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What matters most for newborns' survival? Patterns of socioeconomic determinants of neonatal and post-neonatal mortality in Bolivia

Temporin, Filippo (2019) What matters most for newborns' survival? Patterns of socioeconomic determinants of neonatal and post-neonatal mortality in Bolivia. PhD thesis, The London School of Economics and Political Science (LSE).

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Abstract

This thesis is motivated by the lack of studies on the socioeconomic determinants of neonatal and post-neonatal mortality. While, overall, under-five mortality has decreased substantially over the last decades, the pace of the decline in neonatal mortality rates has been slower, and this trend might be explained by a differential between neonatal and post-neonatal determinants. The aim of this thesis is to analyse the association between a set of socioeconomic factors and infant mortality, focusing on different patterns of association with mortality between the neonatal and post-neonatal periods. Deprivation is the determinant of interest, and is conceptualised as a lack of basic needs related to housing conditions; therefore, non-monetary measures of deprivation based on observed indicators relating to living standards are used. This thesis consists of three studies. The first is a country-level longitudinal study using World Bank data, which finds that poverty and access to clean water are fundamental determinants of both neonatal and post-neonatal mortality. The second study aims to investigate the distribution of deprivation in Bolivia using Demographic and Health Survey data, providing background information for the study of determinants of neonatal and post-neonatal mortality in the country. Bolivia is found to have a high level of segregation in regard to deprivation, and five contextual factors (ethnicity, education, administrative region, distance to urban centres and drought-induced migration) are found to be significantly associated with segregation of deprivation. Finally, a micro-level cross-sectional study explores the mechanisms linking deprivation to neonatal and post-neonatal mortality in Bolivia using Demographic and Health Survey data. After decomposing household-level deprivation into its between- and within-community components, community-level absolute deprivation is found to be a significant predictor of neonatal and post-neonatal mortality. Relative deprivation is found to have a significant association with post-neonatal mortality in Bolivia only when calculated at the municipal level, and not at the community level, while deprivation inequality is not associated with infant mortality. Policies aimed at reducing neonatal and post-neonatal mortality in the context of low- and middle-income countries might be oriented by the findings of this thesis.

Item Type: Thesis (PhD)
Additional Information: © 2019 Filippo Temporin
Library of Congress subject classification: H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Departments > Social Policy
Supervisor: Steele, Fiona and Gjonça, Arjan
URI: http://etheses.lse.ac.uk/id/eprint/4049

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