Distance from healthcare facilities and early life mortality: a systematic review and meta-analysis

Abstract

Objective: to update the systematic reviews of the literature discussing the effect of the distance from healthcare facilities on the mortality of children under five years of age using academic papers up to May, 2015. Methodology: a systematic review of the literature and a meta-analysis conducted in accordance with the PRISMA guidelines. A random effect model was estimated and bias and heterogeneity analyses were conducted on the estimates. Results: residing farther than 5 km away from the closest healthcare facility is associated with a greater risk of death during the following periods: perinatal OR 2.76 (CI95% 1.80 – 4.23), neonatal OR 1.62 (CI95% 1.33 – 1.96), infancy OR 1.31 (CI95% 1.16 – 1.48) childhood OR 1.57 (CI95% 1.29 – 1.92) and all age groups OR 1.63 (IC95% 1.41 – 1.88). Conclusion: The authors highlight the importance of considering a geographical distribution of healthcare facilities which reduces death risk among children residing in remote areas, particularly during the first month of life.