Proximate determinants of child mortality in liberia

Abstract

The study looks at the effects of maternal sociodemographic characteristics and the quality of the environment on child survival through two intervening variables, breast-feeding and prenatal care. A linear structural equation modelling approach was used to examine infant and child survival based on a weighted sample of 5180 Liberian children aged 0-5 years. The findings confirm previous studies, but also reveal complex relationships of the role of education, maternal age and breast-feeding in enhancing child survival. PIP:

The hypothesis that female education has a positive direct influence on child survival was investigated through the use of data from the 1986 Demographic and Health Survey of Liberia. Of the 5180 children born in the 5 years preceding the survey, 873 (17%) had died. Even when other socioeconomic variables were controlled, maternal education had a significant positive direct effect (0.167) on child survival at 5 years of age. The percentage of child loss was 17.9% among mothers with no education, 15.5% among those with a primary education, and 14.0% among mothers with an education above the primary level. This effect was weak, however, when compared to that of breastfeeding. The proportion of child mortality was 41.7% among non-breastfeeding mothers compared to only 8.9% among breastfeeding mothers. To the extent that high maternal educational decreased the propensity to breastfeed in this sample, education has a negative indirect effect on child survival--an effect that is counterbalanced somewhat by the tendency of education to increase the likelihood of obtaining prenatal care, the most important source of knowledge about child health. Moreover, prenatal care has the strongest direct effect on breastfeeding status. The excess risk of child mortality among teenage mothers in this survey (19.8%, compared to 14.9% among mothers 35 years of age and above) is believed to reflect to decreasing prevalence of breastfeeding in younger age groups. Overall, the risk of child death was greater in rural areas (17.75) than urban ones (15.6%), but, for breastfed children, the risk was lower in rural areas. These findings indicate a need for greater attention toward promoting breastfeeding as the central element of child survival campaigns.