ArticlePloS one2019
Changes in the spatial distribution of the under-five mortality rate: Small-area analysis of 122 DHS surveys in 262 subregions of 35 countries in Africa.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 68 citations in OpenAlex.
- Geostatistical Modelling and Web-Based Mapping of Malaria Risks Among Children Under Five Years in Nigeria: Evidence From the 2021 Nigeria Malaria Indicator Survey.Health science reports · 2026Article
- Evaluating global health programmes targeting under-5 mortality: problems and recommendations.BMJ global health · 2026Article
- Burden of diarrheal diseases among children under five in East Africa, 2000-2023: insights from the global burden of disease 2023 study.BMC infectious diseases · 2026Article
- Toward a Principled Workflow for Prevalence Mapping Using Household Survey Data.Journal of survey statistics and methodology · 2026Article
- Article
- Disaggregated level child morbidity in Zambia: an application of small area estimation method.Population health metrics · 2025Article
- Comparisons of cox semi-parametric and parametric shared frailty models: application for under-five children survival in sub-Saharan Africa.BMC public health · 2025Article
- Economic and healthcare determinants of under-five mortality in low-income countries.BMC public health · 2025Article
- Article
- Smoothed model-assisted small area estimation of proportions.The Canadian journal of statistics = Revue canadienne de statistique · 2024Article
- Spatiotemporal modeling of under-five mortality and associated risk factors in Ethiopia using 2000-2016 EDHS data.BMC pediatrics · 2024Article
- Spatio-temporal modelling of under-five mortality in Lesotho using demographic and health survey data.African health sciences · 2023Article
- Impact of ignoring sampling design in the prediction of binary health outcomes through logistic regression: evidence from Malawi demographic and health survey under-five mortality data; 2000-2016.BMC public health · 2023Article
- A small area model to assess temporal trends and sub-national disparities in healthcare quality.Nature communications · 2023Article
- Socioeconomic and residence-based related inequality in childhood vaccination in Sub-Saharan Africa: Evidence from Benin.Health science reports · 2023Article
- How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study.BMC health services research · 2023Article
- Mean Temperature and Drought Projections in Central Africa: A Population-Based Study of Food Insecurity, Childhood Malnutrition and Mortality, and Infectious Disease.International journal of environmental research and public health · 2023Article
- Spatiotemporal trends in neonatal, infant, and child mortality (1990-2019) based on Bayesian spatiotemporal modeling.Frontiers in public health · 2023Article
- Spatiotemporal distributions of under-five mortality in Ethiopia between 2000 and 2019.PLOS global public health · 2023Article
- Preterm Birth Among Intrapartum Cesarean Deliveries at Public Hospitals in Southern Ethiopia: A Multicenter Retrospective Analysis of Risk Factors.International journal of women's health · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
The under-five mortality rate (U5MR) is a critical and widely available population health indicator. Both the MDGs and SDGs define targets for improvement in the U5MR, and the SDGs require spatial disaggregation of indicators. We estimate trends in the U5MR for Admin-1 subnational areas using 122 DHS surveys in 35 countries in Africa and assess progress toward the MDG target reductions for each subnational region and each country as a whole. In each country, direct weighted estimates of the U5MR from each survey are calculated and combined into a single estimate for each Admin-1 region across five-year periods. Our method fully accounts for the sample design of each survey. The region-time-specific estimates are smoothed using a Bayesian, space-time model that produces more precise estimates (when compared to the direct estimates) at a one-year scale that are consistent with each other in both space and time. The resulting estimated distributions of the U5MR are summarized and used to assess subnational progress toward the MDG 4 target of two-thirds reduction in the U5MR during 1990-2015. Our space-time modeling approach is tractable and can be readily applied to a large collection of sample survey data. Subnational, regional spatial heterogeneity in the levels and trends in the U5MR vary considerably across Africa. There is no generalizable pattern between spatial heterogeneity and levels or trends in the U5MR. Subnational, small-area estimates of the U5MR: (i) identify subnational regions where interventions are still necessary and those where improvement is well under way; and (ii) countries where there is very little spatial variation and others where there are important differences between subregions in both levels and trends. More work is necessary to improve both the data sources and methods necessary to adequately measure subnational progress toward the SDG child survival targets.
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