Infant Mortality Decline in Zambia: To What Extent Did Maternal Education Influence Infant Mortality Rate Decline for the Period 1992 to 2018?

Abstract

Purpose: In Zambia, infant mortality has reduced from 107 per 1000 live births in 1992, to 42 per 1000 live births during the 2018 period. Across the Globe, it is argued that maternal education (ME) contributes to the reduction in infant mortality (IM). However, the extent to which maternal education influenced the decline in infant mortality in Zambia for the period 1992 to 2018 was not clear. Therefore, this study sought to investigate the extent to which ME influenced the decline in IM in Zambia from 1992 to 2018. Materials and Methods: This study was a secondary data analysis (Trend Analysis). Zambia Demographic and Health Survey (ZDHS) data sets: 1992 to 2018 were used in the analyses. The unit of analysis was IM with sample sizes: 6169, 7066, 6526, 6025,12916 and 9959 respective to the ZDHS years. All analyses were done using SPSS version 25.0. Univariate analysis was done for descriptive statistics. Bivariate analysis, Chi-square was used at 5% level of significance for associations. Point Bi-serial Correction was done between ME and IM at 1% and/or 5% levels of significance. Binary logistic regression at 5% level of significance was used to determine the influence of predictors on IM. Findings: It was found that ME was (negatively) related to IM from 1992 to 2001-2. The correlation coefficients were smaller negatives indicating a very weak negative relationship between ME and IM. In multivariate analysis ME was found to be negatively associated with IM, from 1992 to 2001-2 only. Among the interactions, only the interactions between ME and contraceptive use; ME and preceding birth interval; ME and breast feeding; and ME and antenatal care (visits) significantly influenced the decline in IM from 1992 to 2018. Singularly, ME influenced the decline in IM rate to a lesser extent (only marginally). When interacted with contraceptive use, preceding birth interval, breast feeding and antenatal care, ME influenced the decline in IM to a larger extent. Implications to Theory, Practice and Policy: in order to come up with more robust interventions to further reduce IM in the country, these interactions should be considered in the planning and implementation of child health programs such as the child health nutrition, national partnership for maternal, new-born and child health, child health week, Integrated Community Case Management of Childhood Illnesses (ICCM), and the Support to Safe motherhood and New-born Health among others.