This further analysis examines levels trends and determinants of neonatal mortality in Rwanda usi... more This further analysis examines levels trends and determinants of neonatal mortality in Rwanda using data from the 2000 2005 and 2010 Rwanda Demographic and Health Surveys (RDHS). The analysis begins with estimates of the neonatal mortality rate (NMR) overall and within each category of selected potential predictors of neonatal death in the five years preceding each survey. Multivariate log probability models are then used to determine whether key indicators are independently associated with neonatal mortality in Rwanda after adjusting for socio-demographic factors that could confound the association. Finally multivariate decomposition procedures are used to determine the extent to which each selected indicator contributes to the observed reduction in neonatal mortality. Between 2000 and 2010 a dramatic decline in under-five mortality in Rwanda was accompanied by a more modest reduction in the NMR. The improvement in the NMR was largely concentrated in rural areas where coverage of m...
This further analysis examines levels, trends, and determinants of neonatal mortality in Rwanda, ... more This further analysis examines levels, trends, and determinants of neonatal mortality in Rwanda, using data from the 2000, 2005, and 2010 Rwanda Demographic and Health Surveys (RDHS). The analysis begins with estimates of the neonatal mortality rate (NMR), overall and within each category of selected potential predictors of neonatal death, in the five years preceding each survey. Multivariate log probability models are then used to determine whether key indicators are independently associated with neonatal mortality in Rwanda, after adjusting for socio-demographic factors that could confound the association. Finally, multivariate decomposition procedures are used to determine the extent to which each selected indicator contributes to the observed reduction in neonatal mortality. Between 2000 and 2010 a dramatic decline in under-five mortality in Rwanda was accompanied by a more modest reduction in the NMR. The improvement in the NMR was largely concentrated in rural areas, where cov...
This report uses data from Demographic and Health Surveys (DHS) and Service Provision Assessment ... more This report uses data from Demographic and Health Surveys (DHS) and Service Provision Assessment (SPA) surveys conducted in Kenya Rwanda Uganda and Tanzania during the period of 2003-2010. Random-effects logit regression models are fitted to examine the extent to which contraceptive use is associated with the regional family planning supply and service environment and to assess the regional variability in contraceptive use that is explained by these two factors. Contraceptive use information is from the DHS surveys and family planning supply and service environment data are provided in the SPA survey that was conducted within a year of the DHS in each country. The analysis indicates that based on the Kenya 2008-09 DHS Kenya has the highest level of modern contraceptive use among the four countries studied at 39 percent of women of reproductive age. Contraceptive use is lowest in Uganda at 18 percent in the 2006 DHS and only slightly higher in Tanzania at 20 percent in the 2004-05 DH...
The purpose of this analytical study is to advance our understanding of the role of HIV discordan... more The purpose of this analytical study is to advance our understanding of the role of HIV discordance in HIV epidemics particularly as it relates to discordance within the subpopulation of cohabiting partners. Data for the analysis come from DHS surveys in 10 countries in sub-Saharan Africa: Cameroon Kenya Lesotho Malawi Mozambique Swaziland Tanzania Uganda Zambia and Zimbabwe. The countries were selected because their HIV prevalence exceeds 4%. Their most recent surveys were conducted between 2006 and 2012. Among the 10 urban and 10 rural subgroups analyzed only three showed that men and women in cohabiting couples differ significantly in their HIV prevalence. In urban Kenya women in cohabiting couples 1) tend to have higher HIV prevalence than men 2) are less likely than men to be in a discordant partnership and 3) appear to have seroconverted through discordance at a higher rate than men. The opposite pattern was seen in rural Zambia and rural Zimbabwe. These three sectors are the ...
This study uses Demographic and Health Survey (DHS) data to examine patterns and trends in care s... more This study uses Demographic and Health Survey (DHS) data to examine patterns and trends in care seeking for children who have experienced recent fever symptoms of acute respiratory infection (ARI) or diarrhea in USAID maternal and child health (MCH) priority countries. Overall current levels of care seeking among children with recent illness vary widely across the 21 priority countries from nearly 90 percent in the Indonesia 2012 survey to 33 percent in Ethiopia 2011. Results show that care seeking from public sources is predominant in African MCH priority countries while care seeking from private sources is predominant in Asian MCH priority countries. The majority of countries did not show significant improvements between the two most recent DHS surveys in the level of care seeking for fever or symptoms of ARI although care seeking for diarrhea showed more widespread improvement. The use of appropriate antimalarial treatment varied widely across MCH priority countries. Despite the ...
This report assesses the quality of the birth history data in 192 DHS surveys conducted since 199... more This report assesses the quality of the birth history data in 192 DHS surveys conducted since 1990. The birth histories are the source of the age-specific fertility rates the total fertility rate (TFR) and the under-5 mortality rates that are widely used to describe levels differentials and trends in fertility and child mortality in developing countries. The assessment is based on three criteria to identify potential omission of births and/or deaths and three criteria to identify potential displacement or misreporting of date of birth age at death or both. Extreme values should be viewed as symptoms rather than a conclusive diagnosis of poor data quality. The birth histories in most DHS surveys appear to be of excellent quality although several surveys do show symptoms of omission displacement or both. With the selected indicators and criteria omission of births is usually at the level of 2 percent or less and only rarely exceeds 5 percent. Displacement of births is also usually 2 p...
This further analysis examines levels trends and determinants of neonatal mortality in Rwanda usi... more This further analysis examines levels trends and determinants of neonatal mortality in Rwanda using data from the 2000 2005 and 2010 Rwanda Demographic and Health Surveys (RDHS). The analysis begins with estimates of the neonatal mortality rate (NMR) overall and within each category of selected potential predictors of neonatal death in the five years preceding each survey. Multivariate log probability models are then used to determine whether key indicators are independently associated with neonatal mortality in Rwanda after adjusting for socio-demographic factors that could confound the association. Finally multivariate decomposition procedures are used to determine the extent to which each selected indicator contributes to the observed reduction in neonatal mortality. Between 2000 and 2010 a dramatic decline in under-five mortality in Rwanda was accompanied by a more modest reduction in the NMR. The improvement in the NMR was largely concentrated in rural areas where coverage of m...
This further analysis examines levels, trends, and determinants of neonatal mortality in Rwanda, ... more This further analysis examines levels, trends, and determinants of neonatal mortality in Rwanda, using data from the 2000, 2005, and 2010 Rwanda Demographic and Health Surveys (RDHS). The analysis begins with estimates of the neonatal mortality rate (NMR), overall and within each category of selected potential predictors of neonatal death, in the five years preceding each survey. Multivariate log probability models are then used to determine whether key indicators are independently associated with neonatal mortality in Rwanda, after adjusting for socio-demographic factors that could confound the association. Finally, multivariate decomposition procedures are used to determine the extent to which each selected indicator contributes to the observed reduction in neonatal mortality. Between 2000 and 2010 a dramatic decline in under-five mortality in Rwanda was accompanied by a more modest reduction in the NMR. The improvement in the NMR was largely concentrated in rural areas, where cov...
This report uses data from Demographic and Health Surveys (DHS) and Service Provision Assessment ... more This report uses data from Demographic and Health Surveys (DHS) and Service Provision Assessment (SPA) surveys conducted in Kenya Rwanda Uganda and Tanzania during the period of 2003-2010. Random-effects logit regression models are fitted to examine the extent to which contraceptive use is associated with the regional family planning supply and service environment and to assess the regional variability in contraceptive use that is explained by these two factors. Contraceptive use information is from the DHS surveys and family planning supply and service environment data are provided in the SPA survey that was conducted within a year of the DHS in each country. The analysis indicates that based on the Kenya 2008-09 DHS Kenya has the highest level of modern contraceptive use among the four countries studied at 39 percent of women of reproductive age. Contraceptive use is lowest in Uganda at 18 percent in the 2006 DHS and only slightly higher in Tanzania at 20 percent in the 2004-05 DH...
The purpose of this analytical study is to advance our understanding of the role of HIV discordan... more The purpose of this analytical study is to advance our understanding of the role of HIV discordance in HIV epidemics particularly as it relates to discordance within the subpopulation of cohabiting partners. Data for the analysis come from DHS surveys in 10 countries in sub-Saharan Africa: Cameroon Kenya Lesotho Malawi Mozambique Swaziland Tanzania Uganda Zambia and Zimbabwe. The countries were selected because their HIV prevalence exceeds 4%. Their most recent surveys were conducted between 2006 and 2012. Among the 10 urban and 10 rural subgroups analyzed only three showed that men and women in cohabiting couples differ significantly in their HIV prevalence. In urban Kenya women in cohabiting couples 1) tend to have higher HIV prevalence than men 2) are less likely than men to be in a discordant partnership and 3) appear to have seroconverted through discordance at a higher rate than men. The opposite pattern was seen in rural Zambia and rural Zimbabwe. These three sectors are the ...
This study uses Demographic and Health Survey (DHS) data to examine patterns and trends in care s... more This study uses Demographic and Health Survey (DHS) data to examine patterns and trends in care seeking for children who have experienced recent fever symptoms of acute respiratory infection (ARI) or diarrhea in USAID maternal and child health (MCH) priority countries. Overall current levels of care seeking among children with recent illness vary widely across the 21 priority countries from nearly 90 percent in the Indonesia 2012 survey to 33 percent in Ethiopia 2011. Results show that care seeking from public sources is predominant in African MCH priority countries while care seeking from private sources is predominant in Asian MCH priority countries. The majority of countries did not show significant improvements between the two most recent DHS surveys in the level of care seeking for fever or symptoms of ARI although care seeking for diarrhea showed more widespread improvement. The use of appropriate antimalarial treatment varied widely across MCH priority countries. Despite the ...
This report assesses the quality of the birth history data in 192 DHS surveys conducted since 199... more This report assesses the quality of the birth history data in 192 DHS surveys conducted since 1990. The birth histories are the source of the age-specific fertility rates the total fertility rate (TFR) and the under-5 mortality rates that are widely used to describe levels differentials and trends in fertility and child mortality in developing countries. The assessment is based on three criteria to identify potential omission of births and/or deaths and three criteria to identify potential displacement or misreporting of date of birth age at death or both. Extreme values should be viewed as symptoms rather than a conclusive diagnosis of poor data quality. The birth histories in most DHS surveys appear to be of excellent quality although several surveys do show symptoms of omission displacement or both. With the selected indicators and criteria omission of births is usually at the level of 2 percent or less and only rarely exceeds 5 percent. Displacement of births is also usually 2 p...
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