Determinants of mortality differentials in infancy and childhood by sex in Kenya
View/ Open
Date
2001Author
Otieno, Goodwill G
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
The mam objective of this study is to find out the determinants of mortality
differentials by sex among infants and children in Kenya. The study examines sex
differentials in childhood mortality by birth order and also attempts to determine the
principal behavioural mechanisms responsible for mortality differentials among boys and
girls.
The rationale of the study is that once the determinants of mortality differentials by
sex are known then preventing excess mortality among either boys or girls who are exposed to
the same environmental conditions becomes easier. The study applied direct estimation
methods for child mortality rates using the 1993 Kenya Demographic and Health Survey
(KDHS) data. Logistic regression method was used to study the childhood mortality
determinants for males and females separately.
There are wide regional variations in imrnunisation by sex. Higher imrnunisation
coverage was recorded among male children in Western and Rift Valley provinces while in
Coast and Central provinces, more female than male children were vaccinated. Girls in
Coast province and boys in Central province had higher immunisation drop out rates
compared to their counterparts of opposite sex. The analysis further indicates that there were
no significant differentials in the duration of breast feeding and nutritional status of boys and
girls.
Boys and girls are subjected to the same physical and personal environment given that
there are no pronounced differentials by sex in the prevalence of fever and cough, diarrhoea
and also cough with short rapid breathing. At the national level, Kenya has no significant
differentials in the health care coverage given to male and female children suffering from
fever and cough or cough with short rapid breathing. However, at a provincial level,
compared to girls suffering from these ailments, boys in Coast province were more likely to
be given health care attention.
The study finds that immunisation coverage is the most significant determinant of
infant and child mortality. In Coast province with higher girls relative to boys' immunisation
dropout rates, there was higher female than male post neonatal mortality. In Central and
Western provinces with more male than female immunisation dropout rates, boys die more
than girls in the post neonatal period in Central province, and in the 12-23 age group in
Western province. Regarding health care, higher male than female toddler (12-23 months)
mortality in Nairobi province coincides with less frequent parental visits to health care
facilities to treat boys than girls, in the event of fever and cough or cough with short rapid
breathing. Higher female than male Post neonatal mortality in Coast province also coincides
with higher health care coverage given to boys, relative to girls in the event of fever and cough
and also cough with short rapid breathing.
The study recommends an intensification of immunisation promotion programs
placing greater emphasis on equal immunisation coverage for male and female children in
Coast and Central province, and reduced immunisation dropout rates for subsequent doses
after the first dose of DPT and polio vaccines. The study also calls for change in attitude and
practice regarding health-seeking behaviour so as to increase health care coverage among
children of both sexes, especially in Nyanza and Western provinces. Further research is
recommended on a household level analysis of the effect of family composition on mortality
differentials by sex in Kenya.
Publisher
Department of Population Studies, University of Nairobi
Description
Master of Arts (Population Studies)