Monday, 11th of September 2017 |
BMC Public Health. 2015 Mar 9;15:97. doi: 10.1186/s12889-015-1449-3.
Association between gender inequality index and child mortality rates: a cross-national study of 138 countries
Brinda EM1, Rajkumar AP2,3, Enemark U4.
1 Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, 8000, Denmark. ebam@ph.au.dk.
2 Translational Neuropsychiatry Unit, Aarhus University Hospital, Risskov, 8240, Denmark. apr@biomed.au.dk.
3 Department of Biomedicine, Aarhus University, Aarhus, 8000, Denmark. apr@biomed.au.dk.
4 Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, 8000, Denmark. ue@ph.au.dk.
Abstract below; full text is at https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-015-1449-3?site=bmcpublichealth.biomedcentral.com
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 mortalityrates should extend beyond medical interventions and should prioritize womens 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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