Social factors, nutrition and child mortality in a rural subsistance economy.

Abstract

Data from the Zambia National Nutrition Status Survey was used to identify socioeconomic, health, and nutritional factors associated with child mortality among rural residents. In each sample village, all children, who were both under the age of 5 and the youngest child in the family, were given physical examinations and their mothers were interviewed about the socioeconomic characteristics of the family. Mothers were also asked to provide information on the number of live births they had and on the number of children they had who died. Physical disorders, revealed in the physical examinations, were analyzed in regard to their relationship to sibling death rates, and the socioeconomic characteristics of the family were analyzed in regard to their relationship to the child deaths reported by the mothers. Findings were 1) high sibling death rates were positively associated with the presence of malaria and with the presence of malnutrition in the youngest child in the family; 2) the role of malaria in sibling deaths was greater than the role of malnutrition; 3) social factors associated with high child deaths were parental residence in tribal areas, high maternal parity, and low parental educational attainment; 4) subsistence farm families lost 26.0% of their children compared to other occupational groups which lost an average of 20.9% of their children; 5) polygamously married women lost 28.7% of their children compared to monogamously married women. These findings will be used to help formulate policies aimed at reducing the high child mortality rates in rural Zambia. Only after this rate is reduced will rural residents be receptive to family planning.