東華大學圖書館 |

Language: English

Help

回圖書館首頁

手機版館藏查詢

Back

Switch To: Labeled | MARC Mode | ISBD

Linked to FindBook

Google Book

Amazon

博客來

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015./
Author:	Macharia, Peter Mwangi.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	358 p.
Notes:	Source: Dissertations Abstracts International, Volume: 82-12, Section: A.
Contained By:	Dissertations Abstracts International82-12A.
Subject:	Childrens health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28459254
ISBN:	9798728296027

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.
Macharia, Peter Mwangi.

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 358 p.

Source: Dissertations Abstracts International, Volume: 82-12, Section: A.

Thesis (Ph.D.)--Open University (United Kingdom), 2020.

This item must not be sold to any third party vendors.

All-cause under-five mortality (U5M) forms a key parameter for monitoring and planning of health strategies. Decision-makers need to understand subnational variations in U5M and its determinants to plan equitable and efficient service delivery. To improve our understanding of the variation in U5M and its determinants, the thesis estimates trends of U5M, its determinants and their association between 1965 and 2015 across 47 counties used for decision making in Kenya.Twenty household surveys and three censuses (1989-2015) were assembled and aligned to county boundaries. U5M was generated through cohort and period demographic techniques and smoothed via a Bayesian ecological spatio-temporal Gaussian process regression accounting for variation in sample size, demographic methods and spatio-temporal relatedness. The coverage/prevalence of 43 determinants was estimated using small-area estimation and model-based geostatistics approaches. Inequities, summary indices and progress in meeting health development goals were evaluated. Under-five lives saved or lost given the changes in determinants relative to 1993 were computed in a counter-factual framework based on a Bayesian ecological space-time mixed-effects regression model.Nationally, U5M reduced by 62% characterized by declines and reversal. At the county level, reductions were heterogeneous and inequitable ranging between 20% to 80%. Likewise, there was an uneven improvement in the coverage of interventions and reduction in infection prevalence with disadvantaged counties coinciding with high U5M areas. Development goals were sub-optimally achieved for both U5M and determinants. Nationally, U5M reversal in 1990s was associated with rising HIV infection and maternal autonomy decline. Post-2006, U5M decline was associated with a decline in HIV, malaria, stunting and improvement in sanitation, early breastfeeding, institutional delivery, treatment-seeking and maternal autonomy. Declining high parity and fully immunized children were associated with deterioration of U5M. Under-five lives saved or lost were heterogeneous across counties and over time. The results provide new insights to improve child survival for decentralized health planning in Kenya by prioritizing marginalized counties.

ISBN: 9798728296027Subjects--Topical Terms:

3685851
Childrens health.
Subjects--Index Terms:

Under-five mortality

Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.
LDR:03507nmm a2200361 4500 001 2350282
005 20221020125228.5
008 241004s2020 ||||||||||||||||| ||eng d
020 $a 9798728296027
035 $a (MiAaPQ)AAI28459254
035 $a (MiAaPQ)Open_Univ_UK73666
035 $a AAI28459254
040 $a MiAaPQ $c MiAaPQ
100 1 $a Macharia, Peter Mwangi. $3 3689749
245 1 0 $a Mapping Trends and Determinants of Under-Five Mortality at Sub-National Levels in Kenya: 1965 - 2015.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2020
300 $a 358 p.
500 $a Source: Dissertations Abstracts International, Volume: 82-12, Section: A.
500 $a Advisor: Okiro, Emelda.
502 $a Thesis (Ph.D.)--Open University (United Kingdom), 2020.
506 $a This item must not be sold to any third party vendors.
520 $a All-cause under-five mortality (U5M) forms a key parameter for monitoring and planning of health strategies. Decision-makers need to understand subnational variations in U5M and its determinants to plan equitable and efficient service delivery. To improve our understanding of the variation in U5M and its determinants, the thesis estimates trends of U5M, its determinants and their association between 1965 and 2015 across 47 counties used for decision making in Kenya.Twenty household surveys and three censuses (1989-2015) were assembled and aligned to county boundaries. U5M was generated through cohort and period demographic techniques and smoothed via a Bayesian ecological spatio-temporal Gaussian process regression accounting for variation in sample size, demographic methods and spatio-temporal relatedness. The coverage/prevalence of 43 determinants was estimated using small-area estimation and model-based geostatistics approaches. Inequities, summary indices and progress in meeting health development goals were evaluated. Under-five lives saved or lost given the changes in determinants relative to 1993 were computed in a counter-factual framework based on a Bayesian ecological space-time mixed-effects regression model.Nationally, U5M reduced by 62% characterized by declines and reversal. At the county level, reductions were heterogeneous and inequitable ranging between 20% to 80%. Likewise, there was an uneven improvement in the coverage of interventions and reduction in infection prevalence with disadvantaged counties coinciding with high U5M areas. Development goals were sub-optimally achieved for both U5M and determinants. Nationally, U5M reversal in 1990s was associated with rising HIV infection and maternal autonomy decline. Post-2006, U5M decline was associated with a decline in HIV, malaria, stunting and improvement in sanitation, early breastfeeding, institutional delivery, treatment-seeking and maternal autonomy. Declining high parity and fully immunized children were associated with deterioration of U5M. Under-five lives saved or lost were heterogeneous across counties and over time. The results provide new insights to improve child survival for decentralized health planning in Kenya by prioritizing marginalized counties.
590 $a School code: 0949.
650 4 $a Childrens health. $3 3685851
650 4 $a Public health. $3 534748
650 4 $a Vaccines. $3 684854
650 4 $a Womens health. $3 3562508
650 4 $a Trends. $3 3560051
650 4 $a Communication. $3 524709
650 4 $a Epidemiology. $3 568544
650 4 $a Estimates. $3 3561047
650 4 $a Registration. $3 3682192
650 4 $a Births. $3 3681313
650 4 $a Human immunodeficiency virus--HIV. $3 3564909
650 4 $a Maternal & child health. $3 3684291
650 4 $a Age. $3 1486010
650 4 $a Planning. $3 552734
650 4 $a Low income groups. $3 3562917
650 4 $a Infant mortality. $3 3689750
650 4 $a Fertility. $3 832956
650 4 $a Children & youth. $3 3541389
650 4 $a Acquired immune deficiency syndrome--AIDS. $3 3564911
650 4 $a Surveillance. $3 3559358
650 4 $a Breastfeeding & lactation. $3 3562672
650 4 $a Households. $3 579926
650 4 $a Census of Population. $3 3689751
650 4 $a Parameter estimation. $3 567557
653 $a Under-five mortality
653 $a Bayesian ecological spatio-temporal Gaussian process regression accounting
653 $a Development goals
690 $a 0573
690 $a 0766
690 $a 0459
710 2 $a Open University (United Kingdom). $3 3427325
773 0 $t Dissertations Abstracts International $g 82-12A.
790 $a 0949
791 $a Ph.D.
792 $a 2020
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28459254