Does migration improve child survival : Agincourt South Africa 2002?

Date
2008-07-09T12:35:19Z
Authors
Ketlogetswe, Akeem Tshepo
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Abstract
Abstract Background: Studies into risk factors and causes of childhood mortality present the opportunity to identify intervention programs appropriate in different populations in our attempt to reach the WHO Millennium Development Goals. Objectives: To determine whether there is an association between parental labour migration and child mortality in the Agincourt Health and Demographic Surveillance Site (HDSS) in 2002. Methods: Secondary data extracted from the longitudinal database from the Agincourt Health and Demographic Surveillance System were used to study the association between father’s migration and child mortality in 2002 using logistic regression and survival analysis. The analysis included 10050 children born between 01 January 1998 and 31 December 2002. Results: The child mortality in 2002 was 12.9 deaths per 1000 person years. There was a statistically significant difference in death rate in infants (50.9 deaths per 1000 person years), and in children aged 1-4 years (9.6 deaths per 1000 person years). There was no association observed between migration and child mortality (OR: 0.97, 95% CI 0.59-1.60). The factors associated with mortality were the age of the child, the number of siblings that a child had, the refugee status of the mother, age of the mother at birth, breast feeding and whether the mother was deceased or not. The chances of dying were lower in older children compared to younger ones (OR: 0.58, 95% CI 0.50-0.68). Children who had one or more siblings were less likely to die (OR: 0.62, 95% CI 0.51-0.93) compared to those with none. Child mortality risk was higher in children born to refugees than to local residents (OR: 1.56, 95% CI 1.05-2.33). Those children who were not breast fed had increased chances of dying than those breast fed (OR: 5.33, 95% CI 2.60-10.95). The death of a mother increased the risk of the child dying (OR: 9.35, 95% CI 5.02-17.40). About 84.3% of migrants were sending remittances to members of the households remaining behind but there was no significant difference in child mortality among remitters and nonremitters. The leading causes of death among households with migrant father and those with a non-migrant father were infectious diseases (mainly HIV/AIDS related illness) with 47% and 50% respectively. Conclusion: The results from this study suggest that on average children of migrants in a rural area in South Africa do not experience increased mortality compared to children of non-migrants. The findings from this study where no association between fathers’ migration and child mortality was observed were rather inconclusive. So far, this area of research has not been adequately addressed and much remains to be learned about the lives of children left behind by fathers migrating to seek employment elsewhere. For future studies it would be advisable to study in great depth the long term effects of migration on child mortality particularly in Africa.
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migration and child survival
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