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| 題名: | 馬拉威個人和社區因子與孩童健康及健康照護之間的關係
INDIVIDUAL-LEVEL AND COMMUNITY-LEVEL FACTORS ASSOCIATED WITH CHILDHOOD HEALTH OUTCOMES AND CARE PRACTICES IN MALAWI |
| 作者: | 戴彼得
Peter Austin Morton Ntenda |
| 貢獻者: | 公共衛生學系暨研究所
莊媖智
Ying-Chih Chuang |
| 關鍵詞: | Undernutrition,Anemia,Severe Anemia ,Hemoglobin,Multilevel,Generalized Estimating Equation,Child health ,Immunization,Stunting,Wasting,Underweight,Malawi. |
| 日期: | 2018 |
| 上傳時間: | 2018-12-25 11:21:14 (UTC+8) |
| 摘要: | This dissertation contains three studies. The first study addresses whether individual-level and community-level factors have effects on childhood undernutrition in Malawi. The second study uses a multilevel approach to analyze the effects of individual- and community-level factors on childhood anemia, severe anemia, and hemoglobin concentration in Malawi. The third study compares the effects of a wide range of individual and community level factors on childhood immunization in Malawi between the cohort year of 2004 and 2010.
Methods
Study hypotheses are tested through secondary analysis of data from the 2004 and 2010 Malawi Demographic and Health Surveys (MDHSs). The MDHSs were designed to produce nationally representative samples using a stratified two-stage cluster sampling method. A proportional-to-size sampling method was used to select clusters (communities) in the first stage (522 clusters in 2004 and 849 clusters in 2010), households, and household members in the second stage. Both the 2004 and 2010 MDHSs defined a cluster as a census enumeration area containing a systematic sample of 15,091 households in 2004 and 27,345 households in 2010.
Results
Study 1: The risk of childhood undernutrition was significantly higher in males, children with a small birth size, children with a diarrheal episode in the last 2 weeks, children that were a product of multiple births, children born to mothers with either a low socioeconomic status, or a poor education, or who were underweight, and children born in the year 2004. Children born in communities with low and medium wealth, and in communities with low and medium female educational attainment were more likely to be undernourished.
Study 2: The results of the multilevel multivariate regression showed that both childhood anemia and severe anemia were negatively associated with child’s age, no fever in the previous two weeks, height-for-age, and positively associated with residing in the poor household. Childhood anemia was negatively associated with community female education. Child’s age, no fever in the previous two weeks, and maternal Hb levels were positively associated with child Hb concentration while residing in poorest households was negatively associated with children’s Hb concentration.
Study 3: The multivariate analyses show that mother’s low education, having one or none antenatal visits, having no immunization card, having immunization card but not seen, residing in poor households, and living in central region were the most significant factors associated with decreased odds of achieving vaccination coverage and complete vaccination in both 2004 and 2010. However, maternal education was more likely to be associated with children’s immunization in 2010, while the geographical region was more likely to be associated with children’s immunization in 2004. |
| 描述: | 博士論文
指導教授-莊媖智
委員-黃雅莉
委員-莊坤洋
委員-黃俊豪
委員-吳章甫 |
| 資料類型: | thesis |
| 顯示於類別: | [公共衛生學系暨研究所] 其他
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