Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992-2007

Sartorius, Benn K. D.; Kahn, Kathleen; Vounatsou, Penelope; Collinson, Mark A.; Tollman, Stephen M.
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p645
Academic Journal
Background: Infant mortality is an important indicator of population health in a country. It is associated with several health determinants, such as maternal health, access to high-quality health care, socioeconomic conditions, and public health policy and practices. Methods: A spatial-temporal analysis was performed to assess changes in infant mortality patterns between 1992-2007 and to identify factors associated with infant mortality risk in the Agincourt sub-district, rural northeast South Africa. Period, sex, refugee status, maternal and fertility-related factors, household mortality experience, distance to nearest primary health care facility, and socio-economic status were examined as possible risk factors. All-cause and cause-specific mortality maps were developed to identify high risk areas within the study site. The analysis was carried out by fitting Bayesian hierarchical geostatistical negative binomial autoregressive models using Markov chain Monte Carlo simulation. Simulation-based Bayesian kriging was used to produce maps of allcause and cause-specific mortality risk. Results: Infant mortality increased significantly over the study period, largely due to the impact of the HIV epidemic. There was a high burden of neonatal mortality (especially perinatal) with several hot spots observed in close proximity to health facilities. Significant risk factors for all-cause infant mortality were mother's death in first year (most commonly due to HIV), death of previous sibling and increasing number of household deaths. Being born to a Mozambican mother posed a significant risk for infectious and parasitic deaths, particularly acute diarrhoea and malnutrition. Conclusions: This study demonstrates the use of Bayesian geostatistical models in assessing risk factors and producing smooth maps of infant mortality risk in a health and socio-demographic surveillance system. Results showed marked geographical differences in mortality risk across a relatively small area. Prevention of vertical transmission of HIV and survival of mothers during the infants' first year in high prevalence villages needs to be urgently addressed, including expanded antenatal testing, prevention of mother-to-child transmission, and improved access to antiretroviral therapy. There is also need to assess and improve the capacity of district hospitals for emergency obstetric and newborn care. Persisting risk factors, including inadequate provision of clean water and sanitation, are yet to be fully addressed.


Related Articles

  • Grants Assist Community and Migrant Health Center Perinatal Programs.  // Public Health Reports;Mar/Apr89, Vol. 104 Issue 2, p206 

    The article reports that a program of the United States Department of Health and Human Services to reduce infant mortality will increase funds for community and migrant health centers across the country. The funds will help improve the access of pregnant women to perinatal services that are...

  • Socioeconomic determinants of infant mortality: A worldwide study of 152 low-, middle-, and high-income countries. Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia // Scandinavian Journal of Public Health;May2007, Vol. 35 Issue 3, p288 

    Background: To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate...

  • The effectiveness of providing evidenced-based perinatal practice to low-income populations providing perinatal care: Does patient income influence the delivery of quality care? Damon, Amy L.; Parrotta, Carmen D.; Wallace, Lindsey A.; Riley, William // Journal of Hospital Administration;Nov2013, Vol. 2 Issue 4, p82 

    Background: This study examines a national perinatal quality improvement collaborative designed to create high reliability through the use of evidence-based perinatal care bundles. The objective of this study is to determine whether hospitals serving low-income patient populations experienced...

  • Determinants of maternal health services utilization in urban settings of the Democratic Republic of Congo--A Case study of Lubumbashi City. M. L., Abel; Malonga K., Fran‡oise; Dramaix-Wilmet, MichŠle; Donnen, Philippe // BMC Pregnancy & Childbirth;2012, Vol. 12 Issue 1, p66 

    Background: The use of maternal health services, known as an indirect indicator of perinatal death, is still unknown in Lubumbashi. The present study was therefore undertaken in order to determine the factors that influence the use of mother and child healthcare services in Lubumbashi,...

  • Situation Of Infant Mortality And Mother's Health-Seeking Behaviour In Selected Area Of Karachi. Iqbal, Musarrat; Siddiqui, Naila Usman // Pakistan Journal of Gender Studies;Dec2012, Vol. 6, p85 

    Pakistan has one of the highest Infant mortality rates in the world. Most death takes place as a result of Health seeking behavior of mothers or rather lack of it. This study was aimed at finding out situation of Infant mortalityin low-income areas in Karachi, the capital of Sindh, Pakistan. Due...

  • FACTORS ASSOCIATED WITH INFANT AND ADOLESCENCE MORTALITY. Oliveir&, Z. A. R.; Bettiol, H.; Barbieri, M. A.; Gutierrez, M. R. P.; Azenh&, V. M. // Journal of Epidemiology & Community Health;Aug2004 Supplement 1, Vol. 58, pA107 

    The article focuses on factors related to infant mortality. Conditions associated with perinatal period predominated during the first year of life (37.9%) and external causes predominated between 10 and 19 years (77.8%), with predominance among boys (7:1). Preterm birth and low birth weight were...

  • Improving Birth Outcomes Requires Closing the Racial Gap. Christopher, Gail C.; Simpson, Patrick // American Journal of Public Health;Feb2014 Supplement, Vol. 104 Issue S1, pS10 

    The editorial focuses on improving mother and child health in the U.S., noting the decline in infant mortality from 2005 through 2011, and discusses the persistent racial disparities in health care and birth outcomes. The discussion topics include African American infant death rates, the effects...

  • Perinatal interventions and survival in resource-poor settings: which work, which don't, which have the jury out? Osrin, David; Prost, Audrey // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Dec2010, Vol. 95 Issue 12, p1039 

    Perinatal conditions make the largest contribution to the burden of disease in low-income countries. Although postneonatal mortality rates have declined, stillbirth and early neonatal mortality rates remain high in many countries in Africa and Asia, and there is a concentration of mortality...

  • Good prognosis: The rise of e-health in Africa. Mulligan, Gabriella // New African;Mar2015, Issue 548, p66 

    The article offers information on the use and rise in online and mobile-based health services in Africa. Topics discussed include use of Folup application in medical care industry, views of chief executive officer Simon Spurr, and use of Short Message Service (SMS) messaging for addressing...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics