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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The effect of distance to health-care facilities on childhood mortality in rural Burkina Faso
American Journal of Epidemiology, Volume 173, No. 5, Year 2011
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Description
This study aims to investigate the relation between distance to health facilities, measured as continuous travel time, and mortality among infants and children younger than 5 years of age in rural Burkina Faso, an area with low health facility density. The study included 24,555 children born between 1993 and 2005 in the Nouna Health and Demographic Surveillance System. The average walking time from each village to the closest health facility was obtained for both the dry and the rainy season, and its effect on infant (<1 year), child (1-4 years), and under-5 mortality overall was analyzed by Cox regression. The authors observed 3,426 childhood deaths, corresponding to a 5-year survival of 85%. Walking distance was significantly related to both infant and child mortality, although the shape of this effect varied distinctly between the 2 age groups. Overall, under-5 mortality, adjusted for confounding, was more than 50% higher at a distance of 4 hours compared with having a health facility in the village (P < 0.0001, 2 sided). The region of residence was an additional determinant for under-5 mortality. The findings of this study emphasize the importance of geographic accessibility of health care for child survival in sub-Saharan Africa and demonstrate the need to improve health-care access to achieve the Millennium Development Goals. © The Author 2011.
Authors & Co-Authors
Schoeps, Anja
Germany, Heidelberg
Universität Heidelberg
Gabrysch, Sabine
Germany, Heidelberg
Universität Heidelberg
Niamba, Louis
Burkina Faso, Nouna
Centre de Recherche en Sante de Nouna
Sié, Alie
Burkina Faso, Nouna
Centre de Recherche en Sante de Nouna
Becher, Heiko
Germany, Heidelberg
Universität Heidelberg
Statistics
Citations: 161
Authors: 5
Affiliations: 2
Identifiers
Doi:
10.1093/aje/kwq386
ISSN:
00029262
e-ISSN:
14766256
Research Areas
Health System And Policy
Maternal And Child Health
Study Locations
Burkina Faso