Gonah Laston, Sibanda Dumisani, Nomatshilla Sibusiso C
Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, South Africa.
Ann Glob Health. 2024 Dec 24;90(1):81. doi: 10.5334/aogh.4591. eCollection 2024.
In Zimbabwe, studies have mainly focused on child and maternal factors contributing to under‑5‑year mortality, and little has been published concerning the paternal social determinants, which are also important. The goal of this paper is to investigate the paternal social determinants of infant and childhood mortality in Zimbabwe. The study analyzed cross‑sectional secondary data from the Zimbabwe Demographic Health Survey (ZDHS) 2015 to investigate paternal determinants of infant and child mortality. Multivariate logistic regression and Cox regression were conducted for separate analyses of infant and child data to determine the odds and risk of death informed by paternal factors. Kaplan-Meier survival curves were used to determine the importance of paternal factors in determining under‑five survival. Younger paternal age, lower level of education, lower wealth index, unemployment, and rural geographical location are important contributing factors for childhood mortality, and these factors were found to be interconnected and interrelated in producing the observed outcomes. Paternal characteristics are important contributing factors for child survival, but not alone. The interaction between child characteristics, household (paternal and maternal), community, and public/global‑policy‑level factors is important in shaping observed childhood mortality outcomes. Social determinants for child survival are interlinked and interdependent on each other in producing the observed childhood mortality outcomes, and no one factor is more important than the other. Each factor represents an important component but not one that is individually sufficient to produce an outcome.
在津巴布韦,研究主要集中在导致5岁以下儿童死亡的儿童和孕产妇因素上,而关于同样重要的父亲社会决定因素的研究发表得很少。本文的目的是调查津巴布韦婴儿和儿童死亡的父亲社会决定因素。该研究分析了2015年津巴布韦人口与健康调查(ZDHS)的横断面二手数据,以调查婴儿和儿童死亡的父亲决定因素。对婴儿和儿童数据分别进行多变量逻辑回归和Cox回归,以确定由父亲因素导致的死亡几率和风险。使用Kaplan-Meier生存曲线来确定父亲因素在决定5岁以下儿童生存方面的重要性。父亲年龄较小、教育水平较低、财富指数较低、失业以及农村地理位置是儿童死亡的重要促成因素,并且发现这些因素在产生观察到的结果方面相互关联。父亲的特征是儿童生存的重要促成因素,但并非唯一因素。儿童特征、家庭(父亲和母亲)、社区以及公共/全球政策层面因素之间的相互作用,对于塑造观察到的儿童死亡结果很重要。儿童生存的社会决定因素在产生观察到的儿童死亡结果方面相互联系且相互依存,没有一个因素比另一个因素更重要。每个因素都代表一个重要组成部分,但并非单独一个因素就足以产生结果。