Factors Affecting Under – Five Mortality in the Mfantsiman Municipality of the Central Region Ghana.

Abstract

Introduction: Under – five mortality is a major problem in the world with millions of children not surviving to celebrate their fifth birthday. It is the fourth millennium development goal of which all countries were tasked to reduce by two thirds by the end of 2015. A further reduction to 25 or fewer deaths by 2030 as stipulated in the sustainable development goals. Ghana has made some strides towards achieving its target of reducing under – five mortality by two thirds but it is unlikely the target will be attained. There is the need to identify factors that influence under –five mortality to enable the right targeting of where, when and how public health resources should be channeled to address child health issues, improve health and avoid untimely deaths. Objective: The study sought to identify factors that affect under – five mortality in the municipality and describe the mortality trends within the area. Methods: A retrospective review of medical records of children aged 0 – 59 months who died in the Saltpond Municipal Hospital between 1st January, 2011 and 31st December, 2015. Both maternal and key informant interviews were conducted to identify the causes of under – five mortality and to explore the trends and all factors that will explain the observable trends. A data abstraction form designed for this study was used to retrieve data from 156 medical records on age, sex, duration of stay, diagnosis, cause of death and type of death. A structured questionnaire was used to gather information on demographic characteristics of 65 mothers, and 5 key informant interviews conducted to gather information on institutional predictors of under – five mortality. Data was entered into Microsoft Excel 2013 and STATA version 13 was used to perform the univariate and bivariate analysis. Results: Of the 156 records reviewed, 31.4% were neonates, 30.8% were infants and 37.8% were children. There is a steady rise in under five mortality in the hospital from 2011 to 2015 with a death rate of 1.7%. The major causes of death in neonates, infants and children are neonatal infections, acute respiratory infections and malaria respectively. The top five causes of death in children under five years are severe infections, neonatal infections, malaria, anaemia and acute respiratory infections. Neither maternal educational level nor any other factors in the study was found to be significantly associated with the type of death. However, the relationship between the type of death and child’s weight at admission and the cause of death were significant (p < 0.001). Conclusion: The major cause of under-five mortality are infectious diseases. Maternal and child health care needs to be re-structured focusing on disease prevention with more emphasis on environmental sanitation, health education and promotion and good nutrition