Abstract
BackgroundIn spite of global decline in under-five mortality, the goal of achieving MDG 4 still remains largely unattained in low and middle income countries as the year 2015 closes-in. To accelerate the pace of mortality decline, proven interventions with high impact need to be implemented to help achieve the goal of drastically reducing childhood mortality. This paper explores the association between socio-economic and demographic factors and under-five mortality in an impoverished region in rural northern Ghana.MethodsWe used survey data on 3975 women aged 15–49 who have ever given birth. First, chi-square test was used to test the association of social, economic and demographic characteristics of mothers with the experience of under-five death. Subsequently, we ran a logistic regression model to estimate the relative association of factors that influence childhood mortality after excluding variables that were not significant at the bivariate level.ResultsFactors that significantly predict under-five mortality included mothers’ educational level, presence of co-wives, age and marital status. Mothers who have achieved primary or junior high school education were 45% less likely to experience under-five death than mothers with no formal education at all (OR = 0.55, p < 0.001). Monogamous women were 22% less likely to experience under-five deaths than mothers in polygamous marriages (OR = 0.78, p = 0.01). Similarly, mothers who were between the ages of 35 and 49 were about eleven times more likely to experience under-five deaths than those below the age of 20 years (OR = 11.44, p < 0.001). Also, women who were married had a 27% less likelihood (OR = 0.73, p = 0.01) of experiencing an under-five death than those who were single, divorced or widowed.ConclusionTaken independently, maternal education, age, marital status and presence of co-wives are associated with childhood mortality. The relationship of these indicators with women’s autonomy, health seeking behavior, and other factors that affect child survival merit further investigation so that interventions could be designed to foster reductions in child mortality by considering the needs and welfare of women including the need for female education, autonomy and socioeconomic well-being.
Highlights
In spite of global decline in under-five mortality, the goal of achieving MDG 4 still remains largely unattained in low and middle income countries as the year 2015 closes-in
Due to disagreements in existing literature on the influence of particular social, economic and demographic attributes of mothers on under-five mortality coupled with sparse information on the topic in the Ghanaian setting, this paper further examine social, economic and demographic factors that influence under-five deaths and the magnitude of their influence in a rural impoverished setting in northern Ghana
The region is predominantly rural, with 79% of its residents located in rural areas and as high as 72.3% of households are headed by males, total fertility rate is 3.43 and under-five mortality stands at 128 per 1000 live births [21]
Summary
In spite of global decline in under-five mortality, the goal of achieving MDG 4 still remains largely unattained in low and middle income countries as the year 2015 closes-in. Under-five mortality decline has improved from 1.2% per year between 1990 and 1995, to 3.9% per year between 2005 and 2012 [1] In spite of this substantial drop in global child mortality rate, about 6.6 million children still die every year before their fifth birthday worldwide which implies 18,000 under-five children die Children in sub-Saharan Africa have the highest risk of death in the first month of life and are still leading in under-five mortality rates with one in every nine children dying before their fifth birthday as of 2011 [2]. The rate of improvement in child survival in SubSaharan Africa is insufficient to meeting United Nations Millennium Development Goal 4 of reducing under-five mortality rate by two-thirds between 1990 and 2015 as it has the highest risk of death in the first month of life and is among the regions showing the least progress globally [1,2]. Not married (single/widowed/divorced) Married Occupation Farming Self Employed
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