Socioeconomic determinants of infant mortality in Kenya
Date
2008-10-23T10:09:47Z
Authors
Mustafa, Hisham
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Abstract
Background: This study examines the socioeconomic factors associated with infant and
postneonatal mortality in Kenya and tries to quantify these associations in order to put
those factors in ranked order so as to prioritize them in health policy plans aiming to
decrease infant and postneonatal mortality. The study has used wealth index, mother’s
highest educational level, mother’s occupation and place of residence as exposures of
interest. Methods: The study uses analytical cross-sectional design through secondary
data analysis of the 2003 Kenyan Demographic and Health Survey (KDHS) dataset for
children. Series of logistic regression models were fitted to select the significant factors
both in urban and rural areas and for infant and postneonatal mortality, separately,
through the use of backward stepwise technique. Then the magnitude of the significance
for each variable was tested using the Wald’s test, and hence the factors were ranked
ordered according to their overall P-value. Results: After excluding non-singleton births
and children born less than one year before the survey, a sample size of 4 495 live births
was analyzed with 458 infants died before the first year of life giving IMR of 79.6 deaths
per 1000 live births. After adjusting for all biodemographic and other health outcome
determining factors, the analyses show no significant association between socioeconomic
factors and infant mortality in both urban and rural Kenya. The exclusion of deaths that
occurred in the first month of ages shows that risk of postneonatal (OR 3.09; CI: 1.29 –
7.42) mortality, in urban Kenya, were significantly higher for women working in
agricultural sector than nonworking women. While in rural Kenya, the risk of
postneonatal (OR 0.42; CI: 0.20 – 0.90) mortality were significantly lower for mothers with secondary school level of education than mothers with no education. Conclusions:
There is lack of socioeconomic differentials in infant mortality in both urban and rural
Kenya. However, breastfeeding, ethnicity and gender of the child in urban areas on one
hand and breastfeeding, ethnicity and fertility factors on the other hand are the main
predictors of mortality in this age group. Furthermore, results for postneonatal mortality
show that level of maternal education is the single most important socioeconomic
determinant of postneonatal mortality in urban Kenya while mother’s occupation is the
single most important socioeconomic determinant of postneonatal mortality in rural
areas. Other determinants of postneonatal mortality are ethnicity and gender of the child
in urban areas, while in rural areas; the other main predictors are ethnicity, breast feeding
and fertility factors.
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Keywords
infant mortality, Kenya, socioeconomic factors