The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh
Introduction: Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and b...
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doaj-5637a6494a9a44f4b27410c3ffc82c522020-11-24T23:47:12ZengTaylor & Francis GroupGlobal Health Action1654-98802016-02-019011410.3402/gha.v9.2974129741The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in BangladeshTanvir M. Huda0Tazeen Tahsina1Shams El Arifeen2Michael J. Dibley3 Sydney School of Public Health, The University of Sydney, Sydney, Australia Centre for Child and Adolescent Health, icddr,b, Dhaka, Bangladesh Centre for Child and Adolescent Health, icddr,b, Dhaka, Bangladesh Sydney School of Public Health, The University of Sydney, Sydney, AustraliaIntroduction: Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives: This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design: We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results: The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion: The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage.http://www.globalhealthaction.net/index.php/gha/article/view/29741/pdf_244social determinants of healthinequalityinequityuniversal health coverageneonatal mortalityinfant mortalityunder-five mortalityhealth inequalityintersectoral actionBangladesh |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tanvir M. Huda Tazeen Tahsina Shams El Arifeen Michael J. Dibley |
spellingShingle |
Tanvir M. Huda Tazeen Tahsina Shams El Arifeen Michael J. Dibley The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh Global Health Action social determinants of health inequality inequity universal health coverage neonatal mortality infant mortality under-five mortality health inequality intersectoral action Bangladesh |
author_facet |
Tanvir M. Huda Tazeen Tahsina Shams El Arifeen Michael J. Dibley |
author_sort |
Tanvir M. Huda |
title |
The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh |
title_short |
The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh |
title_full |
The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh |
title_fullStr |
The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh |
title_full_unstemmed |
The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh |
title_sort |
importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in bangladesh |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9880 |
publishDate |
2016-02-01 |
description |
Introduction: Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives: This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design: We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results: The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion: The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage. |
topic |
social determinants of health inequality inequity universal health coverage neonatal mortality infant mortality under-five mortality health inequality intersectoral action Bangladesh |
url |
http://www.globalhealthaction.net/index.php/gha/article/view/29741/pdf_244 |
work_keys_str_mv |
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