Under-five mortality in Zambia has declined since 1990, with reductions accelerating after 2000. Zambia's scale-up of malaria control is viewed as the driver of these gains, but past studies have not fully accounted for other potential factors. This study sought to systematically evaluate the impact of malaria vector control on under-five mortality. Using a mixed-effects regression model, we quantified the relationship between malaria vector control, other priority health interventions, and socioeconomic indicators and district-level under-five mortality trends from 1990 to 2010. We then conducted counterfactual analyses to estimate under-five mortality in the absence of scaling up malaria vector control. Throughout Zambia, increased malaria vector control coverage coincided with scaling up three other interventions: the pentavalent vaccine, exclusive breast-feeding, and prevention of mother-to-child transmission of HIV services. This simultaneous scale-up made statistically isolating intervention-specific impact infeasible. Instead, in combination, these interventions jointly accelerated declines in under-five mortality by 11% between 2000 and 2010. Zambia's scale-up of multiple interventions is notable, yet our findings highlight challenges in quantifying program-specific impact without better health data and information systems. As countries aim to further improve health outcomes, there is even greater need—and opportunity—to strengthen routine data systems and to develop more rigorous evaluation strategies.
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Merima Ali and Odd-Helge Fjeldstad
Artisanal Gold Mining Camps in the Butana (Eastern Sudan) as Migration Hubs
Musa Adam Abdul-Jalil
The cost of doing politics in Ireland: What does violence against politicians look like and how is it gendered?
Fiona Buckley, Lisa Keenan, Mack Mariani
Devastated jungle and dispossessed peasantry: military operations against deforestation that left peasant Colombians homeless in the Amazon region
Sammy Andrea Sánchez Garavito
Lobbying in tax policy making: The case of VAT-reform in Tanzania
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The politics of revenue bargaining: Triggers, processes, and outcomes
Lobbyism or bribery
Elgar Concise Encyclopedia of Corruption Law
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Nordic Journal of Migration Research