Priority setting towards achieving under-five mortality target in Africa in context of sustainable development goals: an ordinary least squares (OLS) analysis

Global Health Research and Policy

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[1] 0000 0001 0684 8852, grid.264352.4, Center for Urban Ecology and Sustainability, Suffolk University, 8 Ashburton Pl, 02108, Boston, MA, USA;0000 0001 2353 285X, grid.170693.a, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, 33612, Tampa, FL, USA;0000 0001 2353 285X, grid.170693.a, School of Geosciences, University of South Florida, 4202 E. Fowler Ave, 33620, Tampa, FL, USA;0000 0004 1936 8091, grid.15276.37, College of Communications and Journalism, University of Florida, 32611, Gainesville, FL, USA;

关键词: Under-five mortality;    Sustainable development goals;    Africa;    Social determinants of health;    Health literacy;   

DOI  :  10.1186/s41256-019-0108-0

来源: publisher

【 摘 要 】

BackgroundAfrica reduced its under-5 mortality rate (U5MR) by more than 50% during the MDGs era. However, it still has by far the highest average U5MR in the world – 81 deaths compared to a global average of 43 deaths per 1000 births, with eight of the ten countries in the world with the highest child mortality rates. The primary objective of our study was to examine the socioeconomic, healthcare, and environmental determinants that most account for U5MR disparities between African countries.MethodsWe used a series of ordinary least squares (OLS) regression models to assess the effects of 14 distinct socioeconomic, environmental and healthcare variables that account for the high U5MR differentials that persist between African countries. We conducted our analysis on 43 countries for which data were available. Using a dummy variable, we also emphasized factors that may be accounting for the disparity between the eight worst-performing countries and the remainder of the continent.ResultsAmong all the determinants analyzed in our study, the results reveal that the factors that most account for the inequities observed are, in order, expenditure on healthcare (p < 0.01), total fertility rate (p < 0.01), income per capita (p < 0.05), and access to clean water (p < 0.1).ConclusionsOur results show that the gap between the best and worst performing countries in Africa can be significantly narrowed if government and donor interventions will target downstream factors such as improving education for mothers and sensitising them about birth control since fertility rate differences play a critical role. Improving accessibility to clean water sources to reduce outbreaks of diarrhea diseases is also observed as a critical factor.

【 授权许可】

CC BY