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Thesis (M.M. (Finance & Investment))--University of the Witwatersrand, Faculty of Commerce, Law and Management, Graduate School of Business Administration, 2013. / This study examined the portfolio theory of dollarization of Ize and Yeyati (2003) to see if it holds in Argentina and Tanzania, this study was conducted to see if the variables of the exchange rate volatility and inflation rate fluctuation contribute to dollarization. Moreover, it shows that there is a relationship between the level of dollarization on nominal interest rate, inflation rate and exchange rate as the portfolio theory predict. The Chow test (Chow (1960) was used to test for the equality of coefficients in Argentina and Tanzania as separate samples. The results indicated that the correlation analysis and regression analysis in both countries there is disagreement over the assumptions and showed that exchange rate, inflation rate and interest rates do not have a significant effect on the level of dollarization. This means that the theory of portfolio do not hold for the case of Tanzania and Argentina and it is suggested that because the nature of the relationship is not linear, a new research design can be developed or it simply means that the portfolio theory is incorrect. We recommend that further research be pursued using the same variables as in this study but using different forms, such as using real as opposed to using nominal values, using non-linear forms instead of using a linear estimation method. Or the search for the significant explanatory variable of dollarization and the variables could only be included in a process that calls for the formulation of new theory to replace the current theory. The new variables to be included are government quality, monetary policy agility, individual heterogeneity, domestic debt, default risk, institutional quality and financial integration.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the award of a degree of Master of Science (med) in population based field Epidemiology. Johannesburg, South Africa, 2006.

Introduction The fourth Millennium Development Goal (MDG) calls for a reduction in newborn mortality but newborn mortality is one of the world’s most neglected health problems. While there has been significant progress in reducing deaths among children under age five over the past decade, the proportion of under five mortality that occur in the neonatal period, an estimated 38% in 2000, is increasing. Therefore the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. It is therefore extremely important to make available the much needed epidemiological information regarding the time, place and causes of neonatal deaths which will enable greater attention to policies aimed at reducing levels of mortality and programme planning. Objectives The objective of this study was to investigate the relationship between neonatal mortality and place of delivery in Rufiji in rural Tanzania. The specific objectives were: 1.to measure and compare the neonatal mortality rates among neonates born in and outside health facilities, 2. to compare the maternal characteristics of those who deliver in and outside health facilities, 3. to compare cause-specific neonatal mortality among neonates born in and outside health facilities and 4.to measure the association between place of delivery and neonatal mortality. Methods Data from the Rufiji Demographic Surveillance System (RDSS), Tanzania, was used for the analysis. A total of 5124 live births and 166 neonatal deaths were recorded from 1st January, 2005 to 31st December, 2006. Place of delivery and place of death were categorized as either health facility or outside health facility. Neonatal mortality rates were calculated by dividing the number of neonatal deaths to the total number of live births and multiplied by 1000. Data on causes of death were collected using verbal autopsies. Cause specific mortality was determined by using physician coding according to a list of causes of death based on the 10th revision of International Classification of Diseases. Household characteristics and assets ownership of the mothers of the neonates were used to construct a wealth index as proposed by Filmer and Pritchett in 20011. The index was calculated using Principal Component Analysis (PCA) in Stata version 10 software. A chi-square (x2) test at 5% significant level was also used to compare the maternal characteristics by place of delivery and neonatal characteristics and place of delivery. Univariate and multivariate logistic regression models were also used to assess the association between neonatal mortality and place of delivery as well as between neonatal mortality and maternal risk factors, while adjusting for potential confounders. Results The highest number of neonatal deaths occurred during the first week of life 111(67%), the remainder occurred from the second week to the fourth weeks of life 55(33%). The overall neonatal mortality rate was 32/1000 live births. Neonatal mortality rate was higher in children born outside heath facilities 43/1000 live births compared with those born in health facilities 27/1000 live births. The two major causes of deaths in both health facility deliveries and outside health facility deliveries were birth injury or asphyxia n=29 (26%) and prematurity/low birth weight n=25 (22%). Mothers who delivered out-side a health facility were 1.6 times more likely to have experienced neonatal death [unadjusted OR=1.6, p-value = 0.002, 95% CI 1.2, 2.2] compared to mothers who delivered in health facility and this was statistically significant. After adjusting for maternal risk factors, mothers who delivered outside a health facility were 1.7 times more likely to have experienced neonatal death [adjusted OR=1.7, p-value = 0.002, 95% CI 1.2, 2.4] compared to mothers who delivered in a health facility and this was statistically significant. Maternal household socio-economic status and parity were the only other factors that were found to be statistically significantly associated with neonatal mortality in the multivariate analysis. For instance, least poor mothers were found to be 40% less likely to have experienced neonatal death [adjusted OR = 0.6, pvalue = 0.046, 95% CI 0.4, 1.1] compared to the poorest mothers and this was statistically significant. Less poor mothers were also found to be 50% less likely to experience neonatal mortality [adjusted OR =0.5, p-value = 0.002, 95% CI 0.3, 0.8] compared to the poorest mothers. Mothers who had parity of three to four (3-4) were found to be 40% less likely to have experienced neonatal death compared to mothers who had parity of one to two (1-2). Mothers who had parity of five (5) and above were also found to be 50% less likely to have experienced neonatal death compared to those who had parity of one to two (1-2). Conclusion Place of delivery has a very important role in neonatal survival in this rural setting. In order to reduce neonatal mortality, pregnant women should be encouraged and supported to give birth to their newborns in a health facility while discouraging deliveries that occurred outside health facility. Infrastructure, such as emergency transport, to facilitate health facility deliveries requires attention.

Background Disparities in health outcomes between the poor and the rich are increasingly attracting attention from researchers and policy-makers. However, policies aimed at reducing inequities need to be based on a sound assessment of the nature, magnitude and determinants of the problem, as policy decisions based on intuition are likely to be misguided. Objective The work investigates the relationship between household socio-economic status and under-five mortality at Rufiji DSS in year 2005. The specific objectives were; 1.To construct wealth and concentration indices for households with children under age five. 2. To measure health inequality by poorest / least poor mortality rate ratio and the use of concentration index 3. To determine significance in gradient of mortality rates across wealth index quintiles by a trend test (chi-square) 4. To assess the magnitude of association between socio-economic status of households and under-five mortality. Methods Data from Rufiji DSS, Tanzania was used for the analysis. Out of 11,189 children under five years of age from 7298 households, 251 died in the year 2005. These yielded a total of 9341.6 PYO in 2005 which was used in the analysis. Household wealth index was constructed by use of Principal Component Analysis (PCA), as a proxy measure of each household SES. From this index households were categorized into five quintiles (i.e., poorest, poorer, poor, less poor and least poor). Kaplan-Meier (K-M) survival estimates of incidence rates were used to estimate mortality rates per 1000 PYO for infants (0-1), children (1-4) and under-fives. Health inequality was measured by poorest to least poor mortality rate ratio and by computing mortality concentration indices. Trend test chi-square was used to determine significance in gradient of mortality rates across wealth index quintiles. Risk factors of child mortality were assessed by the use of Poisson regression taking into account potential confounders. Results The result indicates that the mortality rate was higher for infants (123.4 per 1000 PYO, 95% CI (104.3, 146.1)) than for children aged 1-4 years (17.3 per 1000 PYO, 95% CI (14.3, 20.9)). Under-five mortality was 26.9 per 1000 PYO (95% CI (23.7, 30.4)). The poorest to least poor ratio were 1.5, 3.8 and 2.4 for infants, children, and under-five year olds, respectively indicating that children in the poorest quintile were more likely to die as compared to those in the least poor household. Computed values for concentration indices were negative (infant C= -0.07, children C= -0.24 and under-five C= -0.16) indicating a disproportionate concentration of under-five mortality among the poor. The mortality rates trend test chi-square across wealth index quintiles were significant for both children (P<0.001) and under-five year old children (P<0.001) but not for infants (P=0.10). In univariate Poisson regression, children in the least poor households were shown to have a 58% significantly reduced risk of dying as compared to the poorest households [crude RR=0.42, P < 0.001, 95% CI (0.27 - 0.62)]. The effect of household socio-economic status attenuated after adjusting for maternal education, maternal age and occupation. Children in vi the least poor households had a 52% significantly reduced risk of dying as compared to the poorest households [adjusted RR=0.48, P = 0.002, 95% CI (0.30 - 0.80)]. Conclusion The study shows that household socio-economic inequality is associated with under-five mortality in Rufiji DSS in 2005 and that the survival advantage of under-five year old children is associated with maternal education. Reducing poverty and making essential health services more available to the poor are critical to improving overall childhood mortality in rural Tanzania.