Spatial association and modelling of under-5 mortality in Thailand, 2020

Submitted: 2 July 2023
Accepted: 7 August 2023
Published: 31 August 2023
Abstract Views: 743
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Under-5 mortality rate (U5MR) is a key indicator of child health and overall development. In Thailand, despite significant steps made in child health, disparities in U5MR persist across different provinces. We examined various socio-economic variables, health service availability and environmental factors impacting U5MR in Thailand to model their influences through spatial analysis. Global and Local Moran’s I statistics for spatial autocorrelation of U5MR and its related factors were used on secondary data from the Ministry of Public Health, National Centers for Environmental Information, National Statistical Office, and the Office of the National Economic and Social Development Council in Thailand. The relationships between U5MR and these factors were modelled using ordinary least squares (OLS) estimation, spatial lag model (SLM) and spatial error model (SEM). There were significant spatial disparities in U5MR across Thailand. Factors such as low birth weight, unemployment rate, and proportion of land use for agricultural purposes exhibited significant positive spatial autocorrelation, directly influencing U5MR, while average years of education, community organizations, number of beds for inpatients per 1,000 population, and exclusive breastfeeding practices acted as protective factors against U5MR (R2 of SEM = 0.588).The findings underscore the need for comprehensive, multi-sectoral strategies to address the U5MR disparities in Thailand. Policy interventions should consider improving socioeconomic conditions, healthcare quality, health accessibility, and environmental health in high U5M areas. Overall, this study provides valuable insights into the spatial distribution of U5MR and its associated factors, which highlights the need for tailored and localized health policies and interventions.

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Aheto J, Yankson R, Chipeta M, 2020. Geostatistical analysis and mapping: social and environmental determinants of under-five child mortality, evidence from the 2014 Ghana demographic and health survey. BMC Public Health 20:1–12. DOI: https://doi.org/10.1186/s12889-020-09534-3
Alabi O, Baloye D, Doctor H, Oyedokun O, 2016. Spatial Analysis of Under-five Mortality Clustering in Northern Nigeria: Findings from Nahuche Health and Demographic Surveillance System, Zamfara State. Int J Trop Dis Health 15:1–10. DOI: https://doi.org/10.9734/IJTDH/2016/24709
Amouzou A, Habi O, Bensaïd K, 2012. Reduction in child mortality in Niger: a Countdown to 2015 country case study. Lancet 380:1169–1178. DOI: https://doi.org/10.1016/S0140-6736(12)61376-2
Anselin L, 1988. Spatial Econometrics: Methods and Models,Springer Netherlands, 254 pp. DOI: https://doi.org/10.1007/978-94-015-7799-1
Anselin L, 1995. Local Indicators of Spatial Association—LISA. Geogr Anal 27:93–115. DOI: https://doi.org/10.1111/j.1538-4632.1995.tb00338.x
Anselin L, Bera A, 1998. Spatial Dependence in Linear Regression Models with an Introduction to Spatial Econometrics, Handbook of Applied Economic Statistics, 237–290.
Aregbeshola B, Khan S, 2018. Out-of-Pocket Payments, Catastrophic Health Expenditure and Poverty Among Households in Nigeria 2010. Int J Health Policy Manag 7:798–806. DOI: https://doi.org/10.15171/ijhpm.2018.19
Bhutta Z, Das J, Bahl R, Lawn J, Salam R, Paul V, Sankar M, Blencowe H, Rizvi A, Chou V, Walker N, 2014. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet 384:347–370. DOI: https://doi.org/10.1016/S0140-6736(14)60792-3
Department of Provincial Administration, 2022. Official Statistics Registration System, https://stat.bora.dopa.go.th/stat/statnew/statyear/#/.
Dooley D, Prause J, 2005. Birth weight and mothers’ adverse employment change. J Health Soc Behav 46:141–155 DOI: https://doi.org/10.1177/002214650504600202
Fenske R, Kissel J, Lu C, Kalman D, Simcox N, Allen E, Keifer M,2000. Biologically based pesticide dose estimates for children in an agricultural community. Environ Health Perspect 108:515–520 DOI: https://doi.org/10.1289/ehp.00108515
Gakidou E, Cowling K, Lozano R, Murray C, 2010. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. Lancet 376:959–974 DOI: https://doi.org/10.1016/S0140-6736(10)61257-3
Hassan M, Ramadan A, TahounM, Omran A, Ali S, Esmail O, Elrewany E, El-Meligy P, Elzayat A, Malawany D, Mahboob A, Eldewiki M, Hammouda E, Ghazy R, 2021. Geospatial characterizing of Under-Five Mortality in Alexandria, Egypt. MedRxiv 2021.04.24.21255886. DOI: https://doi.org/10.1101/2021.04.24.21255886
Hug L, Alexander M, You D, Alkema L, 2019. National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health 7:e710–e720. DOI: https://doi.org/10.1016/S2214-109X(19)30163-9
Jutte D, Roos L, Brownell M, 2011. Administrative record linkage as a tool for public health research. Annu Rev Public Health 32:91–108. DOI: https://doi.org/10.1146/annurev-publhealth-031210-100700
Kuhn R, 2010. Routes to low mortality in poor countries revisited. Popul Dev Rev 36:655–692. DOI: https://doi.org/10.1111/j.1728-4457.2010.00353.x
LeSage J, Pace R, 2009. Introduction to Spatial Econometrics (1st ed.), Chapman and Hall/CRC. DOI: https://doi.org/10.1201/9781420064254
Li Z, Hsiao Y, Godwin J, Martin B, Wakefield J,Clark S, 2019. Changes in the spatial distribution of the under-five mortality rate: Small-area analysis of 122 DHS surveys in 262 subregions of 35 countries in Africa. PLoS One14:e0210645. DOI: https://doi.org/10.1371/journal.pone.0210645
Liyew A, Kassie A, Teshale A, Alem A, Yeshaw Y, Tesema G, 2021. Exploring spatiotemporal distribution of under-five mortality in Ethiopia: further analysis of Ethiopian Demographic and Health Surveys 2000, 2005, 2011 and 2016. BMJ Paediatr Open 5:e001047. DOI: https://doi.org/10.1136/bmjpo-2021-001047
Marmot M, 2005. Social determinants of health inequalities. Lancet 365:1099–1104. DOI: https://doi.org/10.1016/S0140-6736(05)71146-6
Moran P, 1948. The Interpretation of Statistical Maps. J R Stat Soc Series B Stat Methodol 10:243–251 DOI: https://doi.org/10.1111/j.2517-6161.1948.tb00012.x
Mulholland E, Smith L, Carneiro I, Becherc H, Lehmann D, 2008. Equity and child-survival strategies. Bull World Health Organ 86:399–407. DOI: https://doi.org/10.2471/BLT.07.044545
National Statistical Office of Thailand, 2022. National Statistic Report, http://statbbi.nso.go.th/staticreport/page/sector/th/index.aspx.
Newborn Health WHO Team, 2018. Reaching every newborn national 2020 milestones progress report 2018, World Health Organization.
Noori N, DerraK, Valea I, Oron A, Welgo A, Rouamba T, Boua P, Somé A, Rouamba E, Wenger E, Sorgho H, Tinto H, Ouédraogo A, 2021. Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS). BMC Public Health 21:1–8. DOI: https://doi.org/10.1186/s12889-021-11483-4
Piantadosi S, Byar D, Green S, 1988. The ecological fallacy. Am J Epidemiol 127:893–904. DOI: https://doi.org/10.1093/oxfordjournals.aje.a114892
Pronyk P, Harpham T, Busza J, Phetla G, Morison L, Hargreaves J, Kim J, Watts C, Porter J, 2008. Can social capital be intentionally generated? a randomized trial from rural South Africa. Soc Sci Med 67:1559–1570. DOI: https://doi.org/10.1016/j.socscimed.2008.07.022
Quattrochi J, Jasseh M, Mackenzie G, Castro M, 2015. Spatial analysis of under-5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia. Trop Med Int Health 20:941–951. DOI: https://doi.org/10.1111/tmi.12490
Strategy and Planning Division, 2020. Thai Public Health Statistics A.D.2020, Ministry of Public Health, Thailand.
Szklo M, Nieto J, 2007. Epidemiology: Beyond the Basics, Jones & Bartlett Learning.
United Nations Children’s Fund, World Health Organization, World Bank Group, 2021. Levels and trends in child malnutrition: UNICEF/WHO/The World Bank Group joint child malnutrition estimates: key findings of the 2021 edition.
United Nations, 2018. Transforming Our World: The 2030 Agenda for Sustainable Development, A New Era in Global Health, Springer Publishing Company.
Victora C, Adair L, Fall C, Hallal P, Martorell R, Richter L,Sachdev H, 2008. Maternal and child undernutrition: consequences for adult health and human capital. Lancet 371:340–357. DOI: https://doi.org/10.1016/S0140-6736(07)61692-4
Victora C, Bahl R, Barros A, França G, Horton S, Krasevec J, Murch S, Sankar M, Walker N, Rollins N, Allen K, Dharmage S, Lodge C, Peres K, Bhandari N, Chowdhury R, Sinha B, Taneja S, Giugliani E, Richter L, 2016. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet 387:475–490. DOI: https://doi.org/10.1016/S0140-6736(15)01024-7
Wagstaff A, Claeson M, 2004. The millenium development goals for health: rising to the challenges, The World Bank.
Ward M, Jones R, Brender J, Kok T, Weyer P, Nolan B, Villanueva C, Breda S,2018. Drinking Water Nitrate and Human Health: An Updated Review. Int J Environ Res Public Health 15:1557. DOI: https://doi.org/10.3390/ijerph15071557
WHO, 2001. The optimal duration of exclusive breastfeeding: Report of an expert consultation, World Health Organization.
WHO, 2020. Children: improving survival and well-being, World Health Organization.
WHO, 2022. WHO recommendations for care of the preterm or low-birth-weight infant, World Health Organization.
Wooldridge J, 2013. Introductory Econometrics: A Modern Approach, South-Western, Cengage Learning.
Zondi M, Mwambi H, Melesse S, 2020. Spatial Modelling of Under-five Mortality in Lesotho with Reference to 2014 Demographic and Health Surveillance Dataset. The Open Public Health J 13:289–297. DOI: https://doi.org/10.2174/1874944502013010289

How to Cite

Suerungruang, S., Sornlorm, K., Laohasiriwong, W., & Mahato, R. K. (2023). Spatial association and modelling of under-5 mortality in Thailand, 2020. Geospatial Health, 18(2). https://doi.org/10.4081/gh.2023.1220