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Entrenched Geographical and Socioeconomic Disparities in Child Mortality: Trends in Absolute and Relative Inequalities in Cambodia

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  • Eliana Jimenez-Soto
  • Jo Durham
  • Andrew Hodge

Abstract

Background: Cambodia has made considerable improvements in mortality rates for children under the age of five and neonates. These improvements may, however, mask considerable disparities between subnational populations. In this paper, we examine the extent of the country's child mortality inequalities. Methods: Mortality rates for children under-five and neonates were directly estimated using the 2000, 2005 and 2010 waves of the Cambodian Demographic Health Survey. Disparities were measured on both absolute and relative scales using rate differences and ratios, and where applicable, slope and relative indices of inequality by levels of rural/urban location, regions and household wealth. Findings: Since 2000, considerable reductions in under-five and to a lesser extent in neonatal mortality rates have been observed. This mortality decline has, however, been accompanied by an increase in relative inequality in both rates of child mortality for geography-related stratifying markers. For absolute inequality amongst regions, most trends are increasing, particularly for neonatal mortality, but are not statistically significant. The only exception to this general pattern is the statistically significant positive trend in absolute inequality for under-five mortality in the Coastal region. For wealth, some evidence for increases in both relative and absolute inequality for neonates is observed. Conclusion: Despite considerable gains in reducing under-five and neonatal mortality at a national level, entrenched and increased geographical and wealth-based inequality in mortality, at least on a relative scale, remain. As expected, national progress seems to be associated with the period of political and macroeconomic stability that started in the early 2000s. However, issues of quality of care and potential non-inclusive economic growth might explain remaining disparities, particularly across wealth and geography markers. A focus on further addressing key supply and demand side barriers to accessing maternal and child health care and on the social determinants of health will be essential in narrowing inequalities.

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  • Eliana Jimenez-Soto & Jo Durham & Andrew Hodge, 2014. "Entrenched Geographical and Socioeconomic Disparities in Child Mortality: Trends in Absolute and Relative Inequalities in Cambodia," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-9, October.
    • Handle: RePEc:plo:pone00:0109044
    DOI: 10.1371/journal.pone.0109044
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    References listed on IDEAS

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    2. von Grebmer, Klaus & Bernstein, Jill & Nabarro, David & Prasai, Nilam & Amin, Shazia & Yohannes, Yisehac & Sonntag, Andrea & Patterson, Fraser, 2016. "Indice Globale della Fame 2016: Obiettivo Fame Zero," IFPRI books, International Food Policy Research Institute (IFPRI), number 978-0-89629-230-7.
    3. von Grebmer, Klaus & Bernstein, Jill & Nabarro, David & Prasai, Nilam & Amin, Shazia & Yohannes, Yisehac & Sonntag, Andrea & Patterson, Fraser, 2016. "2016 Global hunger index: Getting to zero hunger," IFPRI books, International Food Policy Research Institute (IFPRI), number 978-0-89629-226-0.
    4. Raoul Bermejo III & Sonja Firth & Andrew Hodge & Eliana Jimenez-Soto & Willibald Zeck, 2015. "Overcoming Stagnation in the Levels and Distribution of Child Mortality: The Case of the Philippines," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-13, October.

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