title: Corruption kills: estimating the global impact of corruption on children deaths.
abstract: BACKGROUND
  Information on the global risk factors of children mortality is crucial to guide global efforts to improve survival. Corruption has been previously shown to significantly impact on child mortality. However no recent quantification of its current impact is available.
  
  
  METHODS
  The impact of corruption was assessed through crude Pearson's correlation, univariate and multivariate linear models coupling national under-five mortality rates in 2008 to the national "perceived level of corruption" (CPI) and a large set of adjustment variables measured during the same period.
  
  
  RESULTS
  The final multivariable model (adjusted R(2)= 0.89) included the following significant variables: percentage of people with improved sanitation (p.value<0.001), logarithm of total health expenditure (p.value = 0.006), Corruption Perception Index (p.value<0.001), presence of an arid climate on the national territory (p = 0.006), and the dependency ratio (p.value<0.001). A decrease in CPI of one point (i.e. a more important perceived corruption) was associated with an increase in the log of national under-five mortality rate of 0.0644. According to this result, it could be roughly hypothesized that more than 140000 annual children deaths could be indirectly attributed to corruption.
  
  
  CONCLUSIONS
  Global response to children mortality must involve a necessary increase in funds available to develop water and sanitation access and purchase new methods for prevention, management, and treatment of major diseases drawing the global pattern of children deaths. However without paying regard to the anti-corruption mechanisms needed to ensure their proper use, it will also provide further opportunity for corruption. Policies and interventions supported by governments and donors must integrate initiatives that recognise how they are inter-related.
authors.affiliation: Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC-EC INSERM CIE 802, Cayenne General Hospital, Cayenne, French Guiana. matthieu@hanf.fr
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
authors.forename: Astrid
authors.initials: A
authors.lastname: Van-Melle
authors.forename: Florence
authors.initials: F
authors.lastname: Fraisse
authors.forename: Amaury
authors.initials: A
authors.lastname: Roger
authors.forename: Bernard
authors.initials: B
authors.lastname: Carme
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
mesh_terms: D002648:Child; D046688:Child Mortality; D002980:Climate; D003415:Crime; D005102:Health Expenditures; D006801:Humans; D038622:Internationality; D008962:Models, Theoretical; D015999:Multivariate Analysis; D012498:Sanitary Engineering
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