Determinants of child mortality in a rural Ugandan community.

Abstract

To estimate the rate of and risk factors associated with child mortality in rural eastern Uganda. A community based cross-sectional study using the preceding birth technique--a robust method of obtaining information of survival of the previous child. A rural district in Eastern Uganda. In total, 2888 multigravidae were interviewed in April and May 1999. Number of deaths among children born alive. The under-two child mortality rate was 108 per 1000 livebirths. The annual child mortality was 82 per 1000 child-years of risk. Child mortality was associated with low parental education, being born to adolescent mothers or mothers aged 35 or more. Unconditional logistic regression showed that children born to uneducated parents had a doubled risk of not celebrating their second birthday. It was three times more likely for a child to die in the neonatal period than in the first year of life. Child mortality risk decreased by 4% and 6% for every year of education attained by mothers and fathers, respectively. Parity, residence and marital status were not associated with excess risk of child mortality. Seasonal mortality followed the El Nino rainfall pattern. Finally, there were geographical differences in child mortality although this was not statistically significant. Monitoring trends in child mortality at district level can be done using the preceding birth technique in antenatal settings. Maternal education, an important predictor of child survival should be included in routine data collection at clinics.