title: Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986-2011.
abstract: BACKGROUND
  Although Vietnam has taken great efforts to reduce child mortality in recent years, a large number of children still die at early age. Only a few studies have been conducted to identify at-risk groups in order to provide baseline information for effective interventions.
  
  
  OBJECTIVE
  The study estimated the overall trends in infant mortality rate (IMR) and under-five mortality rate (U5MR) during 1986-2011 and identified demographic and socioeconomic determinants of child mortality.
  
  
  METHODS
  Data from the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000 (MICS2), 2006 (MICS3) and 2011 (MICS4) were analysed. The IMR and U5MR were calculated using the indirect method developed by William Brass. Unadjusted and adjusted odds ratios were estimated to assess the association between child death and demographic and socioeconomic variables. Region-stratified stepwise logistic regression was conducted to test the sensitivity of the results.
  
  
  RESULTS
  The IMR and U5MR significantly decreased for both male and female children between 1986 and 2010. Male children had higher IMR and U5MR compared with females in all 3 years. Women who were living in the Northern Midlands and Mountain areas were more likely to experience child deaths compared with women who were living in the Red River Delta. Women who were from minor ethnic groups, had low education, living in urban areas, and had multiple children were more likely to have experienced child deaths.
  
  
  CONCLUSIONS
  Baby boys require more healthcare attention during the first year of their life. Comprehensive strategies are necessary for tackling child mortality problems in Vietnam. This study shows that child mortality is not just a problem of poverty but involves many other factors. Further studies are needed to investigate pathways underlying associations between demographic and socioeconomic conditions and childhood mortality.
authors.affiliation: JW Lee Center for Global Medicine, Seoul National University, College of Medicine, Seoul, Korea; diana0224@gmail.com; diana24@snu.ac.kr.
authors.forename: Hwa-Young
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam; dovandzung@gmail.com.
authors.forename: Dung
authors.initials: D
authors.lastname: Van Do
authors.affiliation: JW Lee Center for Global Medicine, Seoul National University, College of Medicine, Seoul, Korea.
authors.forename: Sugy
authors.initials: S
authors.lastname: Choi
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam.
authors.forename: Oanh Thi Hoang
authors.initials: OT
authors.lastname: Trinh
authors.affiliation: Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh City, Vietnam.
authors.forename: Kien Gia
authors.initials: KG
authors.lastname: To
mesh_terms: D000293:Adolescent; D000328:Adult; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D011203:Poverty; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology
keywords: MICS; Vietnam; infant mortality; mortality trends; survey analysis; under-five mortality