ArticleBMC public health2025
Quantifying the attributable burden of economic inequality on under-five mortality across ten African countries: a WHO HEAT-based analysis.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDespite global declines in under-five mortality, African countries continue to experience high rates, with socioeconomic disparities undermining progress toward Sustainable Development Goal 3.2. While wealth gradients in child survival are well documented, the proportion of deaths directly attributable to inequality remains poorly quantified across national contexts.
methodsWe conducted a cross-national secondary analysis using the WHO Health Equity Assessment Toolkit (HEAT) v.6.0. Data from ten African countries for the 2022 reference year were included, comprising a total study population of over 6.5 million live births. Under-five mortality rates were obtained from United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) datasets, disaggregated by wealth quintile and sex. Inequality was assessed using Difference, Ratio, Population Attributable Risk, Population Attributable Fraction, Slope Index of Inequality, and Relative Index of Inequality.
resultsNational under-five mortality ranged from 38.0 per 1,000 live births in Rwanda to 117.3 in Niger, with all countries exceeding the SDG target of ≤ 25. Wealth gradients were present in all settings: the absolute difference between poorest and richest quintiles ranged from 11.3 (South Sudan) to 67.0 (Mali). Inequality-attributable burdens were highest in Mali (PAR - 41.9; PAF - 44.7%), Togo (PAR - 25.6; PAF - 42.5%), and Madagascar (PAR - 22.7; PAF - 34.5%). Gradient measures confirmed steep inequities in Mali and Togo (SII ≤ -56.3; RII 2.3). Male children had higher mortality, but sex-attributable fractions were negligible.
conclusionUp to 45% of under-five deaths in high-burden African countries are attributable to economic inequality. Embedding equity metrics into child survival strategies and targeting the poorest households are essential to accelerate progress toward ending preventable child deaths. Precision public health targeting the poorest quintiles is crucial to reducing preventable child deaths in Africa.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.