Factors affecting infant mortalirty in Kenya
Limiri, Kanampiu L
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The study set out to investigate factors affecting infant mortality in Kenya. Specifically, the study sought to determine the effects of selected socio-economic, socio-cultural environmental and biological/behavioural factors on infant mortality in Kenya. and finally to compare the results with those based on the analysis of 1993 Kenya demographic and health survey (KDHS) data. This study is based on a sample of3620 births from 1998 KDHS data out of which 224 died before celebrating the first birthday. The Mosley and Chen analytic model was adopted to guide the study. The formulated study hypotheses were tested using the dependent variable defined as the risk of death for children less than one year of age. I first performed bivariate analysis to assess the strength of association between each of the explanatory variables and the dependent variable and the direction of the effect. Results of the bivariate analysis show that type of marriage, ethnicity, region of residence, maternal age at birth, place of delivery. length of preceding birth interval, maternal education, paternal education, source of water and toilet facility had significant association with the risk of infant mortality. """ ,<' In order to answer the research questions adequately, multivariate analysis was performed with four sub models fitted with each sub model corresponding to each specific objective of the study. From the socio-economic sub model only paternal education had significant effect on the risk of infant mortality. Multivariate analysis of socio-cultural factors indicated that ethnicity and region of residence had significant effect on infant mortality risks. Similarly with respect to the region of residence infant mortality is highest in Nyanza province followed by coast. From the environmental sub-model, both toilet facility and source of drinking water have significant effect on infant mortality. whereas in the biological and behavioural sub model, length of preceding birth interval, number of antenatal visits and place of delivery influence the risk of infant mortality. In the final analysis model, place of delivery ethnicity, type of marriage, number of antenatal visits and paternal education are the determinants of infant mortality The last objective of the study was to compare those results with those based on the 1993 data. For these reason variables similar to those of 1998 were selected from the 1993 data set for analysis. Comparing the results we find that whereas in 1993 only ethnicity and toilet facility are the determinants of infant mortality in 1998, place of delivery, type of marriage, number of antenatal visits and paternal education in addition to ethnicity are the determinants of infant mortality. The study therefore concluded that infant mortality situation in Kenya could be explained by inadequate use of health services, persistent socio-cultural traditions and low levels of paternal education and by extension low household economic status. The findings of this study have implications for both policy and research. The study shows that there is need to lower cost of health services especially maternity and preventive health care services to ensure that all children are delivered in hospitals and encourage mothers to go for antenatal checks. The study further indicates that improvements in infant survival can be promoted if the problem of persistent socio cultural traditions such as polygamy is addressed. Finally the study suggests that research on the mechanisms through which paternal education affect infant mortality needs to be investigated.