Areal and socioeconomic differentials in infant and child mortality in Cameroon.

Given its geographical, socio-economic, ethnic and cultural diversity, Cameroon offers an excellent setting for investigating the contribution of geographical and socioeconomic factors to mortality differences in infancy and childhood. Such research is crucial for designing appropriate health policies at the national and regional levels. Using data from a nationally representative sample of more than 12,000 births, this study assesses infant and child mortality differences in Cameroon by residence area, mother's education, ethnicity, marital status and union type, religion and the interplay of those factors on differentials mortality. The most vulnerable groups of children in the country are: rural residents; residents of the East, North and South-West regions; Kaka-Baya and Fulbe-Fulani children; and children whose mothers have no education, are Traditionalists, are unmarried, or are in polygamous unions. Lack of maternal schooling alone explains all the excess childhood mortality of Fulbe-Fulani children, most of the excess mortality of children of the North and East regions, most of the excess mortality of the countryside vis-á-vis the metropolitan areas of Yaoundé and Douala, and most of the excess mortality of children of Traditionalists. The robustness of the excess neonatal mortality of newborns in the East region probably reflects the higher prevalence of tetanus in that region compared to the rest of the country. The study also suggests that the place/region of residence in Cameroon is likely to be a proxy for inequalities in the provision of and/or use of health services.

Determinants of mortality among Cameroonian children: are the effects of breastfeeding and pace of childbearing artifacts?

"We analyse a rich data source, the Yaounde round of surveys [conducted] by IFORD (Institut de Formation et de Recherche Demographiques) during the late seventies and early eighties in several African urban centers. We argue that despite important limitations, these surveys are potentially very useful as a source of verification of hypotheses that have been heretofore improperly tested with retrospective surveys. Using the Yaounde round we obtain fine-tuned estimates of the effects of lactation and timing of following conception on infant and child mortality. We are able to identify the role played by birthweight, types of breastfeeding, and antecedent illnesses and thus control for important variables that are not normally recorded in conventional demographic surveys. We show that potential biases associated with losses to follow-up and selection processes are of little significance." (SUMMARY IN ITA AND FRE)

Correlates of malnutrition among children under 2 years of age admitted to hospital in Yaoundé, Cameroon.

A survey of health status, biodemographics, and use of health care services of all children under 2 years of age, consecutively admitted to the Baudeloque ward of the Central Hospital of Yaoundé, Cameroon, was conducted over a 12-month period (1984). During the admission procedure, each child's mother or surrogate mother was interviewed and the child was weighted according to study protocol; additional data were collected by review of hospital records. A total of 669 children were recruited into the study sample; there were no refusals. Nutritional status was estimated by categories based on weight for age. Overall, 43 per cent of the sample were of normal weight-for-age, and 6 per cent, 19 per cent, and 32 per cent were categorized as having severe, moderate, and mild malnutrition, respectively. Multinomial logit modelling was used to identify independent correlates of mild, moderate, and severe PEM simultaneously. The study findings underscore the broad health benefits of immunizations. Furthermore, any prior contact of mother or child with the health care system appears to be associated with better nutritional status on hospital admission. Children with mothers employed outside the home may benefit particularly from health services outreach programmes.

Determinants of low birthweight: a comparative study.

The study compares biological, socioeconomic and behavioural determinants of low birthweight in Cameroon and the United States. Some factors in low birthweight are found to be cross-national, but others are specific to the setting. Positive risk factors of low birthweight in both countries include unmarried motherhood, female sex, multiple births, and preterm births. Outcome of the previous pregnancy is a positive risk factor in the US, but not in Cameroon. Significant negative risk factors include prenatal care visits (in both countries), mother's education (in the US only), births to mothers aged 20-34 and birth orders of 2 or more (in Cameroon only). Separate analyses of all births and the subsamples of singleton births reveal that estimates for the two groups differ only marginally.