The people of Afghanistan who have withstood over twenty-three years of conflict have suffered in... more The people of Afghanistan who have withstood over twenty-three years of conflict have suffered in many ways, including the lack of an essential and effective health system. This has resulted in one of the worst health situations in the world. The fledgling government of Afghanistan is attempting to establish a stable country where democracy can promote peace, stability and security for its people. The Afghanistan National Army's Defense Health Sector plays a critical role related to those aims that underscores the significant need for collaborative efforts between the Afghan Government, the United States, the United Nations, various non-governmental organisations and the broad international community. The United States (US) Army Medical Department's doctrine of providing Combat Health Support utilises the tenets of science-based health care to deliver: (1) lifesaving services to the soldier and the beneficiary population, (2) restorative treatment, (3) medical evacuation when appropriate, (4) logistics to support all delivery services and services planning, and (5) preventive medicine to preclude illness and injury and effective patient administration services to facilitate positive outcomes. It is within this framework that US military medical professionals have worked jointly with the Afghan Military Medical System to build an effective, efficient and sustainable military medical healthcare system for the Army and a growing beneficiary population which may eventually exceed one million family members and government officials. In this paper we describe the current roles of various civil and military agencies in support of the Afghanistan military medical system and highlight new and ongoing initiatives in logistics, laboratory services, evacuation and preventive health.
Many people in developing countries are still struggling to emerge from the realm of extreme pove... more Many people in developing countries are still struggling to emerge from the realm of extreme poverty, where economic improvements tend to benefit a small, affluent group of the population and cause growing inequality in health and nutrition that affects the most vulnerable groups of the population, including women and children. To examine how household and community economic inequality affects nutritional status in women using information on 6,922 nonpregnant women aged 15 to 49 years included in the 2000 Cambodia Demographic and Health Survey. Nutritional status is defined with the use of the body-mass index (BMI). BMI less than 18.5 kg/m2 is defined as undernourishment. The household wealth index was calculated from household ownership of durable assets and household characteristics. Community wealth is an average household wealth index at the community level. Household and community economic inequalities were measured by dividing the wealth index into quintiles. The effects of ho...
... and Health Surveys (DHS), Path/Macro International, 11785 Beltsville Drive, Calverton, MD 207... more ... and Health Surveys (DHS), Path/Macro International, 11785 Beltsville Drive, Calverton, MD 20705, 301-572-0947, alfredo.fort@orcmacro.com ... Several other donors, DfID and UNICEF, covered the costs of provincial level dissemination because of the keen interest nationwide. ...
The problems of food insecurity and under-nutrition remain particularly severe in countries recov... more The problems of food insecurity and under-nutrition remain particularly severe in countries recovering from recent wars or civil unrest, where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. Using information on 3,235 chil- dren aged 0-59 month(s) included in the 2000 Cambodia Demographic and Health Survey, this study examined how economic inequality was associated with inequalities in chronic childhood under-nutrition. An under-nourished (stunted) child was defined as having his/her height-for-age more than two standard deviations below the reference median. Household wealth status was measured by an index based on household ownership of durable assets. Binary and multinomial logistic regressions were used for esti- mating the effects of household wealth status on moderate and severe stunting. The results indicated that children in the poorest 20% households were more than twice as likely to suffer ...
Despite improvements in public health in recent decades, levels of infant and child mortality rem... more Despite improvements in public health in recent decades, levels of infant and child mortality remain unacceptably high, particularly in developing countries where primary healthcare services including prenatal care services are not universally available. Using information on 7,001 childbirths in five years preceding the 2004 Bangladesh Demographic and Health Survey, this study examined the relationship between receiving prenatal care during pregnancy and infant mortality using multivariate survival analysis. The results are presented in hazard ratios (HR) with 95% confidence intervals (95% CI). Results indicate that children of mothers who did not receive prenatal care during pregnancy were more than twice as likely to die during infancy as children whose mothers received prenatal care during pregnancy (HR=2.40, 95% CI: 1.74, 3.31) independent of child's sex, delivery assistance, birth order; mother's age at child birth, nutritional status, education level; household living conditions, and other factors. Children born to older mothers living in households without safe drinking water were at an increased risk. The study concludes that prenatal care is strongly negatively associated with infant mortality in Bangladesh independent of other risk factors. The results suggest that improving prenatal care services at the community level is key to improving child survival in Bangladesh.
This paper studies the trend of immunization dropout and its relationship with economic inequalit... more This paper studies the trend of immunization dropout and its relationship with economic inequality among Cambodian children aged 12-59 months, using data from the 2000 and 2005 Cambodia Demographic and Health Surveys (CDHS). We define an 'immunization dropout' as a child who has received at least one dose of trivalent vaccine against diphtheria, pertussis, and tetanus (DPT), but failed to receive his or her third dose to complete the schedule before 12 months of age. Socioeconomic status is represented by household wealth index quintiles. The level of DPT dropouts from 1996 to 2004 decreased from 22% to 10%. The difference in DPT3 dropouts between children of the highest household wealth quintile and children of the lowest and lower wealth quintiles significantly improved over these years. In 2000, the children of the lowest wealth quintile were almost three times as likely as the children of the highest wealth quintile not to complete the third dose of DPT (Odds Ratios [OR] = 2.92, P = 0.001). In 2005, however, the difference was small and statistically insignificant (OR = 1.42, P = 0.290). These results demonstrated that the child immunization program in Cambodia improved significantly over the past years. The improvement was observed in children of all economic strata, especially among the children of the poorer households.
Abstract Background Cambodia still suffers high levels of neonatal mortality and maternal mortali... more Abstract Background Cambodia still suffers high levels of neonatal mortality and maternal mortality despite recent progress. Continuum of care refers to the continuity of care throughout pregnancy, birth, and after delivery—that is, use of antenatal care [ANC], skilled birth attendance [SBA], and postnatal care [PNC]). Assuring continuity of care has become a key programme strategy for improving the health of mothers and newborns. Successful service delivery that offers continuum of care relies on understanding where the gaps are in seeking care along the continuum and what factors contribute to these gaps. Methods To address these issues, we analysed the 2010 Cambodia Demographic and Health Survey data. Three random-effects logit regressions were fitted to identify factors facilitating continuation of care along the pathway from pregnancy to the postnatal period. Findings Three of every five Cambodian women received ANC, SBA, and PNC for their most recent birth, which is remarkable for a country where 30% of the population lives below the poverty line. Still, 40% did not receive all three maternal services. Over 90% (n=6472; 95% CI 88–91) of women who had a livebirth in the 5 years before the survey had at least one antenatal visit during the pregnancy and 59% (n=6472; 95% CI 57–62%) had the WHO-recommended four or more visits. After receiving ANC, however, 11% (n=5804, 95% CI 10–12) of women had SBA but no PNC, 8% (n=5804; 95% CI 7–10) had PNC but no SBA, and 13% (n=5804; 95% CI 12–15) received neither. Poor women, in particular, suffered from low access to care. Regional variation was substantial. The proportion of women who received all three maternal services ranged from 14% (n=170; 95% CI 9–21) to 96% (n=538; 95% CI 93–97) among Cambodia's 19 provinces. Differences between provinces accounted for more than a third of the total variation in the percentage of women who went on to receive PNC after receiving SBA. Also, the quality of ANC that women received affected their subsequent use of SBA and PNC. Differences between provinces account for more than a third of the total variation in the continuation from SBA to PNC. Interpretation Despite success in extending the reach of maternal health care, Cambodia needs continuing effort to reduce maternal and neonatal mortality. Increasing continuum of care through an integrated service-delivery system involving both public and private sectors could be a solution to improve maternal and neonatal health. Funding US Agency for International Development.
Levels of infant and child mortality in many developing countries remain unacceptably high, and t... more Levels of infant and child mortality in many developing countries remain unacceptably high, and they are disproportionably higher among high-risk groups such as newborn and infant of multiple births, particularly in countries where advanced medical cares are available only at regional referral levels with limited access by the poor rural women and children. This study examined the relationship between high-risk infant of multiple birth and infant mortality in Bangladesh. The analysis uses information on 7001 childbirths in 5 years preceding the 2004 Bangladesh Demographic and Health Survey to examine the relationship between multiple birth and infant mortality using multivariate analysis, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results indicate that children born multiple birth were more than six-times as likely to die during infancy as those born singletons (hazard ratio = 6.51; 95% confidence interval: 4.10, 10.36). Controlling for all other risk factors does not change the strength and direction of the relationship (hazard ratio = 6.18; 95% confidence interval: 3.65, 10.46). Receiving prenatal care and access to safe drinking water are associated with lower risk. Multiple births are strongly negatively associated with infant survival in Bangladesh independent of other risk factors. This evidence suggests that improving maternal and child health at the community level, screening for high-risk pregnancies and making referral services for these conditions more accessible to the rural women and children will be key to improving child survival in Bangladesh.
To determine the association between maternal HIV infection and infant mortality in Malawi. A syn... more To determine the association between maternal HIV infection and infant mortality in Malawi. A synthetic cohort life table based on the birth history of 2618 childbirths during 1999 and 2004, from the subsample of 2020 mothers who completed interview and were tested for HIV virus in the 2004 Malawi Demographic and Health Survey was used. The survey collected socio-demographic and health data of a natural representative sample of women aged 15 to 49; and obtained voluntary counselling tests for HIV infection from one-third of the representatives of the sample. Associations of maternal HIV status and other factors with infant mortality were estimated using survival regression analysis and the results are presented as hazard ratios (HR) with level of statistical significance (P-value). Children born to HIV-infected mothers were more than two times as likely to die during infancy as those born to uninfected mothers (HR = 2.21; P < 0.01). Controlling for other risk factors and confounding factors for infant mortality further sharpened this relationship (HR = 2.70; P < 0.01). Boys are more likely to die in infancy than girls. Young mothers and mothers not receiving prenatal care, and low-birthweight children and children living in rural areas, particular so in the northern region, were associated with a higher risk of infant mortality. Maternal HIV infection is strongly associated with infant mortality in Malawi independent of many other factors. Results from this study suggest that the HIV/AIDS epidemic has had an enormous impact on child well-being, child survival and infant mortality. The impact increases as the HIV/AIDS epidemic matures and infection in mothers and adults increases.
Objective: Food insecurity and undernutrition remain particularly severe in developing countries ... more Objective: Food insecurity and undernutrition remain particularly severe in developing countries where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. This study ...
Ce rapport présente les résultats des analyses approfondies qui sont effectuées dans le cadre des... more Ce rapport présente les résultats des analyses approfondies qui sont effectuées dans le cadre des activités secondaires à mener après la publication des résultats du rapport principal des Enquêtes Démographiques et de Santé du Mali réalisées en 1995-1996, 2001, et 2006, ...
Cambodia faces major challenges in its effort to provide access to health care for all. Although ... more Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia.
Despite improvements in child survival in recent decades, levels of infant and child mortality re... more Despite improvements in child survival in recent decades, levels of infant and child mortality remain unacceptably high, particularly among the poor in developing countries recovering from recent wars and civil unrests. Using information on 8498 childbirths in five years preceding the 2000 Cambodia Demographic and Health Survey, this study measured the association between economic disparity and infant mortality using multivariate Weibull regression. Results indicate that children born in the poorest 40% households were more than twice as likely to die during infancy as those born in the richest 20% households, even after controlling for pregnancy care, birth weight, household living conditions, and other factors. Children born in the middle-income households also had significantly higher mortality risks. Not receiving antenatal care and low birth weight were associated with an increased risk. Also, boys had a higher risk than girls. The study concludes that poverty is strongly negatively associated with infant survival in Cambodia.
The people of Afghanistan who have withstood over twenty-three years of conflict have suffered in... more The people of Afghanistan who have withstood over twenty-three years of conflict have suffered in many ways, including the lack of an essential and effective health system. This has resulted in one of the worst health situations in the world. The fledgling government of Afghanistan is attempting to establish a stable country where democracy can promote peace, stability and security for its people. The Afghanistan National Army's Defense Health Sector plays a critical role related to those aims that underscores the significant need for collaborative efforts between the Afghan Government, the United States, the United Nations, various non-governmental organisations and the broad international community. The United States (US) Army Medical Department's doctrine of providing Combat Health Support utilises the tenets of science-based health care to deliver: (1) lifesaving services to the soldier and the beneficiary population, (2) restorative treatment, (3) medical evacuation when appropriate, (4) logistics to support all delivery services and services planning, and (5) preventive medicine to preclude illness and injury and effective patient administration services to facilitate positive outcomes. It is within this framework that US military medical professionals have worked jointly with the Afghan Military Medical System to build an effective, efficient and sustainable military medical healthcare system for the Army and a growing beneficiary population which may eventually exceed one million family members and government officials. In this paper we describe the current roles of various civil and military agencies in support of the Afghanistan military medical system and highlight new and ongoing initiatives in logistics, laboratory services, evacuation and preventive health.
Many people in developing countries are still struggling to emerge from the realm of extreme pove... more Many people in developing countries are still struggling to emerge from the realm of extreme poverty, where economic improvements tend to benefit a small, affluent group of the population and cause growing inequality in health and nutrition that affects the most vulnerable groups of the population, including women and children. To examine how household and community economic inequality affects nutritional status in women using information on 6,922 nonpregnant women aged 15 to 49 years included in the 2000 Cambodia Demographic and Health Survey. Nutritional status is defined with the use of the body-mass index (BMI). BMI less than 18.5 kg/m2 is defined as undernourishment. The household wealth index was calculated from household ownership of durable assets and household characteristics. Community wealth is an average household wealth index at the community level. Household and community economic inequalities were measured by dividing the wealth index into quintiles. The effects of ho...
... and Health Surveys (DHS), Path/Macro International, 11785 Beltsville Drive, Calverton, MD 207... more ... and Health Surveys (DHS), Path/Macro International, 11785 Beltsville Drive, Calverton, MD 20705, 301-572-0947, alfredo.fort@orcmacro.com ... Several other donors, DfID and UNICEF, covered the costs of provincial level dissemination because of the keen interest nationwide. ...
The problems of food insecurity and under-nutrition remain particularly severe in countries recov... more The problems of food insecurity and under-nutrition remain particularly severe in countries recovering from recent wars or civil unrest, where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. Using information on 3,235 chil- dren aged 0-59 month(s) included in the 2000 Cambodia Demographic and Health Survey, this study examined how economic inequality was associated with inequalities in chronic childhood under-nutrition. An under-nourished (stunted) child was defined as having his/her height-for-age more than two standard deviations below the reference median. Household wealth status was measured by an index based on household ownership of durable assets. Binary and multinomial logistic regressions were used for esti- mating the effects of household wealth status on moderate and severe stunting. The results indicated that children in the poorest 20% households were more than twice as likely to suffer ...
Despite improvements in public health in recent decades, levels of infant and child mortality rem... more Despite improvements in public health in recent decades, levels of infant and child mortality remain unacceptably high, particularly in developing countries where primary healthcare services including prenatal care services are not universally available. Using information on 7,001 childbirths in five years preceding the 2004 Bangladesh Demographic and Health Survey, this study examined the relationship between receiving prenatal care during pregnancy and infant mortality using multivariate survival analysis. The results are presented in hazard ratios (HR) with 95% confidence intervals (95% CI). Results indicate that children of mothers who did not receive prenatal care during pregnancy were more than twice as likely to die during infancy as children whose mothers received prenatal care during pregnancy (HR=2.40, 95% CI: 1.74, 3.31) independent of child's sex, delivery assistance, birth order; mother's age at child birth, nutritional status, education level; household living conditions, and other factors. Children born to older mothers living in households without safe drinking water were at an increased risk. The study concludes that prenatal care is strongly negatively associated with infant mortality in Bangladesh independent of other risk factors. The results suggest that improving prenatal care services at the community level is key to improving child survival in Bangladesh.
This paper studies the trend of immunization dropout and its relationship with economic inequalit... more This paper studies the trend of immunization dropout and its relationship with economic inequality among Cambodian children aged 12-59 months, using data from the 2000 and 2005 Cambodia Demographic and Health Surveys (CDHS). We define an 'immunization dropout' as a child who has received at least one dose of trivalent vaccine against diphtheria, pertussis, and tetanus (DPT), but failed to receive his or her third dose to complete the schedule before 12 months of age. Socioeconomic status is represented by household wealth index quintiles. The level of DPT dropouts from 1996 to 2004 decreased from 22% to 10%. The difference in DPT3 dropouts between children of the highest household wealth quintile and children of the lowest and lower wealth quintiles significantly improved over these years. In 2000, the children of the lowest wealth quintile were almost three times as likely as the children of the highest wealth quintile not to complete the third dose of DPT (Odds Ratios [OR] = 2.92, P = 0.001). In 2005, however, the difference was small and statistically insignificant (OR = 1.42, P = 0.290). These results demonstrated that the child immunization program in Cambodia improved significantly over the past years. The improvement was observed in children of all economic strata, especially among the children of the poorer households.
Abstract Background Cambodia still suffers high levels of neonatal mortality and maternal mortali... more Abstract Background Cambodia still suffers high levels of neonatal mortality and maternal mortality despite recent progress. Continuum of care refers to the continuity of care throughout pregnancy, birth, and after delivery—that is, use of antenatal care [ANC], skilled birth attendance [SBA], and postnatal care [PNC]). Assuring continuity of care has become a key programme strategy for improving the health of mothers and newborns. Successful service delivery that offers continuum of care relies on understanding where the gaps are in seeking care along the continuum and what factors contribute to these gaps. Methods To address these issues, we analysed the 2010 Cambodia Demographic and Health Survey data. Three random-effects logit regressions were fitted to identify factors facilitating continuation of care along the pathway from pregnancy to the postnatal period. Findings Three of every five Cambodian women received ANC, SBA, and PNC for their most recent birth, which is remarkable for a country where 30% of the population lives below the poverty line. Still, 40% did not receive all three maternal services. Over 90% (n=6472; 95% CI 88–91) of women who had a livebirth in the 5 years before the survey had at least one antenatal visit during the pregnancy and 59% (n=6472; 95% CI 57–62%) had the WHO-recommended four or more visits. After receiving ANC, however, 11% (n=5804, 95% CI 10–12) of women had SBA but no PNC, 8% (n=5804; 95% CI 7–10) had PNC but no SBA, and 13% (n=5804; 95% CI 12–15) received neither. Poor women, in particular, suffered from low access to care. Regional variation was substantial. The proportion of women who received all three maternal services ranged from 14% (n=170; 95% CI 9–21) to 96% (n=538; 95% CI 93–97) among Cambodia's 19 provinces. Differences between provinces accounted for more than a third of the total variation in the percentage of women who went on to receive PNC after receiving SBA. Also, the quality of ANC that women received affected their subsequent use of SBA and PNC. Differences between provinces account for more than a third of the total variation in the continuation from SBA to PNC. Interpretation Despite success in extending the reach of maternal health care, Cambodia needs continuing effort to reduce maternal and neonatal mortality. Increasing continuum of care through an integrated service-delivery system involving both public and private sectors could be a solution to improve maternal and neonatal health. Funding US Agency for International Development.
Levels of infant and child mortality in many developing countries remain unacceptably high, and t... more Levels of infant and child mortality in many developing countries remain unacceptably high, and they are disproportionably higher among high-risk groups such as newborn and infant of multiple births, particularly in countries where advanced medical cares are available only at regional referral levels with limited access by the poor rural women and children. This study examined the relationship between high-risk infant of multiple birth and infant mortality in Bangladesh. The analysis uses information on 7001 childbirths in 5 years preceding the 2004 Bangladesh Demographic and Health Survey to examine the relationship between multiple birth and infant mortality using multivariate analysis, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results indicate that children born multiple birth were more than six-times as likely to die during infancy as those born singletons (hazard ratio = 6.51; 95% confidence interval: 4.10, 10.36). Controlling for all other risk factors does not change the strength and direction of the relationship (hazard ratio = 6.18; 95% confidence interval: 3.65, 10.46). Receiving prenatal care and access to safe drinking water are associated with lower risk. Multiple births are strongly negatively associated with infant survival in Bangladesh independent of other risk factors. This evidence suggests that improving maternal and child health at the community level, screening for high-risk pregnancies and making referral services for these conditions more accessible to the rural women and children will be key to improving child survival in Bangladesh.
To determine the association between maternal HIV infection and infant mortality in Malawi. A syn... more To determine the association between maternal HIV infection and infant mortality in Malawi. A synthetic cohort life table based on the birth history of 2618 childbirths during 1999 and 2004, from the subsample of 2020 mothers who completed interview and were tested for HIV virus in the 2004 Malawi Demographic and Health Survey was used. The survey collected socio-demographic and health data of a natural representative sample of women aged 15 to 49; and obtained voluntary counselling tests for HIV infection from one-third of the representatives of the sample. Associations of maternal HIV status and other factors with infant mortality were estimated using survival regression analysis and the results are presented as hazard ratios (HR) with level of statistical significance (P-value). Children born to HIV-infected mothers were more than two times as likely to die during infancy as those born to uninfected mothers (HR = 2.21; P < 0.01). Controlling for other risk factors and confounding factors for infant mortality further sharpened this relationship (HR = 2.70; P < 0.01). Boys are more likely to die in infancy than girls. Young mothers and mothers not receiving prenatal care, and low-birthweight children and children living in rural areas, particular so in the northern region, were associated with a higher risk of infant mortality. Maternal HIV infection is strongly associated with infant mortality in Malawi independent of many other factors. Results from this study suggest that the HIV/AIDS epidemic has had an enormous impact on child well-being, child survival and infant mortality. The impact increases as the HIV/AIDS epidemic matures and infection in mothers and adults increases.
Objective: Food insecurity and undernutrition remain particularly severe in developing countries ... more Objective: Food insecurity and undernutrition remain particularly severe in developing countries where improvements in economic conditions have tended to benefit the advantaged groups and resulted in widespread inequalities in health. This study ...
Ce rapport présente les résultats des analyses approfondies qui sont effectuées dans le cadre des... more Ce rapport présente les résultats des analyses approfondies qui sont effectuées dans le cadre des activités secondaires à mener après la publication des résultats du rapport principal des Enquêtes Démographiques et de Santé du Mali réalisées en 1995-1996, 2001, et 2006, ...
Cambodia faces major challenges in its effort to provide access to health care for all. Although ... more Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia.
Despite improvements in child survival in recent decades, levels of infant and child mortality re... more Despite improvements in child survival in recent decades, levels of infant and child mortality remain unacceptably high, particularly among the poor in developing countries recovering from recent wars and civil unrests. Using information on 8498 childbirths in five years preceding the 2000 Cambodia Demographic and Health Survey, this study measured the association between economic disparity and infant mortality using multivariate Weibull regression. Results indicate that children born in the poorest 40% households were more than twice as likely to die during infancy as those born in the richest 20% households, even after controlling for pregnancy care, birth weight, household living conditions, and other factors. Children born in the middle-income households also had significantly higher mortality risks. Not receiving antenatal care and low birth weight were associated with an increased risk. Also, boys had a higher risk than girls. The study concludes that poverty is strongly negatively associated with infant survival in Cambodia.
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