| Item type |
デフォルトアイテムタイプ_（フル）(1) |
| 公開日 |
2023-03-18 |
| タイトル |
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タイトル |
Association between Proximity to a Health Center and Early Childhood Mortality in Madagascar |
|
言語 |
en |
| 作成者 |
Kashima, Saori
Suzuki, Etsuji
Okayasu, Toshiharu
Louis, Razafimahatratra Jean
Eboshida, Akira
Subramanian, S. V.
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| アクセス権 |
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アクセス権 |
open access |
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アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
| 権利情報 |
|
|
権利情報 |
(c) 2012 Kashima et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| 主題 |
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主題Scheme |
NDC |
|
主題 |
490 |
| 内容記述 |
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内容記述 |
Objective: To evaluate the association between proximity to a health center and early childhood mortality in Madagascar, and to assess the influence of household wealth, maternal educational attainment, and maternal health on the effects of distance. Methods: From birth records of subjects in the Demographic and Health Survey, we identified 12565 singleton births from January 2004 to August 2009. After excluding 220 births that lacked global positioning system information for exposure assessment, odds ratios (ORs) and their 95% confidence intervals (CIs) for neonatal mortality and infant mortality were estimated using multilevel logistic regression models, with 12345 subjects (level 1), nested within 584 village locations (level 2), and in turn nested within 22 regions (level 3). We additionally stratified the subjects by the birth order. We estimated predicted probabilities of each outcome by a three-level model including cross-level interactions between proximity to a health center and household wealth, maternal educational attainment, and maternal anemia. Results: Compared with those who lived >1.5-3.0 km from a health center, the risks for neonatal mortality and infant mortality tended to increase among those who lived further than 5.0 km from a health center; the adjusted ORs for neonatal mortality and infant mortality for those who lived >5.0-10.0 km away from a health center were 1.36 (95% CI: 0.92-2.01) and 1.42 (95% CI: 1.06-1.90), respectively. The positive associations were more pronounced among the second or later child. The distance effects were not modified by household wealth status, maternal educational attainment, or maternal health status. Conclusions: Our study suggests that distance from a health center is a risk factor for early childhood mortality (primarily, infant mortality) in Madagascar by using a large-scale nationally representative dataset. The accessibility to health care in remote areas would be a key factor to achieve better infant health. |
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言語 |
en |
| 出版者 |
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出版者 |
Public Library of Science |
| 言語 |
|
|
言語 |
eng |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
|
資源タイプ |
journal article |
| 出版タイプ |
|
|
出版タイプ |
VoR |
|
出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| 関連情報 |
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|
識別子タイプ |
DOI |
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|
関連識別子 |
10.1371/journal.pone.0038370 |
| 関連情報 |
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|
識別子タイプ |
DOI |
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|
関連識別子 |
http://dx.doi.org/10.1371/journal.pone.0038370 |
| 収録物識別子 |
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収録物識別子タイプ |
ISSN |
|
収録物識別子 |
1932-6203 |
| 開始ページ |
|
|
開始ページ |
e38370 |
| 書誌情報 |
PLoS ONE
PLoS ONE
巻 7,
号 6,
p. e38370,
発行日 2012
|
| 旧ID |
34767 |
PLoS-One_7_e38370.pdf (1.3 MB)
