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dc.contributor.authorFagbamigbe, A. F.
dc.contributor.authorOyinlola, F. F.
dc.contributor.authorMorakinyo, O. M.
dc.contributor.authorAdebowale, A. S.
dc.contributor.authorFagbamigbe, O. S.
dc.contributor.authorUthman, A. O.
dc.identifier.citationFagbamigbe , A F , Oyinlola , F F , Morakinyo , O M , Adebowale , A S , Fagbamigbe , O S & Uthman , A O 2021 , ' Mind the gap : what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysis ' , BMC Public Health , vol. 21 , 575 .
dc.identifier.otherPURE: 273500008
dc.identifier.otherPURE UUID: f164af5a-bb6e-430c-ad49-f5e00964c4f6
dc.identifier.otherJisc: 02e119f98333427abb1271c39c0ad3f6
dc.identifier.otherpublisher-id: s12889-021-10615-0
dc.identifier.othermanuscript: 10615
dc.identifier.otherScopus: 85103207156
dc.identifier.otherWOS: 000634779900007
dc.descriptionFunding: CARTA is jointlyled by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No--B 8606.R02), Sida (Grant No: 54100029), and the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z).en
dc.description.abstractBackground: Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities.  Methods: Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010–2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p <0.05 in Stata Version 16 while visualization was implemented in R Statistical Package.  Results: Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p <0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p <0.001), Cambodia (OR = 1.201; p <0.031), Cameroon (OR = 1.377; p <0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p <0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p <0.001), Indonesia (OR = 1.219; p <0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p <0.001), Nigeria (OR = 1.492; p <0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p <0.001), Uganda (OR = 1.214; p <0.001), and Yemen (OR = 1.249; p <0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education.  Conclusions: The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.
dc.relation.ispartofBMC Public Healthen
dc.rightsCopyright © The Author(s). 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.en
dc.subjectRural-non-rural inequalitiesen
dc.subjectFairlie multivariable decompositionen
dc.subjectLow- and middle-income countriesen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleMind the gap : what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysisen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Statisticsen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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