ArticleBMJ global health2018
Girls' hidden penalty: analysis of gender inequality in child mortality with data from 195 countries.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Comparative analysis of predictors of child mortality in Ethiopia via frequentist and Bayesian approaches.Scientific reports · 2025Article
- Child Mortality and Nutritional Risks in Rural Chad: A Community-Based Cross-Sectional Study in Béré.International journal of environmental research and public health · 2025Article
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- Analysis of Maternal and Infant Death Reporting System (MIDRS) in a North Indian State during 2013-2018.Journal of family medicine and primary care · 2022Article
- A Women's Rights-Based Approach to Reducing Child Mortality: Data from 193 Countries Show that Gender Equality does Affect Under-five Child Mortality.Maternal and child health journal · 2022Article
- Sex inequality in under-five deaths and associated factors in low and middle-income countries: a Fairlie decomposition analysis.BMC public health · 2022Article
- Barriers to Access of Healthcare Services for Rural Women-Applying Gender Lens on TB in a Rural District of Sindh, Pakistan.International journal of environmental research and public health · 2021Article
- Levels and potential drivers of under-five mortality sex ratios in low- and middle-income countries.Paediatric and perinatal epidemiology · 2021Article
- Trends and geographic variability in gender inequalities in child mortality and stunting in India, 2006-2016.Maternal & child nutrition · 2021Article
- Impact of high-risk fertility behaviours on underfive mortality in Asia and Africa: evidence from Demographic and Health Surveys.BMC pregnancy and childbirth · 2021Article
- Gender-related influences on adherence to advice and treatment-seeking guidance for infants and young children post-hospital discharge in Bangladesh.International journal for equity in health · 2021Article
- Trends of inequalities in care seeking behavior for under-five children with suspected pneumonia in Ethiopia: evidence from Ethiopia demographic and health surveys (2005-2016).BMC public health · 2021Article
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- A scoping review of methods for assessment of sex differentials in early childhood mortality.BMC pediatrics · 2021Article
- Gender Equity and Vertically Transmitted Infections: A Country-Level Analysis Across 153 Countries.Health equity · 2021Article
- Review
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- We all progress through progress towards gender equality.EClinicalMedicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGender inequality has been associated with child mortality; however, sex-specific mortalities have yet to be explored. The aim of this study is to assess the associations between gender inequality and the child mortality sex ratio at country level, worldwide and to infer on possible mechanisms.
methodsData on sex-specific under-five mortality rates (U5MR) and the corresponding sex ratio (U5MSR) for the year 2015, by country, were retrieved from the Unicef database. Excess under-five female mortality was derived from previous published work. Gender inequality was measured using the Gender Inequality Index (GII). Additional biological and social variables have been included to explore potential mechanistic pathways.
resultsA total of 195 countries were included in the analysis. In adjusted models, GII was significantly negatively associated with the U5MSR (β=-0.29 (95% CI -0.42 to -0.16), p<0.001) and borderline significantly positively associated with excess under-five female mortality (β = 3.25 (95% CI -0.28 to 6.67, p=0.071). The association between GII and U5MSR was strong and statistically significant only in low-income and middle-income countries and in the Western Pacific area.
conclusionThe more gender unequal a society is, the more girls are penalised in terms of their survival chances, in particular in low-income and middle-income countries. In order to decrease child mortality and excess girl mortality, global policy should focus on reducing gender inequality surrounding measures of reproductive health, women's political empowerment, educational attainment and participation in the workforce.
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