What drives inequity in child mortality? A study of a community in rural Ethiopia.

In African countries like Ethiopia there are large differences between communities in the risk of child death. Several interventions are now available to reduce child mortality in developing countries. Unfortunately the children who get those intervention s tend to be those at lowest risk, leading to an increase in the mortality difference between those at highest risk and the rest. To avoid this we need to know which children are at highest risk. This is usually measured from family wealth, but in Africa, especially Ethiopia, this has failed to explain differences in child death rates. Instead, it appears that many children are at high risk because they live far away from the health services. This study will compare distance from health facilities and a h ospital with poverty, ethnic group and other factors to determine the effect of each on risk of death. In a large district with only a single hospital we will find out which children are using the hospital and other health facilities and their likelihood of receiving other services such as immunization, and compare this with their risk of dying in the community. This will provide the Ethiopian Government with evidence on which to base their future health service plans.