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Association between gender inequality index and child mortality rates: a cross-national study of 138 countries.

Brinda EM, Rajkumar AP, Enemark U - BMC Public Health (2015)

Bottom Line: Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001).Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001).We have documented statistically significant positive associations between GII and child mortality rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, 8000, Denmark. ebam@ph.au.dk.

ABSTRACT

Background: Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain.

Methods: We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables.

Results: Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001). Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001).

Conclusions: We have documented statistically significant positive associations between GII and child mortality rates. Our results suggest that the initiatives to curtail child mortality rates should extend beyond medical interventions and should prioritize women's rights and autonomy. We discuss major pathways connecting gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of children of both genders.

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Related in: MedlinePlus

Association between gender inequality index (GII) and under five child mortality rates (per 1000 live births) in 138 countries.
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Fig1: Association between gender inequality index (GII) and under five child mortality rates (per 1000 live births) in 138 countries.

Mentions: GII had significant positive correlation with NMR (Spearman ρ = 0.98; p < 0.001), IMR (Spearman ρ = 0.99; p < 0.001) and U5MR (Spearman ρ = 0.91; p < 0.001). We present the bivariate and multivariate robust regression models for the association between GII and child mortality rates in Table 1. We present the scatter plot between the GII and U5MR of 138 countries as Figure 1. Various child mortality rates had significant association with GII after adjusting for per capita GDP and immunization coverage. These multivariate models including GII could explain 57% of variability in NMR (R2 = 0.57), 43% of variability in IMR (R2 = 0.43) and 32% of variability in U5MR (R2 = 0.32), around the globe. We calculated the female to male mortality ratios by dividing female U5MR by male U5MR. This ratio was also significantly associated with increasing GII (β = 26.8; 95% CI = 12.8-40.8; p <0.001), after adjusting for the confounders.Table 1


Association between gender inequality index and child mortality rates: a cross-national study of 138 countries.

Brinda EM, Rajkumar AP, Enemark U - BMC Public Health (2015)

Association between gender inequality index (GII) and under five child mortality rates (per 1000 live births) in 138 countries.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4353466&req=5

Fig1: Association between gender inequality index (GII) and under five child mortality rates (per 1000 live births) in 138 countries.
Mentions: GII had significant positive correlation with NMR (Spearman ρ = 0.98; p < 0.001), IMR (Spearman ρ = 0.99; p < 0.001) and U5MR (Spearman ρ = 0.91; p < 0.001). We present the bivariate and multivariate robust regression models for the association between GII and child mortality rates in Table 1. We present the scatter plot between the GII and U5MR of 138 countries as Figure 1. Various child mortality rates had significant association with GII after adjusting for per capita GDP and immunization coverage. These multivariate models including GII could explain 57% of variability in NMR (R2 = 0.57), 43% of variability in IMR (R2 = 0.43) and 32% of variability in U5MR (R2 = 0.32), around the globe. We calculated the female to male mortality ratios by dividing female U5MR by male U5MR. This ratio was also significantly associated with increasing GII (β = 26.8; 95% CI = 12.8-40.8; p <0.001), after adjusting for the confounders.Table 1

Bottom Line: Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001).Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001).We have documented statistically significant positive associations between GII and child mortality rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, 8000, Denmark. ebam@ph.au.dk.

ABSTRACT

Background: Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain.

Methods: We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables.

Results: Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001). Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001).

Conclusions: We have documented statistically significant positive associations between GII and child mortality rates. Our results suggest that the initiatives to curtail child mortality rates should extend beyond medical interventions and should prioritize women's rights and autonomy. We discuss major pathways connecting gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of children of both genders.

Show MeSH
Related in: MedlinePlus