Determinants of under-Five Mortality in Lesotho
Abstract
Although the social and economic conditions in Lesotho have improved, under-five
mortality has remained one of the major problems in the country. Documentation of the
factors influencing under-five mortality is an important problem that needs to be
addressed. This study aimed to estimate the effect of social, economic, demographic
health and environmental factors on under-five mortality in Lesotho.
Data source:
The study used data extracted from the 2004, 2009 and 2014, Lesotho Demographic and
Health Survey to investigate the levels and trends in under-five mortality whereas the
2014 Lesotho Demographic and Health Survey was used to explore the factors influencing
under-five mortality in the country. The outcome variable was the child’s survival status
i.e. the child being either alive or dead. The explanatory variables were the socioeconomic
and demographic factors for mother and child, respectively. Variables were
selected through conceptualised Mosley and Chen model and relevant literature.
Results:
Linear regression analysis suggests that Lesotho will fail to achieve goal 3 of the
sustainable development goals, should rates of under-5 mortality continue to decline in
slower rates as observed in previous years.
The chi-square test shows that higher under-5 mortalities were recorded from children
residing in rural areas, who were never breastfed, born to uneducated mothers, delivered
at home, born to mothers who never attended ante-natal care classes or went for checkup
after delivery, residing in a household that access water from a borehole and whose
main source of cooking fuel is gas or smoke emitting fuel.
The association of under-five mortality and selected variables was further investigated
through four binary logistic regression models. First three models were performed to test
association between under-five mortality and socio-economic, bio-demographic and
environmental factors respectively. In the last model all variables which presented a
strong relationship and higher significance level were included. Among all the variables
that were tested, parity and breast-feeding status were significant at 1% while Ante Natal
Care visit, check-up after delivery, maternal age, maternal education, type of cooking fuel
and source of drinking water were significant at 10%.
Conclusion:
The study therefore concluded that significant socio-economic and demographic factors
in Lesotho are maternal education and type of residences while bio-demographic and
health factors are breast feeding status, parity, maternal age, ante-natal visit and checks
after delivery and environmental factors include type of cooking fuel and toilet facility.
Insignificant factors include the child’s sex, birth order, source of drinking water and
wealth index.
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