Determinants of the Recent RISE in Childhood Mortality in Sub-Saharan Africa: Evidence from Kenya

Introduction

Childhood mortality rates in Kenya increased in the 1990s and early 2000s following decades of decline. Evidence from Demographic Health Survey data shows increase in under-5 mortality rate by 26 percent from 91 in 1993 to 115 in 2003.

Research Questions

This study examines factors associated with the recent rise in childhood mortality in Kenya. In particular, it explores the role of macro and micro level factors in explaining the rising trend in under-5 mortality.

Data and Methods

The study is based on two main types of data – individual and macro level data. Individual level data are obtained from Kenya Demographic and Health Surveys (KDHS) conducted in 1989, 1993, 1998, and 2003. Macro-level data were gathered from government administrative records and comprise indicators of access and utilization of health services covering the period 1979-2003 to coincide with period spanned by the survey data.

The Cox regression model is used in the multivariate analysis of factors associated with under-five mortality in Kenya. The coefficients are examined for each period using pooled data, and applied on the differences in means between the mortality declining and rising periods to obtain the change in hazards.

Results

Results show that that macro factors, particularly high HIV/AIDS prevalence and the general deterioration in the quality of childcare, were largely responsible for the rise in childhood mortality in the 1990s and early 2000s. However, their impact was attenuated by individual level factors such as increasing maternal education and reduction in birth rates.