| Autor: |
David Bishai, K C Samir Kumar, Hugh Waters, Michael Koenig, Joanne Katz, Subarna K Khatry, Keith P West |
| Předmět: |
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| Zdroj: |
Health Policy & Planning; Jan2005, Vol. 20 Issue 1, p60-66, 7p |
| Abstrakt: |
Objective: This paper examines gender, caste and economic differentials in child mortality in the context of a cluster-randomized trial of vitamin A distribution, in order to determine whether or not the intervention narrowed these differentials.Design: The study involved secondary analysis of data from a placebo-controlled randomized field trial of vitamin A supplements. The study took place between 19891991 in rural Sarlahi District of Nepal, with 30?059 children age 6 to 60 months. The main outcome measures were differences in mortality between boys and girls, between highest Hindu castes and others, and between the poorest quintile and the four other quintiles.Results: Without vitamin A, girls in rural Nepal experience 26.1 deaths per 1000, which is 8.3 deaths more than the comparison population of boys. With vitamin A the mortality disadvantage of girls is nearly completely attenuated, at only 1.41 additional deaths per 1000 relative to boys. Vitamin A supplementation also narrowed mortality differentials among Hindu castes, but did not lower the concentration of mortality across quintiles of asset ownership. The vitamin A-related attenuation in mortality disadvantage from gender and caste is statistically significant.Conclusions: We conclude that universal supplementation with vitamin A narrowed differentials in child death across gender and caste in rural Nepal. Assuring high-coverage vitamin A distribution throughout Nepal could help reduce inequalities in child survival in this population. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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