Background
Methods
Indicators and definitions
Indicators | Definition |
---|---|
Stunting | Percentage of children with a height-for-age z-score < −2 standard deviations from the reference median |
Wasting | Percentage of children with a weight-for-height z-score < −2 standard deviations from the reference median |
Underweight | Percentage of children with a weight-for-age z-score < −2 standard deviations from the reference median |
Neonatal mortality rate (NMR) | The number of neonates dying before reaching 28 days of age per 1000 live births |
Infant mortality rate (IMR) | The number of deaths among children under 12 months of age per 1000 live births |
Under-5 mortality rate (U5MR) | The number of deaths among children under 5 years of age per 1000 live births |
Measles vaccination | Percentage of children aged 12 to 23 months who received measlesa,b
|
Full immunization | Percentage of children aged 12 to 23 months who received BCG, measles, and three doses of polio and DPTb,a
|
Contraceptive prevalence (modern method) | Percentage of currently married women aged 15 to 49 who currently use a modern method of contraception |
Antenatal care visits, 4 or more (ANC4+) | Percentage of mothers aged 15 to 49 who had a live birth in the past 5 years who received at least 4 antenatal care visits from any skilled personnel during pregnancy for the most recent birth |
Skilled birth attendant (SBA) | Percentage of live births to mothers aged 15 to 49 in the past five years that were attended by skilled health attendant |
Data sources and variable construction
Data analysis
Results
Trends
2000 | 2005 | 2011 | 2014 | Change (Latest-Earliest) | |
---|---|---|---|---|---|
Stunting | 57.0 | 49.5 | 44.1 | 40.6 | −16.4 |
Wasting | 12.5 | 12.4 | 10.1 | 8.9 | −3.6 |
Underweight | 41.9 | 34.1 | 29.1 | 26.6 | −15.3 |
NNMR | 48.4 | 39.3 | 37.4 | 34.3 | −14.1 |
IMR | 95.9 | 77.6 | 58.9 | 59.3 | −36.6 |
U5MR | 163.9 | 123.3 | 87.1 | 80.1 | −83.8 |
Measles vaccination | 27.0 | 36.5 | 56.7 | - | 29.7 |
Full immunization | 14.6 | 21.6 | 24.9 | - | 10.3 |
Contraceptive | 7.2 | 15.7 | 30.0 | 45.2 | 38.0 |
ANC4+
| 10.4 | 11.9 | 15.9 | 24.2 | 13.8 |
SBA | 5.7 | 5.7 | 10.0 | 15.5 | 9.8 |
Absolute and relative inequalities
Top 60% | Bottom 40% | Difference | Ratio | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Earliest Survey | Latest Survey | Earliest Survey | Latest Survey | Earliest Survey | Latest Survey |
p-value | Earliest Survey | Latest Survey |
p-value | |
Stunting | 55.2 | 36.2 | 59.4 | 45.9 | −4.2 | −9.8 | 0.064 | 0.9 | 0.8 | 0.013 |
Wasting | 12.4 | 7.5 | 12.7 | 10.6 | −0.3 | −3.0 | 0.077 | 1.0 | 0.7 | 0.034 |
Underweight | 39.9 | 23.1 | 44.7 | 30.9 | −4.7 | −7.8 | 0.189 | 0.9 | 0.7 | 0.011 |
NNMR | 53.8 | 40.3 | 40.9 | 27.1 | 12.9 | 13.2 | 0.977 | 1.3 | 1.5 | NA |
IMR | 105.8 | 60.7 | 82.2 | 57.7 | 23.6 | 3.0 | 0.176 | 1.3 | 1.1 | NA |
U5MR | 171.9 | 79.0 | 152.7 | 81.7 | 19.2 | −2.7 | 0.212 | 1.1 | 1.0 | NA |
Measles vaccination | 33.9 | 62.1 | 17.5 | 49.9 | 16.5 | 12.2 | 0.354 | 1.9 | 1.2 | 0.006 |
Full immunization | 19.3 | 30.3 | 8.1 | 18.1 | 11.2 | 12.2 | 0.796 | 2.4 | 1.7 | 0.143 |
Contraceptive | 10.1 | 50.8 | 3.2 | 36.6 | 6.9 | 14.2 | 0.033 | 3.2 | 1.4 | 0.002 |
ANC4+ | 14.8 | 34.8 | 4.3 | 10.6 | 10.4 | 24.2 | 0.000 | 3.4 | 3.3 | 0.876 |
SBA | 8.9 | 24.2 | 1.2 | 5.0 | 7.7 | 19.3 | 0.000 | 7.5 | 4.9 | 0.142 |
Richest Quintile | Poorest Quintile | Difference | Ratio | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Earliest Survey | Latest Survey | Earliest Survey | Latest Survey | Earliest Survey | Latest Survey |
p-val | Earliest Survey | Latest Survey |
p-val | |
Stunting | 47.7 | 27.4 | 59.3 | 47.1 | −11.6 | −19.7 | 0.057 | 0.8 | 0.6 | 0.002 |
Wasting | 8.9 | 7.4 | 12.1 | 11.7 | −3.2 | −4.3 | 0.656 | 0.7 | 0.6 | 0.559 |
Underweight | 31.0 | 16.6 | 43.8 | 33.4 | −12.8 | −16.8 | 0.237 | 0.7 | 0.5 | 0.003 |
NNMR | 42.3 | 45.3 | 33.7 | 36.8 | 8.6 | 8.4 | 0.991 | 1.3 | 1.2 | NA |
IMR | 88.2 | 67.7 | 77.9 | 67.0 | 10.3 | 0.7 | 0.669 | 1.1 | 1.0 | NA |
U5MR | 137.6 | 78.4 | 136.1 | 89.7 | 1.5 | −11.3 | 0.603 | 1.0 | 0.9 | NA |
Measles vaccination | 53.1 | 79.9 | 18.7 | 47.1 | 34.3 | 32.8 | 0.825 | 2.8 | 1.7 | 0.023 |
Full immunization | 34.8 | 50.9 | 7.2 | 17.5 | 27.6 | 33.4 | 0.419 | 4.8 | 2.9 | 0.153 |
Contraceptive | 26.1 | 57.2 | 3.2 | 30.9 | 23.0 | 26.2 | 0.538 | 8.3 | 1.8 | 0.000 |
ANC4+
| 34.8 | 60.2 | 4.1 | 8.6 | 30.7 | 51.7 | 0.000 | 8.6 | 7.0 | 0.481 |
SBA | 25.4 | 55.6 | 0.9 | 4.5 | 24.5 | 51.0 | 0.000 | 29.6 | 12.3 | 0.060 |
Concentration curves and indexes
Concentration Index | Wagstaff Concentration Index | Erryegers Concentration Index | |||||||
---|---|---|---|---|---|---|---|---|---|
Earliest | Latest |
p-val | Earliest | Latest |
p-val | Earliest | Latest |
p-val | |
Stunting | −0.032 | −0.086 | 0.001 | −0.075 | −0.145 | 0.018 | −0.074 | −0.140 | 0.021 |
Wasting | −0.034 | −0.102 | 0.105 | −0.039 | −0.112 | 0.116 | −0.017 | −0.036 | 0.240 |
Underweight | −0.054 | −0.119 | 0.003 | −0.093 | −0.162 | 0.025 | −0.091 | −0.127 | 0.163 |
NNMR | 0.049 | 0.075 | 0.000 | 0.052 | 0.078 | 0.000 | − | − | − |
IMR | 0.038 | 0.008 | 0.000 | 0.042 | 0.009 | 0.000 | − | − | − |
U5MR | 0.016 | −0.022 | 0.000 | 0.019 | −0.024 | 0.000 | − | − | − |
Measles vaccination | 0.242 | 0.096 | 0.000 | 0.331 | 0.223 | 0.043 | 0.261 | 0.219 | 0.368 |
Full immunization | 0.344 | 0.223 | 0.025 | 0.403 | 0.297 | 0.110 | 0.201 | 0.22 | 0.594 |
Contraceptive | 0.496 | 0.119 | 0.000 | 0.534 | 0.218 | 0.000 | 0.142 | 0.216 | 0.009 |
ANC4+ | 0.474 | 0.381 | 0.017 | 0.529 | 0.503 | 0.578 | 0.197 | 0.369 | 0.000 |
SBA | 0.665 | 0.525 | 0.004 | 0.705 | 0.622 | 0.116 | 0.150 | 0.325 | 0.000 |
Changes in inequality
Rate Differences | Rate Ratio | Conc. Index | Test of Dominance: Concentration Curves | ||||
---|---|---|---|---|---|---|---|
Bottom 40% vs. Top 60% | Poorest (q1) vs. Richest (q5) | Bottom 40% vs. Top 60% | Poorest (q1) vs. Richest (q5) | mca rule | iup rule | ||
Panel A: Health Status
| |||||||
Stunting | Worsened | Worsened | Worsened | Worsened | Worsened | NS | NS |
Wasting | Worsened | NS | Worsened | NS | NS | Worsened | NS |
Underweight | NS | NS | Worsened | Worsened | Worsened | Worsened | NS |
NMRa
| NS | NS | − | − | Improveda
| − | − |
IMRa
| NS | NS | − | − | Improveda
| − | − |
U5MRa
| NS | NS | − | − | Improveda
| − | − |
Panel B: Health Services
| |||||||
Measles vaccination | NS | NS | Improved | Improved | Improved | Improved | NS |
Full immunization | NS | NS | NS | NS | Improvedb
| NS | NS |
Contraceptive | Worsened | NS | Improved | Improved | Improved | Improved | NS |
ANC4+ | Worsened | Worsened | NS | NS | Improvedb
| Improved | NS |
SBA | Worsened | Worsened | NS | Improved | Improvedb
| Improved | Improved |
Decomposition
2000 | 2014 | |||||
---|---|---|---|---|---|---|
Elasticity | Conc. index | Contribution | Elasticity | Conc. index | Contribution | |
Child age | 1.639 | −0.003 | −0.004 | 2.202 | −0.011 | −0.025 |
Child age squared | −0.862 | −0.004 | 0.003 | −1.168 | −0.016 | 0.018 |
Sex (Male) | 0.028 | −0.004 | 0.000 | 0.031 | 0.010 | 0.000 |
Birth order | 0.010 | −0.068 | −0.001 | −0.048 | −0.024 | 0.001 |
Wealth index | −0.192 | 0.142 | −0.027 | −0.310 | 0.180 | −0.056 |
Child HH members | 0.038 | −0.016 | −0.001 | 0.000 | −0.033 | 0.000 |
HH size | −0.008 | −0.025 | 0.000 | 0.057 | 0.005 | 0.000 |
Education (mother) | −0.020 | 0.531 | −0.011 | −0.037 | 0.460 | −0.017 |
Education (HH head) | −0.018 | 0.347 | −0.006 | −0.026 | 0.349 | −0.009 |
Residence (urban) | 0.010 | 0.848 | 0.009 | −0.013 | 0.709 | −0.009 |
Region | . | . | −0.005 | . | . | −0.001 |
Residual | . | . | 0.010 | . | . | 0.055 |
Total | . | . | −0.033 | . | . | −0.042 |
2000 | 2011 | |||||
---|---|---|---|---|---|---|
8a. Measles Vaccination
| Elasticity | Conc. ind | Contribution | Elasticity | Conc. ind | Contribution |
Age (mother’s) | 0.124 | −0.023 | −0.003 | 0.304 | 0.000 | 0.000 |
Child HH members | −0.011 | −0.014 | 0.000 | −0.073 | −0.030 | 0.002 |
HH size | −0.036 | −0.027 | 0.001 | −0.109 | −0.005 | 0.001 |
Wealth index | 1.437 | 0.098 | 0.141 | 0.856 | 0.104 | 0.089 |
Education (mother) | 0.057 | 0.518 | 0.029 | 0.070 | 0.486 | 0.034 |
Education (father) | 0.107 | 0.407 | 0.043 | 0.024 | 0.364 | 0.009 |
Residence (urban) | −0.006 | 0.885 | −0.005 | −0.011 | 0.800 | −0.009 |
Region | . | . | 0.004 | . | . | −0.001 |
Residual | . | . | 0.031 | . | . | −0.029 |
Total | . | . | 0.242 | . | . | 0.096 |
8b. Full Immunization
| ||||||
Age (mother’s) | 0.096 | −0.023 | −0.002 | 0.362 | 0.000 | 0.000 |
Child HH members | 0.015 | −0.014 | 0.000 | −0.091 | −0.030 | 0.003 |
HH size | 0.065 | −0.027 | −0.002 | −0.207 | −0.005 | 0.001 |
Wealth Index | 1.409 | 0.098 | 0.138 | 2.434 | 0.104 | 0.253 |
Education (mother) | 0.110 | 0.525 | 0.058 | 0.042 | 0.486 | 0.021 |
Education (father) | 0.112 | 0.412 | 0.046 | 0.000 | 0.363 | 0.000 |
Residence (urban) | −0.021 | 0.906 | −0.019 | −0.065 | 0.800 | −0.052 |
Region | . | . | . | . | . | −0.005 |
Residual | . | . | . | . | . | 0.002 |
Total | . | . | 0.344 | . | . | 0.223 |
2000 | 2011/14 | |||||
---|---|---|---|---|---|---|
9a. Contraceptive
| Elasticity | Conc. index | Contribution | Elasticity | Conc. index | Contribution |
Age | −0.481 | −0.019 | 0.009 | −0.768 | −0.006 | 0.004 |
Wealth index | 1.028 | 0.099 | 0.102 | 0.780 | 0.101 | 0.079 |
Education (years) | 0.067 | 0.562 | 0.038 | 0.062 | 0.432 | 0.027 |
Residence (urban) | 0.152 | 0.817 | 0.124 | 0.067 | 0.636 | 0.043 |
Protestant | −0.014 | −0.044 | 0.001 | 0.013 | −0.019 | 0.000 |
Muslim | 0.046 | −0.018 | −0.001 | −0.073 | −0.041 | 0.003 |
No more children | 0.275 | 0.020 | 0.006 | 0.096 | 0.002 | 0.000 |
Region | . | . | −0.009 | . | . | 0.003 |
Residual | . | . | 0.227 | . | . | 0.224 |
Total | . | . | 0.496 | . | . | 0.382 |
9b. ANC4+
| ||||||
Age | 0.102 | −0.020 | −0.002 | −0.404 | −0.005 | 0.002 |
Wealth index | 1.430 | 0.100 | 0.143 | 1.764 | 0.130 | 0.230 |
Education (years) | 0.103 | 0.566 | 0.058 | 0.167 | 0.449 | 0.075 |
Residence (urban) | 0.078 | 0.851 | 0.066 | 0.064 | 0.708 | 0.046 |
Region | . | . | 0.021 | . | . | 0.022 |
Residual | . | . | 0.186 | . | . | 0.092 |
Total | . | . | 0.474 | . | . | 0.467 |
9c. SBA
| ||||||
Age | −0.085 | −0.019 | 0.002 | −0.46 | −0.002 | 0.001 |
Child HH members | −0.33 | −0.023 | 0.008 | −0.476 | −0.037 | 0.018 |
HH size | 0.124 | −0.029 | −0.004 | −0.324 | 0.005 | −0.002 |
Wealth index | 1.278 | 0.095 | 0.122 | 2.3 | 0.125 | 0.287 |
Education (years) | 0.096 | 0.53 | 0.051 | 0.161 | 0.441 | 0.071 |
Residence (Urban) | 0.087 | 0.856 | 0.074 | 0.06 | 0.681 | 0.041 |
Region | . | . | 0.023 | . | . | 0.001 |
Residual | . | . | 0.389 | . | . | 0.108 |
Total | . | . | 0.665 | . | . | 0.526 |