ArticleBMC public health2021
Mind the gap: what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysis.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global childhood diarrhoea prevalence and its determinants: a systematic meta-analytic assessment, 1985-2024.EBioMedicine · 2025Pooled it
- Assessing the Impact of Rotavirus Vaccination in Iranian Children Under Five: An Agent-Based Modelling Approach.Health science reports · 2026Article
- Determinants of diarrhea and acute respiratory infection among under-five children in urban-rural Somalia: a nationally representative cross-sectional study.BMC infectious diseases · 2026Article
- A mixed-effects multilevel Poisson regression analysis of diarrhea prevalence among under-five children in Indonesia.Journal of health, population, and nutrition · 2026Article
- Updated Estimates of Childhood Diarrheal Morbidity in 11 Sub-Saharan African Countries Using the Latest Demographic and Health Surveys (2021-2024): A Multilevel Modified Poisson Regression Analysis.BioMed research international · 2026Article
- What are the factors associated with rural-urban inequality in under-5 deaths in low- and middle-income countries? A Fairlie decomposition analysis.PLOS global public health · 2025Article
- Gender differences in depressive symptoms among Chinese older adults based on fairlie decomposition analysis.Heliyon · 2023Article
- Decomposition and comparative analysis of health inequities between the male and female older adults in China: a national cross-sectional study.BMC public health · 2023Article
- Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis.Tropical medicine and health · 2023Article
- Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study.Environmental health insights · 2023Article
- Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis.BMC public health · 2022Article
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Abstract
backgroundDiarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities.
methodsData of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010-2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package.
resultsTwo-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education.
conclusionsThe gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.
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