Abstract

Background: Despite global achievements in reducing early childhood mortality, disparities remain. There have been empirical studies of inequalities conducted in low- and middle-income countries. However, there have been no epidemiological studies on socioeconomic inequalities and early childhood survival in Myanmar.

Objective: To estimate associations between two measures of parental socioeconomic status – household wealth and education – and age-specific early childhood mortality in Myanmar.

Methods: Using cross-sectional data obtained from the Myanmar Demographic Health Survey (2015–2016), univariate and multiple logistic regressions were performed to investigate associations between household wealth and highest attained parental education, and under-5, neonatal, post-neonatal and child mortality. Data for 10,081 children born to 5,932 married women (aged 15–49 years) 10 years prior to the survey, were analysed.

Results: Mortality during the first five years was associated with household wealth. In multiple logistic models, wealth was protective for post-neonatal mortality. After adjusting for individual proximate determinants, the odds of post-neonatal mortality in the richest households were 85% lower (95% CI: 50–96%) than in the poorest households. However, significant association was not found between wealth and neonatal mortality. Parental education was important for early childhood mortality; the highest benefit from parental education was for child mortality in the one- to five-year age bracket. After adjusting for proximate determinants, children with a higher educated parent had 95% (95% CI 77–99%) lower odds of death in this age group compared with children whose parents’ highest educational attainment was at primary level. The association between parental education and neonatal mortality was not significant.

Conclusions: In Myanmar, household wealth and parental education are important for childhood survival before five years of age. This study identified nuanced age-related differences in associations. Health policy must take socioeconomic determinants into account in order to address unfair inequalities in early childhood mortality.

Details

Title
Inequalities in early childhood mortality in Myanmar - Association between parents’ socioeconomic status and early childhood mortality
Author
Sai San Moon Lu 1 ; Jennifer Stewart Williams 2   VIAFID ORCID Logo  ; Johan Nilsson Sommar 3   VIAFID ORCID Logo 

1  Department of Preventive and Social Medicine, University of Medicine Mandalay, Mandalay, Myanmar; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden 
2  Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden; Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, New Lambton Heights, NSW, Australia 
3  Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden 
Publication year
2019
Publication date
2019
Publisher
Taylor & Francis Ltd.
e-ISSN
16549880
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/16549716.2019.1603516
ProQuest document ID
2351041770
Copyright
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.