Within-Country Variation in under-5 Mortality in Bangladesh, Mozambique, Uganda, and Zambia

Laura A. Dwyer-Lindgren, University of Washington
Abraham Flaxman, University of Washington
Haidong Wang, University of Washington
Marie Ng, University of Washington
Gloria Ikilezi, University of Washington
Felix Masiye, University of Zambia
Emmanuela Gakidou, University of Washington
Stephen Lim, University of Washington

Between-country inequalities in under-5 mortality are substantial and well documented. Significant within-country inequalities likely also exist but have not been extensively explored in many developing countries. In this analysis, we estimate district-level trends in under-5 mortality for Bangladesh, Mozambique, Uganda, and Zambia. We apply demographic methods for birth history analysis to available survey and census data in each country. We then apply small area models to these data to estimate time trends in under-5 mortality. These small area models borrow strength across both time and space to improve predictions for each district, even in cases where there is relatively limited data available for a particular district. We use these predictions to explore within-country spatial patterns in levels and trends in under-5 mortality. We also assess the extent of inequality within each country and compare across the four countries.