Table 1 Definition of population-level variables utilized in analysis, adapted from the 2016–2017 Enquête Mortalité, Morbidité et Utilisation des Services (EMMUS-VI) survey

Access to qualified prenatal care

Percentage of women aged 15–49 years who had a live birth and received prenatal care from a qualified provider (physician, nurse, or midwife)

Early child mortality

Average number of children dying between date of birth and fifth birthday, per 1000 live births

Child growth retardation

Percentage of children under age 5 years with a height-for-age Z score of less than − 2, based on a representative sample

Adult employment

Percentage of adults with active employment in the 7 days prior to survey administration (average of reported male and female statistics)

Economic index

On a scale of 0–100, the average percentile of economic well-being for department households, calculated based on the percent of surveyed households belonging to each of the five national income quintiles (quintile 1: 0–19.9%, quintile 2: 20–39.9%, quintile 3: 40–59.9%, quintile 4: 60–79.9%, quintile 5: 80–100%)

Average travel time to the nearest healthcare facility in an emergency

Average travel time to nearby healthcare facility in an emergency, using any travel means available, among seriously injured or ill members of surveyed households who were brought to a healthcare facility within 30 days before survey administration. This was calculated as a weighted average using mean values of survey-specified intervals (0–15, 15–29, 30–59, 60–119, or 120 + minutes) and excluding those with unknown travel time