Geospatial variation and risk factors for under-five mortality in rural Misungwi, North-western Tanzania

Abstract

This study aims to examine if, when holding socio-economic, bio-demographic and healthcare covariates constant, geospatial indicators help to explain variations in the under-five mortality rate across wards from a high focus district of Misungwi in Tanzania. Data were collected from a 2019 survey which canvassed 540 households with 471 women aged 15-49. A total of 737 live births that occurred during five years preceding the survey were analysed. Of all the children born, 46 had died before survey interviews were carried out. Under-5 mortality rates in 27 clusters were calculated. The spatial autocorrelation of under-five mortality rates was estimated by global Moran's index (I). Thematic maps were generated with these rates. The software TerraView 5.4.1 was used for spatial analysis. The results showed substantial cluster-level spatial variations in childhood mortality in the district. Among all the under-five children analysed, the mortality rate was 56 deaths per 1000 live births. The average global Moran's index (I) was I=0.05 for child mortality rate. All global Moran's indices showed p-values <0.05. Thematic maps showed clusters of villages with high rates located closer to streams and further from transport routes. The geospatial factors associated with mortality indicate variability due to exposure and transmission of infectious diseases. These results provide an improved understanding of district level under-five mortality and help in the execution of health policies. Key words: Geographic differentials, deaths, global Moran’s index, health management, Tanzania.