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Spatio-Temporal Child and Maternal Mortality Patterns and Associations with Health Interventions and Health Systems Performance in Sub-Saharan Africa

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Spatio-Temporal Child and Maternal Mortality Patterns and Associations with Health Interventions and Health Systems Performance in Sub-Saharan Africa Spatio-temporal child and maternal mortality patterns and associations with health interventions and health systems performance in sub-Saharan Africa Inauguraldissertation zur Erlangung der Würde eines Doktors der Philosophie vorgelegt der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel Von Ourohiré Millogo Burkina Faso Basel, 2021 Originaldokument gespeichert auf dem Dokumentenserver der Universität Basel https://edoc.unibas.ch Genehmigt von der Philosophisch-Naturwissenschaftlichen Fakultät auf Antrag von Prof. Dr. Jürg Utzinger, PD Dr. Penelope Vounatsou und Prof. Dr. Rainer Sauerborn. Basel, den 25. Juni 2019 Prof. Dr. Martin Spiess Dekan der Philosophisch-Naturwissenschaftlichen Fakultät A la mémoire de mon très cher Papa, MILLOGO Dié Abdoul Malick Table of contents List of abbreviations....................................................................................................................... i List of tables ................................................................................................................................ iii List of figures ............................................................................................................................... v List of supplementary files........................................................................................................... vii List of supplementary figures........................................................................................................ ix List of supplementary tables ......................................................................................................... xi Acknowledgements .................................................................................................................... xiii Summary.....................................................................................................................................xv Chapter 1: Introduction ................................................................................................................. 1 1.1 Trends of maternal and under-5 mortalities ........................................................................ 1 1.2 Maternal and child health in Burkina Faso ......................................................................... 3 1.3 Causes of maternal and under-5 deaths .............................................................................. 4 1.3.1 Causes of maternal deaths .......................................................................................... 4 1.3.2 Causes of under-5 deaths ............................................................................................ 5 1.4 Sources of maternal mortality estimation ........................................................................... 6 1.5 Data sources and maternal mortality measures ................................................................... 7 1.6 Data sources and measures of under-5 mortality rate .......................................................... 8 1.7 Maternal and under-5 key interventions ............................................................................10 1.7.1 Health sector interventions ........................................................................................10 1.7.2 Interventions out of health sector ...............................................................................12 1.8 Health system performance ..............................................................................................13 1.9 Rational of the study .......................................................................................................15 1.10 Goal and objectives .......................................................................................................16 Chapter 2: Geographical variation in the association of child, maternal and household health interventions with under-five mortality in Burkina Faso .................................................................19 Abstract ...................................................................................................................................20 2.1 Introduction........................................................................................................................21 2.2 Methods .............................................................................................................................22 2.2.1 Study area ....................................................................................................................22 2.2.2 Data source ..................................................................................................................22 2.2.3 Statistical analysis ........................................................................................................23 2.2.4 Ethical approval ...........................................................................................................24 2.3 Results ...............................................................................................................................24 2.4 Discussion..........................................................................................................................34 2.5 Acknowledgements.............................................................................................................37 2.6 Appendix ...........................................................................................................................38 Chapter 3: Geographical variation in the association between childhood diseases and under-five mortality in Burkina Faso .............................................................................................................45 Abstract ...................................................................................................................................46 3.1 Introduction........................................................................................................................47 3.2 Methods .............................................................................................................................48 3.2.1 Study area ....................................................................................................................48 3.2.2 Data source and information collected ...........................................................................48 3.2.3 Statistical analysis ........................................................................................................49 3.3 Results ...............................................................................................................................49 3.3.1 Background characteristics of the sample. ......................................................................49 3.3.2 Burden of diseases and the coverage of health interventions ............................................50 3.3.3 Bivariate analysis .........................................................................................................51 3.3.4 Bayesian Weibull survival and spatially varying regression .............................................54 3.4 Discussion..........................................................................................................................55 3.5 Conclusion .........................................................................................................................57 3.6 Acknowledgements.............................................................................................................57 3.7 Appendix ...........................................................................................................................58 Chapter 4: Constructing a malaria-related health service readiness index and assessing its association with child malaria mortality: an analysis of the Burkina Faso 2014 SARA data ................................61 Abstract. ..................................................................................................................................62 4.1 Introduction........................................................................................................................63 4.2 Methods .............................................................................................................................64 4.2.1 Study area and national health system ............................................................................64 4.2.2 Data sources ................................................................................................................64 4.2.4 Statistical analysis ........................................................................................................65 4.3 Results ...............................................................................................................................67 4.3.1 Health facility characteristics and malaria mortality ........................................................67 4.3.2 Domain readiness and tracer indicators ..........................................................................68 4.3.3 Health facility readiness index.......................................................................................70 4.3.4 Association between facility readiness and the malaria mortality .....................................75 4.4 Discussion..........................................................................................................................76 4.5 Conclusion .........................................................................................................................79
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