Public policy for early childhood and social determinants of Acute Respiratory Diseases in under-five children in Colombia. A multi-level analysis

Abstract

Introduction: Despite having public policies, Acute Respiratory Diseases (ARD) continues to cause a high level of childhood morbidity in the least developed territories of Colombia. These inequities and others due to specifics regional aspects have been little examined in studies of public health in the context of very unequal countries like Colombia. Objective. Following the perspective of the social determinants of health, to incorporate an empirical analysis of the effects of social position and public health and non-health policies on the prevalence of ARDs in children under five years old. Methods. The Demographic and Health Survey was used to estimate multilevel logistical regression models as predictors of the prevalence of ARDs. Results. 21% of the change in the probability of the presence of an ARD in children can be attributed to the department in which they reside. These inequities are explained mainly by the level of individual wealth and by territory. While public health policies and territorial administration can compensate for them, the urban-rural gaps operate as barriers in the poorest departments. Conclusions. This study advances our understanding of the incidence of childhood care and attention programs on determinants of health and child welfare in general.