Under-five mortality is declining in most countries. Very few studies have measured
under-five mortality, and its social and environmental determinants, at fine spatial
resolutions, which is relevant for policy purposes. Our aim was to estimated under-five
mortality and its social and environmental determinants at the district level in Ghana. We
used 10% random samples of Ghana’s 2000 and 2010 National Population and Housing
Censuses. We applied indirect demographic methods and a Bayesian spatial model to the
census data on total number of children ever born and children surviving to estimate underfive
mortality (probability of dying by age five, 5q0) for each of Ghana’s 110 districts. We
used the census data to estimate the distributions of households or persons in each district for
fuel used for cooking, sanitation facility, drinking water source, and parental educations.
Median district 5q0 declined from 99 deaths per 1,000 live births in 2000 to 70 in 2010. The
decline ranged between <5% in some northern districts, where 5q0 had been higher in 2000,
to >40% in southern districts, where it had been lower in 2000, exacerbating existing
inequalities. Primary education increased in men and women and more households had
access to improved water and sanitation and cleaner cooking fuels. Higher use of liquefied
petroleum gas for cooking was associated with lower 5q0 in multivariate analysis.
The second paper examines personal particulate matter exposures and locations of 56
students from eight schools in four neighborhoods in of varying socioeconomic status in
Accra, Ghana, using gravimetric and continuous PM2.5 data, with time-matched global
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positioning system coordinates. Personal PM2.5 exposures ranged from less than 10 たg/m3
to
more than 150 たg/m3
(mean 56 たg/m3
). Girls had higher exposure than boys (67 vs. 44
たg/m3
; p-value = 0.001). Exposure was inversely associated with distance of home or school
to main roads, but the associations were not statistically significant in the multivariate model.
Use of biomass fuels in the area where the school was located was also associated with higher
exposure, as was household’s own biomass use. Paved schoolyard surface was associated
with lower exposure.