visit | |||
Family planning needs satisfied among married women |
Statistical analysis
Variables (V) | Outreach services | Clinical services | Community/ family services | ||||
---|---|---|---|---|---|---|---|
Component 1 | Component 2 | Component 3 | Component 1 | Component 2 | Component 1 | Component 2 | |
Measles vaccination |
0.4246
| 0.0208 | 0.0165 | ||||
DTP3 vaccination |
0.4393
| -0.0066 | -0.0037 | ||||
BCG vaccination |
0.4217
| -0.0208 | 0.0291 | ||||
Fully vaccinated |
0.4431
| -0.0037 | 0.0164 | ||||
Tetanus |
0.4177
| -0.1288 | -0.1382 | ||||
Vaccination card |
0.2770
| 0.2731 | 0.0988 | ||||
At least four antenatal visits | -0.0359 |
0.7027
| -0.1839 | ||||
At least one antenatal visit | 0.0122 |
0.6432
| 0.1615 | ||||
Family planning services | -0.0033 | -0.0201 |
0.9539
| ||||
Proportion (%) | 0.52 | 0.21 | 0.12 | ||||
Cumulative variance (%) | 0.52 | 0.73 | 0.85 | ||||
Attended by a doctor at delivery |
0.4326
| -0.1232 | |||||
Access to a skilled birth attendant |
0.5105
| 0.0896 | |||||
Institutional delivery |
0.5610
| -0.0424 | |||||
C-section |
0.4775
| 0.0560 | |||||
Treatment for pneumonia | 0.0732 |
0.6880
| |||||
Treatment for diarrhea | - 0.0648 |
0.7060
| |||||
Proportion (%) | 0.49 | 0.24 | |||||
Cumulative variance (%) | 0.49 | 0.73 | |||||
Underweight |
0.5457
| 0.2679 | |||||
Stunting |
0.6132
| -0.1164 | |||||
Wasting |
0.5872
| 0.0303 | |||||
Total fertility rate |
0.4759
| -0.1285 | |||||
Exclusive breastfeeding for 6 months | -0.2402 |
0.5521
| |||||
Breastfeeding within an hour of birth | 0.2030 |
0.4985
| |||||
Toilet | 0.2658 |
-0.3840
| |||||
Proportion (%) | 0.32 | 0.29 | |||||
Cumulative variance (%) | 0.32 | 0.61 |
Results
Under-five mortality rates and average annual change (AAC)
Under 5 mortality rate/1000 live births | |||||
---|---|---|---|---|---|
Country | year of most recent survey | Years since last survey | penultimate survey | most recent survey | U5MR |
Benin | 2006 | 5.0 | 148 | 132 | 2.3% |
Bolivia | 2003 | 9.5 | 121 | 82 | 4.1% |
Burkina Faso | 2003 | 10.5 | 206 | 190 | 0.8% |
Cambodia | 2005 | 5.5 | 118 | 93 | 4.3% |
Cameroon | 2004 | 6.0 | 151 | 144 | 0.8% |
Chad | 2004 | 7.0 | 201 | 206 | -0.4% |
Egypt | 2005 | 9.0 | 78 | 45 | 6.1% |
Eritrea | 2002 | 7.0 | 133 | 99 | 4.2% |
Ethiopia | 2005 | 5.0 | 167 | 138 | 3.8% |
Ghana | 2003 | 4.7 | 111 | 111 | 0.0% |
Guinea | 2005 | 6.0 | 204 | 175 | 2.6% |
Haiti | 2005 | 11.0 | 151 | 93 | 4.4% |
India | 2006 | 7.0 | 103 | 81 | 3.5% |
Kenya | 2003 | 5.0 | 111 | 116 | -0.9% |
Madagascar | 2004 | 6.3 | 156 | 132 | 2.7% |
Malawi | 2004 | 4.0 | 192 | 152 | 5.8% |
Mali | 2006 | 5.5 | 229 | 201 | 2.4% |
Morocco | 2004 | 11.5 | 93 | 51 | 5.2% |
Mozambique | 2003 | 6.5 | 212 | 163 | 4.0% |
Nepal | 2006 | 5.0 | 96 | 69 | 6.6% |
Niger | 2006 | 8.0 | 274 | 204 | 3.7% |
Philippines | 2003 | 10.0 | 60 | 37 | 4.8% |
Rwanda | 2005 | 5.0 | 200 | 180 | 2.1% |
Senegal | 2005 | 8.0 | 148 | 125 | 2.2% |
Tanzania | 2004 | 8.0 | 156 | 131 | 2.2% |
Uganda | 2006 | 5.5 | 155 | 138 | 2.1% |
Zambia | 2002 | 5.5 | 178 | 178 | 0.0% |
Results of the principal component analysis
Average annual change in outreach, clinical, and community and family components
Outreach services | Clinical services | Community Services | |||||
---|---|---|---|---|---|---|---|
Country | Immunization | Antenatal care | Family planning | Access | Careseeking/ treatment | Nutrition | Breastfeeding |
Benin | -0.1% | -0.1% | -2.2% | 0.9% | -1.1% | -0.9% | 4.1% |
Bolivia | 4.0% | 5.1% | 0.6% | 3.5% | 1.1% | 4.6% | 4.9% |
Burkina Faso | 1.1% | -0.1% | 0.2% | -1.8% | 4.2% | -1.3% | 7.7% |
Cambodia | 8.1% | 15.5% | 6.8% | 13.5% | 1.8% | 5.7% | 17.1% |
Cameroon | 3.1% | 1.6% | -1.0% | -0.8% | -0.6% | 0.0% | 2.9% |
Chad | 0.3% | 4.9% | -15.1% | 0.8% | -6.7% | 0.3% | 2.4% |
Egypt | 1.0% | 7.3% | 1.4% | 7.7% | -1.8% | 4.1% | -0.7% |
Eritrea | 7.4% | 5.7% | 0.3% | 5.5% | 2.9% | 2.2% | 2.3% |
Ethiopia | 7.1% | 1.9% | 9.8% | 3.5% | -0.2% | 1.6% | 4.8% |
Ghana | 1.7% | 1.6% | 1.5% | -0.7% | 4.8% | 1.4% | 8.6% |
Guinea | 1.2% | 1.7% | 6.3% | -0.1% | -1.1% | -1.9% | 8.0% |
Haiti | 2.4% | 2.9% | 4.3% | 3.3% | 2.7% | 1.3% | 4.2% |
India | 1.7% | 3.1% | 1.1% | 2.5% | 0.3% | 0.2% | 3.9% |
Kenya | -1.5% | -2.0% | 0.0% | -3.2% | -4.8% | 1.2% | -0.4% |
Madagascar | 3.5% | 0.4% | 3.4% | 0.6% | 1.2% | -1.8% | 7.1% |
Malawi | -0.9% | 0.3% | 2.1% | 2.0% | 5.4% | 1.7% | 1.9% |
Mali | 7.1% | 3.4% | -1.0% | 3.2% | -2.0% | -0.1% | 5.3% |
Morocco | -0.7% | 7.3% | 1.9% | 7.9% | 3.4% | -2.5% | -0.6% |
Mozambique | 4.6% | 4.0% | 5.7% | 1.2% | 3.8% | 1.5% | 0.0% |
Nepal | 6.1% | 11.7% | 2.4% | 13.4% | 3.7% | 0.5% | 2.0% |
Niger | 4.3% | 2.7% | 2.9% | 3.1% | 2.4% | 1.8% | 15.6% |
Philippines | -0.2% | 1.8% | 1.9% | 2.1% | 1.9% | 1.5% | 2.8% |
Rwanda | -0.6% | 2.7% | 2.9% | -0.1% | 6.4% | 2.6% | -0.2% |
Senegal | 2.5% | 5.9% | 0.0% | 1.1% | 1.6% | 1.7% | 7.3% |
Tanzania | -0.8% | 2.1% | 3.3% | 2.1% | -1.3% | 4.3% | 2.0% |
Uganda | 4.4% | 1.2% | -1.3% | 3.0% | 0.9% | 0.4% | -1.7% |
Zambia | -2.1% | -0.2% | 2.1% | -1.1% | -1.3% | -1.9% | 4.2% |
Correlation between AAC in outreach components and AAC in under-five mortality
Component | Coefficient | 95% Confidence interval | p value* | r2† |
---|---|---|---|---|
Outreach services
| ||||
Component 1: Immunization
| 0.0032 | -0.0004, 0.0069 | 0.08 | 0.09 |
Component 2: antenatal care
| 0.0091 | 0.0029, 0.0152 |
0.006
| 0.38 |
Component 3: family planning
| 0.0090 | 0.0017, 0.0163 |
0.018
| 0.32 |
Clinical services
| ||||
Component 1: access to services
| 0.0091 | 0.0052, 0.0129 |
0.018
|
0.58
|
Component 2: seeking treatment
| 0.0074 | 0.0012, 0.0136 |
0.021
| 0.31 |
Community/ family services
| ||||
Component 1: Nutritional issues
| 0.0019 | -0.0081, 0.0042 | 0.52 | 0.14 |
Component 2: breastfeeding
| 0.0087 | 0.0028, 0.0186 |
0.006
| 0.38 |
Component | Coefficient | 95% Confidence interval | p value* | r2† |
---|---|---|---|---|
Outreach services
| ||||
Component 1: Immunization
| 0.0025 | -0.0030, 0.0081 | 0.33 | 0.10 |
Component 2: antenatal care
| 0.0111 | 0.0006, 0.0216 |
0.039
| 0.29 |
Component 3: family planning
| 0.0060 | -0.0049, 0.0170 | 0.25 | 0.12 |
Clinical services
| ||||
Component 1: access to services
| 0.0118 | 0.0068, 0.0167 |
0.000
|
0.67
|
Component 2: seeking treatment
| 0.0064 | -0.0017, 0.0146 | 0.116 | 0.19 |
Community/ family services
| ||||
Component 1: Nutritional issues
| 0.0110 | 0.030, 0.0190 |
0.01
| 0.40 |
Component 2: breastfeeding
| 0.0058 | -0.0023, 0.0139 | 0.17 | 0.15 |