The impact of child health interventions and risk factors on child survival in Kenya, 1993-2014: a Bayesian spatio-temporal analysis with counterfactual scenarios.

摘要: BACKGROUND During the millennium development goals period, reduction in under-five mortality (U5M) and increases child health intervention coverage were characterised by sub-national disparities inequities across Kenya. The contribution of changing risk factors on changes U5M remains poorly defined. METHODS Sub-national county-level data 43 known to be associated with spanning 1993 2014 assembled. Using a Bayesian ecological mixed-effects regression model, relationships between significant infection quantified 47 counties. coefficients generated used within counterfactual framework estimate deaths averted (U5-DA) for every county year (1993-2014) interventions disease prevalence relative 1993. RESULTS Nationally, stagnation increase 1990s rising human immunodeficiency virus (HIV) reduced maternal autonomy while improvements after 2006 decline HIV malaria, access better sanitation, fever treatment-seeking rates autonomy. Reduced stunting increased early breastfeeding institutional deliveries smaller number U5-DA compared other high parity fully immunised children lives lost. Most occurred varied spatially highest was recorded western coastal Kenya northern lower than western. Central had lowest U5-DA. different regions unique set factors. CONCLUSION Contributions vary sub-nationally. This has important implications targeting future decentralised systems such as those operated Targeting specific where been poor would lead likelihood attainment sustainable goal (SDG) 3.2