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Inequalities in cause-specific mortality in children and adolescents in the Moramanga health survey, Madagascar

Author

Listed:
  • Rila Ratovoson

    (Institut Pasteur de Madagascar
    Institut national d’études démographiques)

  • Bruno Masquelier

    (Institut national d’études démographiques
    Université Catholique de Louvain)

  • Todisoa Andriatahina

    (District Hospital)

  • Reziky Mangahasimbola

    (Institut Pasteur de Madagascar)

  • Zo Andrianirina

    (Soavinandriana Hospital)

  • Gilles Pison

    (Institut national d’études démographiques
    National Museum of Natural History)

  • Laurence Baril

    (Institut Pasteur de Madagascar
    Institut Pasteur of Cambodia)

Abstract

Objectives One child or young adolescent dies every 10 min in Madagascar and large disparities in survival persist. We estimated cause-specific mortality in a cohort of children aged 0–14 in the Moramanga district and explored how causes of death shape these inequalities. Methods Children were followed prospectively between 2012 and 2017. Causes of death were established based on verbal autopsies. Incidence rate ratios were estimated in Poisson regression models. Results The risk of dying before age 15 was 68.1 per thousand live births. Risks of dying were highest in the first year of life (31.2‰) and lowest in children aged 10–14 (6.4‰). The male-to-female sex ratios of mortality increased with age and reached 2.3 among adolescents aged 10–14. Communicable, nutritional and neonatal causes accounted for 79.5% of deaths below age 5 and 47.0% above age 5. Mortality was positively associated with household poverty, lack of education of the household head, and rural residence. Conclusions Interventions should be designed with an equity lens to reduce large disparities in survival and be tailored to the needs of each age-group.

Suggested Citation

  • Rila Ratovoson & Bruno Masquelier & Todisoa Andriatahina & Reziky Mangahasimbola & Zo Andrianirina & Gilles Pison & Laurence Baril, 2020. "Inequalities in cause-specific mortality in children and adolescents in the Moramanga health survey, Madagascar," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(6), pages 781-790, July.
    • Handle: RePEc:spr:ijphth:v:65:y:2020:i:6:d:10.1007_s00038-020-01409-z
    DOI: 10.1007/s00038-020-01409-z
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    1. Chitale Remonja Rabaoarisoa & Rado Rakotoarison & Nivo Heritiana Rakotonirainy & Reziky Tiandraza Mangahasimbola & Alain Berthin Randrianarisoa & Ronan Jambou & Inès Vigan-Womas & Patrice Piola & Rind, 2017. "The importance of public health, poverty reduction programs and women’s empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-18, October.
    2. Erin K Nichols & Peter Byass & Daniel Chandramohan & Samuel J Clark & Abraham D Flaxman & Robert Jakob & Jordana Leitao & Nicolas Maire & Chalapati Rao & Ian Riley & Philip W Setel & on behalf of the , 2018. "The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0," PLOS Medicine, Public Library of Science, vol. 15(1), pages 1-9, January.
    3. Philippe Bocquier & Nyovani Madise & Eliya Zulu, 2011. "Is There an Urban Advantage in Child Survival in Sub-Saharan Africa? Evidence From 18 Countries in the 1990s," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 531-558, May.
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