Le SIDA au Ghana (serveur d'exploration)

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Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Identifieur interne : 000424 ( Pmc/Curation ); précédent : 000423; suivant : 000425

Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs

Auteurs : Gbenga A. Kayode [Pays-Bas] ; Diederick E. Grobbee [Pays-Bas] ; Augustina Koduah [Ghana, Pays-Bas] ; Mary Amoakoh-Coleman [Pays-Bas, Ghana] ; Irene A. Agyepong [Ghana] ; Evelyn Ansah [Ghana] ; Han Van Dijk [Pays-Bas] ; Kerstin Klipstein-Grobusch [Pays-Bas, Afrique du Sud]

Source :

RBID : PMC:4996861

Abstract

Background

Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented.

Design

Ghana Demographic and Health Survey data (1988–2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges.

Results

Since 1988, the annual average rate of decline in neonatal, infant, and under-five mortality in Ghana was 0.6, 1.0, and 1.2%, respectively. From 1988 to 1989, neonatal, infant, and under-five mortality declined from 48 to 33 per 1,000, 72 to 58 per 1,000, and 108 to 83 per 1,000, respectively, whereas from 1989 to 2008, neonatal mortality increased by 2 per 1,000 while infant and under-five mortality further declined by 6 per 1,000 and 17 per 1,000, respectively. However, the observed declines were not statistically significant except for under-five mortality; thus, the proportion of infant and under-five mortality attributed to neonatal death has increased. Most intervention programs implemented to address childhood mortality seem not to have been implemented comprehensively.

Conclusion

Progress towards attaining MDG 4 in Ghana was below the targeted rate, particularly for neonatal mortality as most health policies and programs targeted infant and under-five mortality. Implementing neonatal-specific interventions and improving existing programs will be essential to attain SDG 3.2 in Ghana and beyond.


Url:
DOI: 10.3402/gha.v9.31907
PubMed: 27558221
PubMed Central: 4996861

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PMC:4996861

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<title>Background</title>
<p>Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented.</p>
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<title>Design</title>
<p>Ghana Demographic and Health Survey data (1988–2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges.</p>
</sec>
<sec id="st3">
<title>Results</title>
<p>Since 1988, the annual average rate of decline in neonatal, infant, and under-five mortality in Ghana was 0.6, 1.0, and 1.2%, respectively. From 1988 to 1989, neonatal, infant, and under-five mortality declined from 48 to 33 per 1,000, 72 to 58 per 1,000, and 108 to 83 per 1,000, respectively, whereas from 1989 to 2008, neonatal mortality increased by 2 per 1,000 while infant and under-five mortality further declined by 6 per 1,000 and 17 per 1,000, respectively. However, the observed declines were not statistically significant except for under-five mortality; thus, the proportion of infant and under-five mortality attributed to neonatal death has increased. Most intervention programs implemented to address childhood mortality seem not to have been implemented comprehensively.</p>
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<title>Conclusion</title>
<p>Progress towards attaining MDG 4 in Ghana was below the targeted rate, particularly for neonatal mortality as most health policies and programs targeted infant and under-five mortality. Implementing neonatal-specific interventions and improving existing programs will be essential to attain SDG 3.2 in Ghana and beyond.</p>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Glob Health Action</journal-id>
<journal-id journal-id-type="iso-abbrev">Glob Health Action</journal-id>
<journal-id journal-id-type="publisher-id">GHA</journal-id>
<journal-title-group>
<journal-title>Global Health Action</journal-title>
</journal-title-group>
<issn pub-type="ppub">1654-9716</issn>
<issn pub-type="epub">1654-9880</issn>
<publisher>
<publisher-name>Co-Action Publishing</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27558221</article-id>
<article-id pub-id-type="pmc">4996861</article-id>
<article-id pub-id-type="publisher-id">31907</article-id>
<article-id pub-id-type="doi">10.3402/gha.v9.31907</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Temporal trends in childhood mortality in Ghana: impacts and challenges of health policies and programs</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Kayode</surname>
<given-names>Gbenga A.</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Grobbee</surname>
<given-names>Diederick E.</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Koduah</surname>
<given-names>Augustina</given-names>
</name>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Amoakoh-Coleman</surname>
<given-names>Mary</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0004">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Agyepong</surname>
<given-names>Irene A.</given-names>
</name>
<xref ref-type="aff" rid="AF0004">4</xref>
<xref ref-type="aff" rid="AF0005">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ansah</surname>
<given-names>Evelyn</given-names>
</name>
<xref ref-type="aff" rid="AF0005">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>van Dijk</surname>
<given-names>Han</given-names>
</name>
<xref ref-type="aff" rid="AF0003">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Klipstein-Grobusch</surname>
<given-names>Kerstin</given-names>
</name>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0006">6</xref>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands</aff>
<aff id="AF0002">
<label>2</label>
Ministry of Health, Accra, Ghana</aff>
<aff id="AF0003">
<label>3</label>
Social Science Group, Wageningen University and Research Center, Wageningen, The Netherlands</aff>
<aff id="AF0004">
<label>4</label>
School of Public Health, University of Ghana, Legon, Accra, Ghana</aff>
<aff id="AF0005">
<label>5</label>
Ghana Health Service, Greater Accra Region, Accra, Ghana</aff>
<aff id="AF0006">
<label>6</label>
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</aff>
<author-notes>
<corresp id="cor1">
<label>*</label>
Correspondence to: Gbenga A. Kayode, Julius Center for Health Sciences and Primary Care, P.O. Box 85500, NL-3508 GA Utrecht, The Netherlands, Email:
<email xlink:href="g.a.kayode@umcutrecht.nl">g.a.kayode@umcutrecht.nl</email>
</corresp>
<fn>
<p>Responsible Editor: Stig Wall, Umea University, Sweden.</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>23</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection">
<year>2016</year>
</pub-date>
<volume>9</volume>
<elocation-id content-type="doi">10.3402/gha.v9.31907</elocation-id>
<history>
<date date-type="received">
<day>12</day>
<month>4</month>
<year>2016</year>
</date>
<date date-type="rev-recd">
<day>16</day>
<month>6</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>16</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© 2016 Gbenga A. Kayode et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.</license-p>
</license>
</permissions>
<abstract>
<sec id="st1">
<title>Background</title>
<p>Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented.</p>
</sec>
<sec id="st2">
<title>Design</title>
<p>Ghana Demographic and Health Survey data (1988–2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges.</p>
</sec>
<sec id="st3">
<title>Results</title>
<p>Since 1988, the annual average rate of decline in neonatal, infant, and under-five mortality in Ghana was 0.6, 1.0, and 1.2%, respectively. From 1988 to 1989, neonatal, infant, and under-five mortality declined from 48 to 33 per 1,000, 72 to 58 per 1,000, and 108 to 83 per 1,000, respectively, whereas from 1989 to 2008, neonatal mortality increased by 2 per 1,000 while infant and under-five mortality further declined by 6 per 1,000 and 17 per 1,000, respectively. However, the observed declines were not statistically significant except for under-five mortality; thus, the proportion of infant and under-five mortality attributed to neonatal death has increased. Most intervention programs implemented to address childhood mortality seem not to have been implemented comprehensively.</p>
</sec>
<sec id="st4">
<title>Conclusion</title>
<p>Progress towards attaining MDG 4 in Ghana was below the targeted rate, particularly for neonatal mortality as most health policies and programs targeted infant and under-five mortality. Implementing neonatal-specific interventions and improving existing programs will be essential to attain SDG 3.2 in Ghana and beyond.</p>
</sec>
</abstract>
<kwd-group>
<kwd>neonatal</kwd>
<kwd>infant</kwd>
<kwd>under-five mortality</kwd>
<kwd>Ghana</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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