IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i5p1138-1152.html
   My bibliography  Save this article

An investigation of district spatial variations of childhood diarrhoea and fever morbidity in Malawi

Author

Listed:
  • Kandala, Ngianga-Bakwin
  • Magadi, Monica Akinyi
  • Madise, Nyovani Janet

Abstract

Although diarrhoea and malaria are among the leading causes of child mortality and morbidity in Sub-Saharan Africa, few detailed studies have examined the patterns and determinants of these ailments in the most affected communities. In this paper, we investigate the spatial distribution of observed diarrhoea and fever prevalence in Malawi using individual data for 10,185 children from the 2000 Malawi Demographic and Health survey. We highlight inequalities in child health by mapping the residual district spatial effects using a geo-additive probit model that simultaneously controls for spatial dependence in the data and potential nonlinear effects of covariates. The residual spatial effects were modelled via a Bayesian approach. For both ailments, we were able to identify a distinct district pattern of childhood morbidity. In particular, the results suggest that children living in the capital city are less affected by fever, although this is not true for diarrhoea, where some urban agglomerations are associated with a higher childhood morbidity risk. The spatial patterns emphasize the role of remoteness as well as climatic, environmental, and geographic factors on morbidity. The fixed effects show that for diarrhoea, the risk of child morbidity appears to be lower among infants who are exclusively breastfed than among those who are mixed-fed. However, exclusive breastfeeding was not found to have a protective effect on fever. An important socio-economic factor for both diarrhoea and fever morbidity was parental education, especially maternal educational attainment. Diarrhoea and fever were both observed to show an interesting association with child's age. We were able to discern the continuous worsening of the child morbidity up to 8-12 months of age. This deterioration set in right after birth and continues, more or less linearly until 8-12 months, before beginning to decline thereafter. Independent of other factors, a separate spatial process produces district inequalities in child's health.

Suggested Citation

  • Kandala, Ngianga-Bakwin & Magadi, Monica Akinyi & Madise, Nyovani Janet, 2006. "An investigation of district spatial variations of childhood diarrhoea and fever morbidity in Malawi," Social Science & Medicine, Elsevier, vol. 62(5), pages 1138-1152, March.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:5:p:1138-1152
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00401-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Whitworth, Alison & Stephenson, Rob, 2002. "Birth spacing, sibling rivalry and child mortality in India," Social Science & Medicine, Elsevier, vol. 55(12), pages 2107-2119, December.
    2. Arline Geronimus & Sanders Korenman, 1993. "The socioeconomic costs of teenage childbearing: Evidence and interpretation," Demography, Springer;Population Association of America (PAA), vol. 30(2), pages 281-290, May.
    3. Ludwig Fahrmeir & Stefan Lang, 2001. "Bayesian inference for generalized additive mixed models based on Markov random field priors," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 50(2), pages 201-220.
    4. Peter Diggle & Rana Moyeed & Barry Rowlingson & Madeleine Thomson, 2002. "Childhood malaria in the Gambia: a case‐study in model‐based geostatistics," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 51(4), pages 493-506, October.
    5. Michael Koenig & James Phillips & Oona Campbell & Stan D’Souza, 1990. "Erratum to: Birth intervals and childhood mortality in rural Bangladesh," Demography, Springer;Population Association of America (PAA), vol. 27(4), pages 657-657, November.
    6. Magadi, Monica Akinyi & Madise, Nyovani Janet & Rodrigues, Roberto Nascimento, 2000. "Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities," Social Science & Medicine, Elsevier, vol. 51(4), pages 551-561, August.
    7. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
    8. Defo, B.A., 1996. "Areal and Socioeconomic Differentials in Infant and Child Mortality in Cameroon," Papers 96-05, RAND - Reprint Series.
    9. Bicego, George T. & Ties Boerma, J., 1993. "Maternal education and child survival: A comparative study of survey data from 17 countries," Social Science & Medicine, Elsevier, vol. 36(9), pages 1207-1227, May.
    10. Defo, Barthélémy Kuate, 1996. "Areal and socioeconomic differentials in infant and child mortality in Cameroon," Social Science & Medicine, Elsevier, vol. 42(3), pages 399-420, February.
    11. Geoffrey M. Jacquez, 2000. "Spatial analysis in epidemiology: Nascent science or a failure of GIS?," Journal of Geographical Systems, Springer, vol. 2(1), pages 91-97, March.
    12. Michael Koenig & James Phillips & Oona Campbell & Stan D'Souza, 1990. "Birth Intervals and Childhood Mortality in Rural Bangladesh," Demography, Springer;Population Association of America (PAA), vol. 27(2), pages 251-265, May.
    13. David J. Spiegelhalter & Nicola G. Best & Bradley P. Carlin & Angelika Van Der Linde, 2002. "Bayesian measures of model complexity and fit," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 64(4), pages 583-639, October.
    14. Millard, Ann V., 1994. "A causal model of high rates of child mortality," Social Science & Medicine, Elsevier, vol. 38(2), pages 253-268, January.
    15. E. E. Kammann & M. P. Wand, 2003. "Geoadditive models," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 52(1), pages 1-18, January.
    16. Garg, R. & Omwomo, W. & Witte, J.M. & Lee, L.A. & Deming, M.S., 2001. "Care seeking during fatal childhood illnesses: Siaya District, Kenya, 1998," American Journal of Public Health, American Public Health Association, vol. 91(10), pages 1611-1613.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kandala, Ngianga-Bakwin & Emina, Jacques B. & Nzita, Paul Denis K. & Cappuccio, Francesco P., 2009. "Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo," Social Science & Medicine, Elsevier, vol. 68(9), pages 1728-1736, May.
    2. Few, Roger & Lake, Iain & Hunter, Paul R. & Tran, Pham Gia, 2013. "Seasonality, disease and behavior: Using multiple methods to explore socio-environmental health risks in the Mekong Delta," Social Science & Medicine, Elsevier, vol. 80(C), pages 1-9.
    3. Lawrence Kazembe, 2009. "Modelling individual fertility levels in Malawian women: a spatial semiparametric regression model," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 18(2), pages 237-255, July.
    4. Peter Hangoma & Arild Aakvik & Bjarne Robberstad, 2017. "Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): The case of Zambia," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-21, February.
    5. Yusuf, Shahid & Nabeshima, Kaoru & Wei Ha, 2007. "What makes cities healthy ?," Policy Research Working Paper Series 4107, The World Bank.
    6. Nancy Luke & Hongwei Xu, 2011. "Exploring the meaning of context for health: Community influences on child health in South India," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 24(15), pages 345-374.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. van Soest, A.H.O. & Saha, U.R., 2012. "Birth Spacing, Child Survival and Fertility Decisions : Analysis of Causal Mechanismsa," Discussion Paper 2012-018, Tilburg University, Center for Economic Research.
    2. Congdon, Peter, 2006. "A model for non-parametric spatially varying regression effects," Computational Statistics & Data Analysis, Elsevier, vol. 50(2), pages 422-445, January.
    3. Saha, U.R., 2012. "Econometric models of child mortality dynamics in rural Bangladesh," Other publications TiSEM f734b639-9696-480e-96f0-8, Tilburg University, School of Economics and Management.
    4. Brezger, Andreas & Lang, Stefan, 2006. "Generalized structured additive regression based on Bayesian P-splines," Computational Statistics & Data Analysis, Elsevier, vol. 50(4), pages 967-991, February.
    5. Joseph L Ward & Russell M Viner, 2016. "Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS)," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
    6. Gayen, Kaberi & Raeside, Robert, 2007. "Social networks, normative influence and health delivery in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 65(5), pages 900-914, September.
    7. Susanna M Makela & Rakhi Dandona & T R Dilip & Lalit Dandona, 2013. "Social Sector Expenditure and Child Mortality in India: A State-Level Analysis from 1997 to 2009," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-10, February.
    8. Vellore Arthi & James Fenske, 2018. "Polygamy and child mortality: Historical and modern evidence from Nigeria’s Igbo," Review of Economics of the Household, Springer, vol. 16(1), pages 97-141, March.
    9. Saha, U.R. & van Soest, A.H.O., 2009. "Infant Mortality in Rural Bangladesh : State Dependence vs. Unobserved Heterogeneity," Other publications TiSEM c6939d37-f018-49e2-bc6e-3, Tilburg University, School of Economics and Management.
    10. Marshall Makate, 2016. "Education Policy and Under-Five Survival in Uganda: Evidence from the Demographic and Health Surveys," Social Sciences, MDPI, vol. 5(4), pages 1-17, October.
    11. Julie DaVanzo & Abdur Razzaque & Mizanur Rahman & Lauren Hale & Kapil Ahmed & Mehrab Ali Khan & Golam Mustafa & Kaniz Gausia, 2004. "The Effects of Birth Spacing on Infant and Child Mortality, Pregnancy Outcomes, and Maternal Morbidity and Mortality in Matlab, Bangladesh," Working Papers WR-198, RAND Corporation.
    12. Belitz, Christiane & Lang, Stefan, 2008. "Simultaneous selection of variables and smoothing parameters in structured additive regression models," Computational Statistics & Data Analysis, Elsevier, vol. 53(1), pages 61-81, September.
    13. Volker Schmid & Leonhard Held, 2004. "Bayesian Extrapolation of Space–Time Trends in Cancer Registry Data," Biometrics, The International Biometric Society, vol. 60(4), pages 1034-1042, December.
    14. Klein, Nadja & Herwartz, Helmut & Kneib, Thomas, 2020. "Modelling regional patterns of inefficiency: A Bayesian approach to geoadditive panel stochastic frontier analysis with an application to cereal production in England and Wales," Journal of Econometrics, Elsevier, vol. 214(2), pages 513-539.
    15. Makate, Marshall & Makate, Clifton, 2016. "The causal effect of increased primary schooling on child mortality in Malawi: Universal primary education as a natural experiment," Social Science & Medicine, Elsevier, vol. 168(C), pages 72-83.
    16. Izutsu, Takashi & Tsutsumi, Atsuro & Islam, Akramul Md. & Kato, Seika & Wakai, Susumu & Kurita, Hiroshi, 2006. "Mental health, quality of life, and nutritional status of adolescents in Dhaka, Bangladesh: Comparison between an urban slum and a non-slum area," Social Science & Medicine, Elsevier, vol. 63(6), pages 1477-1488, September.
    17. Brezger, Andreas & Kneib, Thomas & Lang, Stefan, 2005. "BayesX: Analyzing Bayesian Structural Additive Regression Models," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 14(i11).
    18. Emily Smith-Greenaway & Christie Sennott, 2016. "Death and Desirability: Retrospective Reporting of Unintended Pregnancy After a Child’s Death," Demography, Springer;Population Association of America (PAA), vol. 53(3), pages 805-834, June.
    19. Thirunaukarasu Subramaniam & Nanthakumar Loganathan & Erez Yerushalmi & Evelyn Shyamala Devadason & Mazlan Majid, 2018. "Determinants of Infant Mortality in Older ASEAN Economies," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(1), pages 397-415, February.
    20. Tamvada, Jagannadha Pawan, 2010. "The Dynamics of Self-employment in a Developing Country: Evidence from India," MPRA Paper 20042, University Library of Munich, Germany.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:5:p:1138-1152. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.