Pneumonia incidence in children under five in Indonesia: A spatial analysis before, during and transition period of the COVID-19 pandemic
DOI:
https://doi.org/10.62992/k3n77t87Keywords:
Indonesia, Pneumonia, COVID-19, Spatial regressionAbstract
Background: Pneumonia has consistently remained one of the leading causes of mortality among children under five, spanning the periods before, during and in the transition periods of the COVID-19 pandemic.
Objectives: This study investigated the spatial association between healthcare, socioeconomic, environmental factors and the pneumonia incidence rate per 10,000 populations in children under five at the provincial level, comparing 2019 (before COVID-19 pandemic), 2021 (during COVID-19 pandemic) and 2023 (transition period of the COVID-19 pandemic) in Indonesia.
Methods: This study utilized secondary data from the Annual Indonesian Health Profile Books (2019, 2021 and 2023), Statistical Yearbook of Indonesia (2020, 2022 and 2024), Central Statistical Agency’s website and Google Earth Engine. This spatial analysis applied global and local Moran’s I and advanced spatial regression techniques.
Results: The incidence rate of pneumonia in children under five before, during and in the transition period of COVID-19 were 158.10, 80.82 and 129.39 per 10,000 population. Meanwhile, Moran's I values were -0.130, -0.103 and 0.087, respectively indicating a shift from dispersed to clustered spatial autocorrelation, particularly in Java Island. Negative correlations were observed between pneumonia incidence and the number of midwives (across all periods), access to proper sanitation facilities (latrines) (during the COVID-19 pandemic), and precipitation (during the transition period of the COVID-19 pandemic). In contrast, sulphur dioxide levels exhibited a positive spatial autocorrelation both before and during the COVID-19 pandemic.
Conclusion: To reduce pneumonia in children under five in Indonesia, efforts should focus on strengthening midwife availability, access and expanding midwife training programs. Additionally, improving access to sanitation facilities and implementing air quality control measures will also play a key role in reducing pneumonia incidence.
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