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Factors Associated with Child Health in Urban Areas of Bangladesh

M. Sheikh Giash Uddin
Corresponding author:
Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh

M. Mozaffar Hosain
Department of Statistics, Jagannath University, Dhaka-1100, Bangladesh

Abstract/ Executive Summary:

The paper examined the factors associated with infant mortality in urban area and the health-seeking behavior of urban children. This study used data from the Bangladesh Urban and Health Survey 2006. The survey used a multi-stage cluster sampling technique. Households' socioeconomic status was measured using principal component analysis. Both descriptive and logistic regression analyses were used to assess the infant mortality differential of slum and nonslum areas. Infant mortality was astonishingly higher (about 72 percent) among the slum dwellers than among non-slum dwellers. The rich-poor gap in infant mortality is also significant. The prevalence of acute respiratory infection among the slum and non-slum children within two weeks preceding the survey was 14.3 and 10.8 percent, respectively. In slum communities, children were 27 percent less likely to be taken to health facilities for treatment than non-slum communities. Wealth, migration status and the mother's education are identified as important correlates of infant mortality. The findings of this study reveal that there are large differences in infant mortality rates between slum and non-slum urban areas. It will be difficult to achieve millennium development goals if the government ignored the health care need of the urban poor.

Keywords: Infant mortality, Health seeking behaviour, Urban area

Location: In Bangladesh

Start Date:

End Date:

Program Area: Risk Management in Agriculture

Commodity: Nutrition, Health hazard

Objectives:

To identify the determinants of health seeding behavior and infant mortality of urban slum and non-slum population.

Methodology:

Bangladesh Urban and Health Survey (UHS) 2006 data were used for the study. The survey was based on a multi-stage sampling scheme under which the primary sampling units were explicitly crafted to reflect some meaningful notion of urban community or neighborhood. The survey design covers eight statistical domains across which indicator values relating to health were compared. Before data collection ethical clearance had been taken from Bangladesh Medical Research Council (BMRC). The 2006 Urban Health Survey consisted of a total of 29,181 live births. The present analysis included 3,130 slum dwellers and 1,961 non-slum dweller births over the five years preceding the survey, across seven domains of city corporations. For the district municipalities, there were 635 births and 34 infant deaths, which were excluded from this analysis. Total infant deaths occurring in slum and nom-slum populations were 192 and 70, respectively. The reason for considering births and deaths across the five years preceding the survey is that children born in the recent past are relatively more reliable and accurate than those born in the distant past. Recall errors will occur less often for children who were born most recently. The survey also provides a history of illness (diarrhea, fever, cough, rapid breathing, difficult breathing and chest-in-drawings) and treatment received for each under-five children in the sample households in the two weeks preceding the survey. In this study, "migrant" is defined as a respondent whose place of birth was different from the current place of residence. An index of economic status (wealth index) for each household was constructed using principal component analysis. Principal component analysis involves a mathematical procedure that transforms a number of possible correlated variables called principal components (Gwatkin et al. 2000). Despite the growing number of studies attesting evidence of poorer health among people with less education and income, lower status jobs, and poorer housing (Sastry 2004, Wagstaff and Watanabe 2000), there is still debate about the meaning of health inequalities. Analysis of the effects of socio-economic and demographic factors on infant mortality was based on the estimation of regression model. The model examined the effects of maternal and other socio-demographic characteristics on the likelihood of the infant being dead. In the analysis Of the model, death measured as a dichotomous variable was coded 1 if the infant died prior to the date of interview and 0 otherwise. Logistic regression model was used for the analysis to examine the wealth effect on the infant mortality. The coefficient in the analysis represented an increase or decrease in the logarithmic odds of an occurrence of an event associated with a unit or category change in an independent variable. In the regression model, the dependent variable is defined as Yi= 1 if an event occurred (i.e. child died, received treatment during illness) and Yi= 0 if a 011, the event did not occur (i.e. child is alive, did not seek treatment for illness). The logigic regression model is Ln [p/(1 - P_i)]= β₀ + ?β_iX_i. where, P (Y_i= 1) = p_i and P (Y_i= 0) = 1 - p_i; X_i = Independent variables such as maternal and child characteristics, β₀= Intercept term of the regression model, β_i= Regression coefficient of the respective variables, representing the effect or association for individual characteristics. The control variables used in the study include urban domain and maternal education, which are known to have some effects on child health that are independent of the effects of other measures of socioeconomic status. The other control variables used in this study include: the mother's age at birth of the index child, number of children ever born, child sex, wealth quintiles and migration status.

Source of Information: Bangladesh J. Sci. Res. 24(2): l45-l54. 2011 (December)

Article Link (Online Journal):

Funding Source:

Budget:

Total Budget (Tk.) :

Achievement/Findings:

The main objective of the paper was to compare the disparities in infant mortality and health-seeking behaviour in urban areas. The findings confirmed that, when compared by the wealth index, inequalities in childhood morbidity and mortality do exist (Supon et al. 2010, Doorslaer et at. 2006). The analysis also confirmed that the infant mortality rate is higher among slum children than non-slum children; moreover, disparities in mortality are also present when compared between migrant and nonimmigrant characteristics. The findings also show that there is a significant gap in health-seeking behavior between the slum and non-slum populations. In slum communities, children were 27 percent less likely to be taken to health facilities for treatment than non-slum communities. Wealth, migration status and the mother's education are identified as important correlates of infant mortality. The findings of this study reveal that there are large differences in infant mortality rates between slum and non-slum urban areas. It will be difficult to achieve millennium development goals if the government ignored the health care need of the urban poor.

Knowledge Management: Journal