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Inequalities and trends in Neonatal Mortality Rate (NMR) in Ethiopia: Evidence from the Ethiopia Demographic and Health Surveys, 2000–2016

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  • Gebretsadik Shibre
  • Dina Idriss-Wheeler
  • Sanni Yaya

Abstract

Background: Substantial inequality in neonatal mortality rates (NMR) remains in low- and middle-income countries to the detriment of disadvantaged subpopulations. In Ethiopia, there is a dearth of evidence on the extent and trends of disparity in NMR. This study assessed the socioeconomic, residence and sex-based inequalities in NMR, as well as examined its change over a sixteen year period in Ethiopia. Methods: Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Ethiopia Demographic and Health Surveys (EDHS) were analyzed between 2000 and 2016. NMR was disaggregated by four equity stratifiers: education, wealth, residence and sex. In addition, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, Relative Concentration Index (RCI) and Slope Index of Inequality (SII) were calculated to understand inequalities from different perspectives. Corresponding 95% Uncertainty Intervals (UIs) were computed to measure statistical significance. Findings: Large educational inequalities in NMR were found in 2000, 2005, and 2011, while wealth-driven inequality occurred in 2011. Sex disparity was noted in all the surveys, and urban-rural differentials remained in all the surveys except in 2016. While socioeconomic and area-related inequalities decreased over time, sex related inequality did not change during the period of study. Conclusions: NMR appeared to be concentrated among male newborns, neonates born to illiterate and poor women and those living in rural settings. However, the inequality narrowed over time. Interventions appropriate for different subpopulations need to be designed.

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  • Gebretsadik Shibre & Dina Idriss-Wheeler & Sanni Yaya, 2020. "Inequalities and trends in Neonatal Mortality Rate (NMR) in Ethiopia: Evidence from the Ethiopia Demographic and Health Surveys, 2000–2016," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-10, June.
    • Handle: RePEc:plo:pone00:0234483
    DOI: 10.1371/journal.pone.0234483
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    References listed on IDEAS

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    1. Eirin Krüger Skaftun & Merima Ali & Ole Frithjof Norheim, 2014. "Understanding Inequalities in Child Health in Ethiopia: Health Achievements Are Improving in the Period 2000–2011," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    2. Kristine Husøy Onarheim & Solomon Tessema & Kjell Arne Johansson & Kristiane Tislevoll Eide & Ole Frithjof Norheim & Ingrid Miljeteig, 2012. "Prioritizing Child Health Interventions in Ethiopia: Modeling Impact on Child Mortality, Life Expectancy and Inequality in Age at Death," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-9, August.
    3. Alemayehu Ambel & Colin Andrews & Anne Bakilana & Elizabeth Foster & Qaiser Khan & Huihui Wang, 2015. "Maternal and Child Health Inequalities in Ethiopia," World Bank Publications - Reports 23805, The World Bank Group.
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