Abstract
Although the association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations. This study investigated the contribution of several household resources to child mortality, beyond the influence of maternal education as a measure of socioeconomic status. This secondary analysis used data from the 2007 Ghana Maternal Health Survey to explore the relationship of child mortality to household resources. The analysis of 7183 parous women aged 15-45 years examined household resources for their association with maternal reports of any child's death for children aged less than 5 years using a survey-weighted logistic regression model while controlling for sociodemographic and health covariates. The overall household resources index was significantly associated with the death of one or more child in the entire sample (adjusted odd ratios (OR)=0.95; 95% confidence interval (CI): 0.92, 0.98]. In stratified analysis, this finding held for women living in rural but not in urban areas. Having a refrigerator at the time of interview was associated with lower odds of reporting child mortality (OR=0.63; 95%CI: 0.48, 0.83). Having a kerosene lantern (OR=1.40; 95%CI: 1.06, 1.85) or flush toilet (OR=1.84; 95%CI: 1.23, 2.75) was associated with higher odds of reporting child mortality. Adjusted regression models showed only possession of a refrigerator retained significance. Possession of a refrigerator may play a role in child mortality. This finding may reflect unmeasured socioeconomic status or the importance of access to refrigeration in preventing diarrheal disease or other proximal causes of child mortality in sub-Saharan Africa.
Highlights
The association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations
The overall household resources count was significantly associated with child mortality in analyses for the entire sample (adjusted odds ratio (AOR)=0.95; 95% confidence interval (CI): 0.92, 0.98)
Analyses stratified by place of residence showed the household resources count was significantly associated with the death of one or more child in both rural (AOR 0.98; 95%CI: 0.92, 0.98; p
Summary
The association between child mortality and socioeconomic status is well established, the role of household assets as predictors of child mortality, over and above other measures of socioeconomic status, is not well studied in developing nations. Results: The overall household resources index was significantly associated with the death of one or more child in the entire sample (adjusted odd ratios (OR)=0.95; 95% confidence interval (CI): 0.92, 0.98] In stratified analysis, this finding held for women living in rural but not in urban areas. Recent studies in developing countries suggest that household resources (eg electricity, toilet facilities, source of drinking water, type of fuel for cooking, roofing and flooring materials) are associated with lower risk of child mortality[1,2,3,4,5] In these studies, the economic status of the household was operationalized as having possession of assets such as electricity[2] or toilet facilities[5] or access to clean drinking water[4,5] or sound roofing and finished flooring[3]; these were found to significantly increase under-age-5 survival. Few[6,9] accounted for both household assets and maternal education with assets showing significant associations with child mortality when education was controlled
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