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Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015./
作者:	Macharia, Peter Mwangi.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	358 p.
附註:	Source: Dissertations Abstracts International, Volume: 82-12, Section: A.
Contained By:	Dissertations Abstracts International82-12A.
標題:	Childrens health. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28459254
ISBN:	9798728296027

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.
Macharia, Peter Mwangi.

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 358 p.

Source: Dissertations Abstracts International, Volume: 82-12, Section: A.

Thesis (Ph.D.)--Open University (United Kingdom), 2020.

This item must not be sold to any third party vendors.

All-cause under-five mortality (U5M) forms a key parameter for monitoring and planning of health strategies. Decision-makers need to understand subnational variations in U5M and its determinants to plan equitable and efficient service delivery. To improve our understanding of the variation in U5M and its determinants, the thesis estimates trends of U5M, its determinants and their association between 1965 and 2015 across 47 counties used for decision making in Kenya.Twenty household surveys and three censuses (1989-2015) were assembled and aligned to county boundaries. U5M was generated through cohort and period demographic techniques and smoothed via a Bayesian ecological spatio-temporal Gaussian process regression accounting for variation in sample size, demographic methods and spatio-temporal relatedness. The coverage/prevalence of 43 determinants was estimated using small-area estimation and model-based geostatistics approaches. Inequities, summary indices and progress in meeting health development goals were evaluated. Under-five lives saved or lost given the changes in determinants relative to 1993 were computed in a counter-factual framework based on a Bayesian ecological space-time mixed-effects regression model.Nationally, U5M reduced by 62% characterized by declines and reversal. At the county level, reductions were heterogeneous and inequitable ranging between 20% to 80%. Likewise, there was an uneven improvement in the coverage of interventions and reduction in infection prevalence with disadvantaged counties coinciding with high U5M areas. Development goals were sub-optimally achieved for both U5M and determinants. Nationally, U5M reversal in 1990s was associated with rising HIV infection and maternal autonomy decline. Post-2006, U5M decline was associated with a decline in HIV, malaria, stunting and improvement in sanitation, early breastfeeding, institutional delivery, treatment-seeking and maternal autonomy. Declining high parity and fully immunized children were associated with deterioration of U5M. Under-five lives saved or lost were heterogeneous across counties and over time. The results provide new insights to improve child survival for decentralized health planning in Kenya by prioritizing marginalized counties.

ISBN: 9798728296027Subjects--Topical Terms:

3685851
Childrens health.
Subjects--Index Terms:

Under-five mortality

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.
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500 $a Source: Dissertations Abstracts International, Volume: 82-12, Section: A.
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502 $a Thesis (Ph.D.)--Open University (United Kingdom), 2020.
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