Online Program

Factors Associated with Childhood Mortality in the Democratic Republic of Congo, Demographic and Health Survey-2014

Tuesday, November 3, 2015 : 10:43 a.m. - 10:56 a.m.

Paul Law, MD, MPH, MS, School of Medicine, Université Protestante au Congo, Kinshasa, Congo-Kinshasa
Franklin Baer, MHS-TM, DrPH, Baertracks, Harrisonburg, VA
Lawrence Sthreshley, DrPH, NA, IMA WorldHealth, Kinshasa, Congo-Kinshasa
Jenny Tegelvik, MPH, Monitoring and Evaluation, IMA WorldHealth, Kinshasa, Congo-Kinshasa
Susan Durberstein, IMA WorldHeatlh, Washington, DC
Background: According to UNICEF, the Democratic Republic of Congo (DRC) has the 8th highest U5MR at 119/1,000.  In 2014, a Demographic and Health Survey was completed in DRC.  There are only 8 publications on PUBMED from the 2007 DHS and 0 from 2014; whereas, there is much greater use of DHS data in many other countries. In this analysis we review factors associated with U5MR.

Hypothesis: There will be a clinically relevant and statistically significant association between childhood motality and the following: FBO health zone co-management, gender, year of birth, parity, rural/urban, maternal BMI, province, bed net use, wealth index and number of wives in the family.

Methods: DHS 2014 data was used along DHS guidelines for weighting to construct a logistic regression model with death by 5 years old as the outcome variable and the above-mentioned indepedent factors.  STATA 11.1 (StataCorp) was used.  Individual Kaplan Meier Survival curves were used for exploration.  Children with a current age of <60 months at the time of the interview were included.

Results: Parity (OR1.56, p=0.008), Provinces (Bandundu (0.25, p=0.007); Equateur (OR=0.23, p=0.004); Kasai-Oriental (OR=0.33, p=0.041); Nord-Kivu Province (OR=0.28, p=0.027); Sud-Kivu (OR=0.056, p=0.015), DHS Wealth Index (OR=.056, p=0.002), maternal age (OR/year=1.03, p=0.013) were all statistically significant. Gender (OR=0.79), FBO co-management (OR=0.79), urban/rural (OR=0.83), year of birth (OR=1.33), bed net use (OR=0.77), number of wives (OR=1.26), and maternal BMI (OR/unit=1.03) were not statistically significant.

 Discussion: Parity is predictive of higher mortality. Several provinces perform better than the index province of Kinshasa.  Wealth Index and maternal age have strong associations with mortality.  BMI was not associated with childhood mortality.  FBO co-management status, gender, bed net use, and urban/rural status all had strong associations; however, they were not statistically significant.  It is important to continue to evaluate predictors of childhood mortality and modify health delivery strategies accordingly.

Learning Areas:

Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe current factors (FBO Status of Health Zone, Gender, Parity Status, Urban/Rural, Elevation, Year of Birth) associated with CMR in DRC. Discuss current status of DRC's health information sources (limitations and assets) available for such analysis. Design proper weighting procedures for multivariate analyses using the Demographic and Health Survey (DHS) using a common statistical package.

Keyword(s): Child Health, Faith Community

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior advisor to IMA World Health and Vice-President of SANRU focusing on the planning, implementation and supervision of health systems development projects, especially those including between faith-based health networks and their collaboration within national health systems. I am qualified to give this presentation because I have worked for 40+ years in developing decentralized PHC systems with the “universal” objective of “Health for All and by All”.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.