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The Effect of Poverty, Social Inequity, and Maternal Education on Infant Mortality in Nicaragua, 1988-1993

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Specialty Public Health
Date 2000 Jan 12
PMID 10630139
Citations 47
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Abstract

Objectives: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education.

Methods: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups.

Results: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households.

Conclusions: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.

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References
1.
ANTONOVSKY A, Bernstein J . Social class and infant mortality. Soc Sci Med (1967). 1977; 11(8-9):453-70. DOI: 10.1016/0037-7856(77)90022-1. View

2.
Pena R, Liljestrand J, Zelaya E, Persson L . Fertility and infant mortality trends in Nicaragua 1964-1993. The role of women's education. J Epidemiol Community Health. 1999; 53(3):132-7. PMC: 1756845. DOI: 10.1136/jech.53.3.132. View

3.
Caldwell J, McDonald P . Influence of maternal education on infant and child mortality: levels and causes. Health Policy Educ. 1982; 2(3-4):251-67. DOI: 10.1016/0165-2281(82)90012-1. View

4.
WAXLER N, MORRISON B, Sirisena W, Pinnaduwage S . Infant mortality in Sri Lankan households: a causal model. Soc Sci Med. 1985; 20(4):381-92. DOI: 10.1016/0277-9536(85)90013-9. View

5.
Spurlock C, Hinds M, SKAGGS J, Hernandez C . Infant death rates among the poor and nonpoor in Kentucky, 1982 to 1983. Pediatrics. 1987; 80(2):262-9. View