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Inequalities in Child Mortality in Sub-Saharan Africa: a Social Epidemiologic Framework
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences. Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutetet, Stockholm, Sweden.
Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutetet, Stockholm, Sweden.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
2011 (English)In: African Journal of Health Sciences, ISSN 1022-9272, Vol. 18, no 1-2, 14-26 p.Article in journal (Refereed) Published
Abstract [en]

In the past twenty years or so, the study of the determinants of child survival in low-income countries has been based on demographic conceptual frameworks. The most widely known has been the Mosley and Chen framework (1). In that framework, the key concept was a set of proximate determinants, or intermediate variables, that directly influence the risk of morbidity and mortality. It assumes that all the more distal social and economic determinants must operate through these variables to affect child survival. However the Mosley and Chen framework has failed to directly incorporate the complex social dimension of health.The objective of this paper is to link more distal causes for child health by describing a framework that conceptualises the relation between distal and proximal factors and how they operate to cause inequalities in child mortality within sub-Saharan Africa. Additionally the framework defines policy entry points needing support of empirical evidence. Furthermore the paper acknowledges that the social context plays an important role for inequalities in children’s chances of survival. However, the relative importance of the mechanisms presented in the proposed framework may vary among the different countries of sub-Saharan Africa, thus researchers should empirically adapt the framework to their specific context.

Place, publisher, year, edition, pages
2011. Vol. 18, no 1-2, 14-26 p.
Keyword [en]
Child mortality, sub-Saharan Africa, inequalities
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hig:diva-10081OAI: oai:DiVA.org:hig-10081DiVA: diva2:440047
Available from: 2011-09-11 Created: 2011-09-11 Last updated: 2013-05-03Bibliographically approved

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