Abstract:
Introduction Despite the decline in infant and underfive
mortality rates since the last decade, Ghana did not
meet the millennium development goal (MDG) 4 target.
To implement effective interventions that could fast-track
progress towards achieving the sustainable development
goal 3 in 2030, factors contributing to the decline in child
mortality throughout the MDG period and which factor(s)
has/have been consistent in affecting child survival in the
last decade need to be understood.
Methods This study used Demographic and Health
Surveys (DHS) from 2003, 2008 and 2014 and data from
World Bank Development Indicators (2000–2018). We
employed modified Poisson with robust SE and multivariate
decomposition approach to assess risk factors of child
mortality using DHS data from 2003, 2008 and 2014.
Penalised regression was used assess the effect of 25
country-level contextual factors on child survival.
Results The risk of infant mortality is approximately five
times higher among mothers who had multiple births
compared with mothers who had single birth over the
last decade (adjusted relative risk 4.6, 95% CI 3.2 to 6.6,
p<0.001). An increase in the annual percentage of female
labour force participation (FLFP) is associated with the
reduction of approximately 10 and 18 infant and under-five
annual deaths per 1000 live births, respectively.
Conclusions This study found that multiple births and
shorter birth spacing are associated with increased risk
of infant and under-five deaths over the last decade.
Increased in FLFP, and the proportion of children sleeping
under bed-net are associated with reduced risk of both
infants and under-five deaths.
