Wagstaff A, 2002. Poverty and health sector inequalities. Bull World Health Organ 80: 97ā105.
Makinen M, Waters HR, Rauch M, Almagambetova N, Bitran R, Gilson L, McIntyre D, Pannarunithai S, Prieto AL, Ubilla G, Ram S, 2000. Inequalities in health care use and expenditure: empirical data from eight developing countries and countries in transition. Bull World Health Organ 78: 55ā65.
Gwatkin DR, 2000. Health inequalities and the health of the poor. Bull World Health Organ 78: 16.
Karlsson M, Nilsson T, Lyttkens CH, Leeson G, 2010. Income inequality and health: importance of a cross-country perspective. Soc Sci Med 70: 875ā885.
Houweling TA, Kunst AE, 2010. Socio-economic inequalities in childhood mortality in low- and middle-income countries: a review of the international evidence. Br Med Bull 93: 7ā26.
Braveman P, Tarimo E, 2002. Social inequalities in health within countries: not only an issue for affluent nations. Soc Sci Med 54: 1621ā1635.
Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, Black RE, 2013. Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost? Lancet 381: 1417ā1429.
Halvorson SJ, Williams AL, Ba S, Dunkel FV, 2011. Water quality and waterborne disease in the Niger River Inland Delta, Mali: a study of local knowledge and response. Health Place 17: 449ā457.
Fuchs R, Pamuk E, Lutz W, 2010. Education or wealth: which matters more for reducing child mortality in developing countries? Vienna Yearb Popul Res 8: 175ā199.
Chou S-Y, Liu J-T, Grossman M, Joyce T, 2010. Parental education and child health: evidence from a natural experiment in Taiwan. Am Econ J Appl Econ 2: 63ā91.
Greenaway ES, Leon J, Baker DP, 2012. Understanding the association between maternal education and use of health services in Ghana: exploring the role of health knowledge. J Biosoc Sci 44: 733ā747.
LeVine RA, Rowe ML, 2009. Maternal literacy and child health in less-developed countries: evidence, processes, and limitations. J Dev Behav Pediatr 30: 340ā349.
Basu AM, Stephenson R, 2005. Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. Soc Sci Med 60: 2011ā2023.
Jalan J, Ravallion M, 2003. Does piped water reduce diarrhea for children in rural India? J Econom 112: 153ā173.
Tucker J, MacDonald A, Coulter L, Calow RC, 2014. Household water use, poverty and seasonality: wealth effects, labour constraints, and minimal consumption in Ethiopia. Water Resour Rural Dev 3: 27ā47.
Bolaane B, Ikgopoleng H, 2011. Towards improved sanitation: constraints and opportunities in accessing waterborne sewerage in major villages of Botswana. Habitat Int 35: 486ā493.
Mosley WH, Chen LC, 2003. An analytical framework for the study of child survival in developing countries. 1984. Bull World Health Organ 81: 140ā145.
Walsh B, Cullinan J, 2015. Decomposing socioeconomic inequalities in childhood obesity: evidence from Ireland. Econ Hum Biol 16: 60ā72.
Christiani Y, Byles J, Tavener M, Dugdale P, 2015. Socioeconomic related inequality in depression among young and middle-adult women in Indonesia's major cities. J Affect Disord 182: 76ā81.
Doherty E, Walsh B, O'Neill C, 2014. Decomposing socioeconomic inequality in child vaccination: results from Ireland. Vaccine 32: 3438ā3444.
Abu-Zaineh M, Mataria A, Moatti J-P, Ventelou B, 2011. Measuring and decomposing socioeconomic inequality in healthcare delivery: a microsimulation approach with application to the Palestinian conflict-affected fragile setting. Soc Sci Med 72: 133ā141.
Solmi F, Von Wagner C, Kobayashi LC, Raine R, Wardle J, Morris S, 2015. Decomposing socio-economic inequality in colorectal cancer screening uptake in England. Soc Sci Med 134: 76ā86.
Rama M, Li Y, Mitra PK, Newman JL, 2015. Addressing Inequality in South Asia. Washington, DC: The World Bank, 197.
United Nations Organization, 2014. The Millennium Development Goals Report 2014. New York, NY: United Nations Organization.
Urke HB, Bull T, Mittelmark MB, 2011. Socioeconomic status and chronic child malnutrition: wealth and maternal education matter more in the Peruvian Andes than nationally. Nutr Res 31: 741ā747.
Peru Support Group, 2008. The Great Water Debate: Cause and Effect in Peru. London, United Kingdom: Peru Support Group.
Ioris AAR, 2012. The geography of multiple scarcities: urban development and water problems in Lima, Peru. Geoforum 43: 612ā622.
Checkley W, Gilman RH, Black RE, Epstein LD, Cabrera L, Sterling CR, Moulton LH, 2004. Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. Lancet 363: 112ā118.
Fink G, Günther I, Hill K, 2011. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986ā2007. Int J Epidemiol 40: 1196ā1204.
Hill K, Amouzou A, 2006. Chapter 3: Trends in child mortality, 1960 to 2000. Jamison DT, Feachem RG, Makgoba MW, Bos ER, Baingana FK, Hofman KJ, Rogo KO, eds. Disease and Mortality in Sub-Saharan Africa, 2nd edition. Washington, DC: World Bank, 15ā30.
Pradhan J, Arokiasamy P, 2010. Socio-economic inequalities in child survival in India: a decomposition analysis. Health Policy 98: 114ā120.
World Health Organization (WHO) and United Nations Children's Emergency Fund (UNICEF), 2014. Progress on Drinking Water and Sanitation. Geneva, Switzerland: WHO and UNICEF.
Traissac P, Martin-Prevel Y, 2012. Alternatives to principal components analysis to derive asset-based indices to measure socio-economic position in low- and middle-income countries: the case for multiple correspondence analysis. Int J Epidemiol 41: 1207ā1210.
Balk D, Pullum T, Storeygard A, Greenwell F, Neuman M, 2003. Spatial Analysis of Childhood Mortality in West Africa. Calverton, MD: ORC Macro.
O'Donnell O, Van Doorslaer E, Wagstaff A, Lindelow M, 2008. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation, 1st edition. Washington, DC: The Word Bank.
Morasae EK, Forouzan AS, Majdzadeh R, Asadi-Lari M, Noorbala AA, Hosseinpoor AR, 2012. Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach. Int J Equity Health 11: 18.
Freeman MC, Clasen T, Dreibelbis R, Saboori S, Greene LE, Brumback B, Muga R, Rheingans R, 2014. The impact of a school-based water supply and treatment, hygiene, and sanitation programme on pupil diarrhoea: a cluster-randomized trial. Epidemiol Infect 142: 340ā351.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42ā52.
Stark J, GuillƩn S, Brady C, 2012. Follow the Water: Emerging Issues of Climate Change and Conflict in Peru. Lima, Peru: U.S. Agency for International Development, 5.
Huicho L, Trelles M, Gonzales F, 2006. National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions. BMC Public Health 6: 173.
United Nations Children's Emergency Fund (UNICEF), 2009. The State of the World's Children 2009: Maternal and Newborn Health. New York, NY: UNICEF.
MuƱoz I, Paredes M, Thorp R, 2007. Group inequalities and the nature and power of collective action: case studies from Peru. World Dev 35: 1929ā1946.
Perova E, Vakis R, 2012. 5 years in Juntos: new evidence on the program's short and long-term impacts. EconomĆa 35: 53ā82.
Günther I, Fink G, 2010. Water, Sanitation and Children's Health Evidence from 172 DHS Surveys. World Bank Policy Research Paper 5275. Zurich, Switzerland: Prospects Group.
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Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population.
Authors' addresses: Tasneem Bohra, Master of Public Health, School of Public Health, Ecole des Hautes Ćtudes en SantĆ© Publique (EHESP), Rennes, France, E-mail: turbulent.tas@gmail.com. Tarik Benmarhnia and Britt McKinnon, Institute for Health and Social Policy, McGill University, Montreal, Canada, E-mails: tarik.benmarhnia@mcgill.ca and britt.mckinnon@mcgill.ca. Jay S. Kaufman, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada, and Institute for Health and Social Policy, McGill University, Montreal, Canada, E-mail: jay.kaufman@mcgill.ca.
Wagstaff A, 2002. Poverty and health sector inequalities. Bull World Health Organ 80: 97ā105.
Makinen M, Waters HR, Rauch M, Almagambetova N, Bitran R, Gilson L, McIntyre D, Pannarunithai S, Prieto AL, Ubilla G, Ram S, 2000. Inequalities in health care use and expenditure: empirical data from eight developing countries and countries in transition. Bull World Health Organ 78: 55ā65.
Gwatkin DR, 2000. Health inequalities and the health of the poor. Bull World Health Organ 78: 16.
Karlsson M, Nilsson T, Lyttkens CH, Leeson G, 2010. Income inequality and health: importance of a cross-country perspective. Soc Sci Med 70: 875ā885.
Houweling TA, Kunst AE, 2010. Socio-economic inequalities in childhood mortality in low- and middle-income countries: a review of the international evidence. Br Med Bull 93: 7ā26.
Braveman P, Tarimo E, 2002. Social inequalities in health within countries: not only an issue for affluent nations. Soc Sci Med 54: 1621ā1635.
Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, Black RE, 2013. Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost? Lancet 381: 1417ā1429.
Halvorson SJ, Williams AL, Ba S, Dunkel FV, 2011. Water quality and waterborne disease in the Niger River Inland Delta, Mali: a study of local knowledge and response. Health Place 17: 449ā457.
Fuchs R, Pamuk E, Lutz W, 2010. Education or wealth: which matters more for reducing child mortality in developing countries? Vienna Yearb Popul Res 8: 175ā199.
Chou S-Y, Liu J-T, Grossman M, Joyce T, 2010. Parental education and child health: evidence from a natural experiment in Taiwan. Am Econ J Appl Econ 2: 63ā91.
Greenaway ES, Leon J, Baker DP, 2012. Understanding the association between maternal education and use of health services in Ghana: exploring the role of health knowledge. J Biosoc Sci 44: 733ā747.
LeVine RA, Rowe ML, 2009. Maternal literacy and child health in less-developed countries: evidence, processes, and limitations. J Dev Behav Pediatr 30: 340ā349.
Basu AM, Stephenson R, 2005. Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. Soc Sci Med 60: 2011ā2023.
Jalan J, Ravallion M, 2003. Does piped water reduce diarrhea for children in rural India? J Econom 112: 153ā173.
Tucker J, MacDonald A, Coulter L, Calow RC, 2014. Household water use, poverty and seasonality: wealth effects, labour constraints, and minimal consumption in Ethiopia. Water Resour Rural Dev 3: 27ā47.
Bolaane B, Ikgopoleng H, 2011. Towards improved sanitation: constraints and opportunities in accessing waterborne sewerage in major villages of Botswana. Habitat Int 35: 486ā493.
Mosley WH, Chen LC, 2003. An analytical framework for the study of child survival in developing countries. 1984. Bull World Health Organ 81: 140ā145.
Walsh B, Cullinan J, 2015. Decomposing socioeconomic inequalities in childhood obesity: evidence from Ireland. Econ Hum Biol 16: 60ā72.
Christiani Y, Byles J, Tavener M, Dugdale P, 2015. Socioeconomic related inequality in depression among young and middle-adult women in Indonesia's major cities. J Affect Disord 182: 76ā81.
Doherty E, Walsh B, O'Neill C, 2014. Decomposing socioeconomic inequality in child vaccination: results from Ireland. Vaccine 32: 3438ā3444.
Abu-Zaineh M, Mataria A, Moatti J-P, Ventelou B, 2011. Measuring and decomposing socioeconomic inequality in healthcare delivery: a microsimulation approach with application to the Palestinian conflict-affected fragile setting. Soc Sci Med 72: 133ā141.
Solmi F, Von Wagner C, Kobayashi LC, Raine R, Wardle J, Morris S, 2015. Decomposing socio-economic inequality in colorectal cancer screening uptake in England. Soc Sci Med 134: 76ā86.
Rama M, Li Y, Mitra PK, Newman JL, 2015. Addressing Inequality in South Asia. Washington, DC: The World Bank, 197.
United Nations Organization, 2014. The Millennium Development Goals Report 2014. New York, NY: United Nations Organization.
Urke HB, Bull T, Mittelmark MB, 2011. Socioeconomic status and chronic child malnutrition: wealth and maternal education matter more in the Peruvian Andes than nationally. Nutr Res 31: 741ā747.
Peru Support Group, 2008. The Great Water Debate: Cause and Effect in Peru. London, United Kingdom: Peru Support Group.
Ioris AAR, 2012. The geography of multiple scarcities: urban development and water problems in Lima, Peru. Geoforum 43: 612ā622.
Checkley W, Gilman RH, Black RE, Epstein LD, Cabrera L, Sterling CR, Moulton LH, 2004. Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. Lancet 363: 112ā118.
Fink G, Günther I, Hill K, 2011. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986ā2007. Int J Epidemiol 40: 1196ā1204.
Hill K, Amouzou A, 2006. Chapter 3: Trends in child mortality, 1960 to 2000. Jamison DT, Feachem RG, Makgoba MW, Bos ER, Baingana FK, Hofman KJ, Rogo KO, eds. Disease and Mortality in Sub-Saharan Africa, 2nd edition. Washington, DC: World Bank, 15ā30.
Pradhan J, Arokiasamy P, 2010. Socio-economic inequalities in child survival in India: a decomposition analysis. Health Policy 98: 114ā120.
World Health Organization (WHO) and United Nations Children's Emergency Fund (UNICEF), 2014. Progress on Drinking Water and Sanitation. Geneva, Switzerland: WHO and UNICEF.
Traissac P, Martin-Prevel Y, 2012. Alternatives to principal components analysis to derive asset-based indices to measure socio-economic position in low- and middle-income countries: the case for multiple correspondence analysis. Int J Epidemiol 41: 1207ā1210.
Balk D, Pullum T, Storeygard A, Greenwell F, Neuman M, 2003. Spatial Analysis of Childhood Mortality in West Africa. Calverton, MD: ORC Macro.
O'Donnell O, Van Doorslaer E, Wagstaff A, Lindelow M, 2008. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their Implementation, 1st edition. Washington, DC: The Word Bank.
Morasae EK, Forouzan AS, Majdzadeh R, Asadi-Lari M, Noorbala AA, Hosseinpoor AR, 2012. Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach. Int J Equity Health 11: 18.
Freeman MC, Clasen T, Dreibelbis R, Saboori S, Greene LE, Brumback B, Muga R, Rheingans R, 2014. The impact of a school-based water supply and treatment, hygiene, and sanitation programme on pupil diarrhoea: a cluster-randomized trial. Epidemiol Infect 142: 340ā351.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42ā52.
Stark J, GuillƩn S, Brady C, 2012. Follow the Water: Emerging Issues of Climate Change and Conflict in Peru. Lima, Peru: U.S. Agency for International Development, 5.
Huicho L, Trelles M, Gonzales F, 2006. National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions. BMC Public Health 6: 173.
United Nations Children's Emergency Fund (UNICEF), 2009. The State of the World's Children 2009: Maternal and Newborn Health. New York, NY: UNICEF.
MuƱoz I, Paredes M, Thorp R, 2007. Group inequalities and the nature and power of collective action: case studies from Peru. World Dev 35: 1929ā1946.
Perova E, Vakis R, 2012. 5 years in Juntos: new evidence on the program's short and long-term impacts. EconomĆa 35: 53ā82.
Günther I, Fink G, 2010. Water, Sanitation and Children's Health Evidence from 172 DHS Surveys. World Bank Policy Research Paper 5275. Zurich, Switzerland: Prospects Group.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 33 | 33 | 15 |
Full Text Views | 403 | 120 | 2 |
PDF Downloads | 217 | 63 | 1 |