Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys

Hodge, Andrew, Firth, Sonja, Marthias, Tiara and Jimenez-Soto, Eliana (2014) Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys. PLoS One, 9 7: e103597.1-e103597.10. doi:10.1371/journal.pone.0103597

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Author Hodge, Andrew
Firth, Sonja
Marthias, Tiara
Jimenez-Soto, Eliana
Title Location matters: trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2014-07-25
Sub-type Article (original research)
DOI 10.1371/journal.pone.0103597
Open Access Status DOI
Volume 9
Issue 7
Start page e103597.1
End page e103597.10
Total pages 10
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2015
Language eng
Formatted abstract
Background: Considerable improvements in life expectancy and other human development indicators in Indonesia are thought to mask considerable disparities between populations in the country. We examine the existence and extent of these disparities by measuring trends and inequalities in the under-five mortality rate and neonatal mortality rate across wealth, education and geography.

Methodology: Using data from seven waves of the Indonesian Demographic and Health Surveys, direct estimates of under-five and neonatal mortality rates were generated for 1980-2011. Absolute and relative inequalities were measured by rate differences and ratios, and where possible, slope and relative indices of inequality. Disparities were assessed by levels of rural/urban location, island groups, maternal education and household wealth.

Findings: Declines in national rates of under-five and neonatal mortality have accorded with reductions of absolute inequalities in clusters stratified by wealth, maternal education and rural/urban location. Across these groups, relative inequalities have generally stabilised, with possible increases with respect to mortality across wealth subpopulations. Both relative and absolute inequalities in rates of under-five and neonatal mortality stratified by island divisions have widened.

Conclusion: Indonesia has made considerable gains in reducing under-five and neonatal mortality at a national level, with the largest reductions happening before the Asian financial crisis (1997-98) and decentralisation (2000). Hasty implementation of decentralisation reforms may have contributed to a slowdown in mortality rate reduction thereafter. Widening inequities between the most developed provinces of Java-Bali and those of other island groupings should be of particular concern for a country embarking on an ambitious plan for universal health coverage by 2019. A focus on addressing the key supply side barriers to accessing health care and on the social determinants of health in remote and disadvantaged regions will be essential for this plan to be realised.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 31 Jul 2014, 15:33:09 EST by Dr Andrew Hodge on behalf of School of Public Health