Decomposing the rural-urban gap in the factors of under-five mortality in sub-Saharan Africa? Evidence from 35 countries

BMC Public Health

Olalekan A. Uthman¹  Sanni Yaya²  Ghose Bishwajit²  Friday Okonofua³ 

[1] 0000 0000 8809 1613, grid.7372.1, Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;0000 0001 2182 2255, grid.28046.38, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, Canada;Women’s Health and Action Research Centre, Benin City, Nigeria;University of Medical Sciences, Ondo City, Ondo State, Nigeria;0000 0001 2218 219X, grid.413068.8, Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria;

关键词: Under-5 mortality;    Global Health;    Sub-Saharan Africa;    Decomposition;    Urban-rural;   

DOI  :  10.1186/s12889-019-6940-9

来源: publisher

【 摘 要 】

BackgroundUnderstanding urban-rural gap in childhood survival is essential for health care interventions and to explain disparities in the determinants of Under-5 mortality. There is dearth of information about the factors explaining differentials in urban-rural Under-5 mortality especially in sub-Saharan Africa (SSA). In this study, we sought to quantify the contributions of bio-demographic, socioeconomic and proximate factors in explaining the urban-rural gap in Under-5 mortality in SSA.MethodsThis study utilized secondary data from Demographic and Health Survey (DHS) in 35 sub-Saharan countries conducted between 2006 and 2016. Child (aged 0 and 59 months) death was the outcome variable in this study. Oaxaca-Blinder decomposition was used to decipher urban-rural gap in the factors of Under-5 mortality.ResultsSignificant urban-rural differentials were observed in Under-5 mortality across bio-demographic, socioeconomic and proximate factors. In the decomposition model, about 44.27% of urban group and 74.71% of rural group had Under-5 mortality in sub-Saharan countries. Maternal age, education, use of newspaper, TV, wealth index, total children ever born, size of baby and age at first birth contributed towards explaining urban-rural gap inUnder-5 mortality.ConclusionThese findings could be contributory to health care system improvement and socioeconomic developmental plans to address under-5 mortality in SSA. Strengthening maternal and child health (MCH) programmes, specifically in rural areas and improving health care services would help to ensure overall child survival.

【 授权许可】

CC BY