title: Overcoming Stagnation in the Levels and Distribution of Child Mortality: The Case of the Philippines.
abstract: BACKGROUND
  Health-related within-country inequalities continue to be a matter of great interest and concern to both policy makers and researchers. This study aims to assess the level and the distribution of child mortality outcomes in the Philippines across geographical and socioeconomic indicators.
  
  
  METHODS
  Data on 159,130 children ever borne were analysed from five waves of the Philippine Demographic and Health Survey. Direct estimation was used to construct under-five and neonatal mortality rates for the period 1980-2013. Rate differences and ratios, and where possible, slope and relative indices of inequality were calculated to measure disparities on absolute and relative scales. Stratification was undertaken by levels of rural/urban location, island groups and household wealth.
  
  
  RESULTS
  National under-five and neonatal mortality rates have shown considerable albeit differential reductions since 1980. Recently released data suggests that neonatal mortality has declined following a period of stagnation. Declines in under-five mortality have been accompanied by decreases in wealth and geography-related absolute inequalities. However, relative inequalities for the same markers have remained stable over time. For neonates, mixed evidence suggests that absolute and relative inequalities have remained stable or may have risen.
  
  
  CONCLUSIONS
  In addition to continued reductions in under-five mortality, new data suggests that the Philippines have achieved success in addressing the commonly observed stagnated trend in neonatal mortality. This success has been driven by economic improvement since 2006 as well as efforts to implement a nationwide universal health care campaign. Yet, such patterns, nonetheless, accorded with persistent inequalities, particularly on a relative scale. A continued focus on addressing universal coverage, the influence of decentralisation and armed conflict, and issues along the continuum of care is advocated.
authors.affiliation: UNICEF Philippines, Makati City, Philippines; Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Raoul
authors.initials: R
authors.lastname: Bermejo
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Firth
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hodge
authors.affiliation: School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Eliana
authors.initials: E
authors.lastname: Jimenez-Soto
authors.affiliation: UNICEF Philippines, Makati City, Philippines; Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
authors.forename: Willibald
authors.initials: W
authors.lastname: Zeck
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010679:Philippines; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult