Child and Maternal Mortality
in Islamic Countries
7
We have conducted the secondary analyses of the following data sets:
1. Demographic and Health Surveys (DHS) of 28 OIC countries (multiple rounds where
available)
2. UNICEF’s Multiple Indicator Cluster Surveys (MICS) of Iraq (four rounds: 2000, 2006,
2011 and 2018)
3. The United Nations Maternal Mortality Estimation Inter-agency Group (MMEIG: WHO,
UNICEF, UNFPA, the World Bank) estimates of maternal mortality database
4. IHME/GBD (Global Burden of Diseases Group) estimates of maternal mortality database
5. The UN Inter-agency Group for Child Mortality Estimation (UN-IGME) group’s
estimates of child mortality database
6. The World Health Organization (WHO) Global Health Expenditure Database
In addition, we have conducted in-depth interviews of key stakeholders in four case-study
countries: Bangladesh, Indonesia, Cote d’Ivoire and Iraq. The rationales for selecting the case-
study countries are discussed in Chapter-III. The interviews were conducted using semi-
structured questionnaires for standardizing the content areas of information. The key
stakeholders were identified through consultations of country partners. We interviewed
government officials (Ministry of Health, Ministry of Planning and Financing), UN Organization
officials (UNICEF/UNFPA), donor agencies, NGO and public health research
organizations/institutions, and faculty/scientists at universities who are experts in MNCH field.
1.2.2 Health Financing Analysis
We examined the health financing situations of the case study countries by using the Global
Health Expenditure Database (GHED), which provides internationally comparable data on
health spending for close to 190 countries from 2000 to 2016. The database is open access
publicly available on the World Health Organization (WHO)’s GHED website
. It supports
the goal of Universal Health Coverage by helping monitor the availability of resources for health
and the extent to which they are used efficiently and equitably. This, in turn, helps ensure health
services are available and affordable when people need them.
1.3. Conceptual framework
Our analytical work is guided by a conceptual framework based on strong sociological and
epidemiological theoretical basis of maternal and child mortality determinants. We examine the
utility of the following models in the current contexts and their relevance to OIC countries.
● The child mortality literature has been heavily influenced by the Mosley and Chen21
framework (1984) that combines socioeconomic and medical factors in understanding
the causal pathways that lead to high child mortality. The model considers that all social
and economic determinants must operate through five sets of proximate (or
intermediate) determinants: maternal factors (age, parity, birth interval);
environmental factors (food, sanitation, insect vectors); nutritional deficiency; injury;
and personal illness control (preventive and curative care). They consider income and
education as the two most common distal determinant factors for child mortality.
● The Mosley and Chen framework has also influenced subsequently the development of
the framework for analyzing the determinants of maternal mortality. McCarthy and