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Social inequality in infant mortality in Angola: Evidence from a population based study

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  • Gebretsadik Shibre

Abstract

Introduction: Within country inequality in infant mortality poses a big challenge for countries moving towards the internationally agreed upon targets on child mortality by 2030. There is a lack of high-quality evidence on infant mortality measured through different dimensions of social inequality in Angola. Thus, this paper was carried out to address the knowledge gap by conducting in-depth examination of infant mortality rate (IMR) inequality among population subgroups to provide more nuanced evidence to help end IMR disparity in the country. Methods: The World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) was used to analyze IMR inequality. HEAT is a software application that facilitates examination of disparities in reproductive, maternal, neonatal and child health indicators using the WHO Health Equity Monitor (HEM) database. Inequality of IMR was analyzed through disaggregation by five equity stratifiers: education, wealth, gender, subnational region and residence. These were analyzed through three inequality measures: Population Attributable Risk, Ratio and Slope Index of Inequality. A 95% confidence Interval (CI) was built around point estimates to determine statistical significance. Results: A notable disadvantage was found for children born to poor (Population Attributable Risk (PAR): -27.0; -28.4, -26.0) and uneducated (PAR: -17.0; -17.9, -16.0), women who live in rural areas (PAR: -7.3;-7.8, -6.7) and those residing in certain regions of the country (PAR: -43.0; 45.3, -4). Male infants had a higher risk of death than female infants (PAR: -6.8;-7.5, -6.2). The subnational regional variation of IMR had been the most evident when compared with the disparities in the other equity stratifers. Conclusions: Policymakers and planners need to address the disproportionately higher clustering of IMR among infants born to disadvantaged subpopulations through interventions that benefit such subgroups.

Suggested Citation

  • Gebretsadik Shibre, 2020. "Social inequality in infant mortality in Angola: Evidence from a population based study," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-12, October.
    • Handle: RePEc:plo:pone00:0241049
    DOI: 10.1371/journal.pone.0241049
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    1. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
    2. Hajizadeh, Mohammad & Nandi, Arijit & Heymann, Jody, 2014. "Social inequality in infant mortality: What explains variation across low and middle income countries?," Social Science & Medicine, Elsevier, vol. 101(C), pages 36-46.
    3. Waldron, Ingrid, 1983. "Sex differences in human mortality: The role of genetic factors," Social Science & Medicine, Elsevier, vol. 17(6), pages 321-333, January.
    4. Knöbel, Harald H. & Yang, Wen-Shan & Ho, Mei-Shang, 1994. "Urban-rural and regional differences in infant mortality in Taiwan," Social Science & Medicine, Elsevier, vol. 39(6), pages 815-822, September.
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