Modeling Determinants of Under-Five Mortality in Rural and Urban Ghana

Abstract

The disparity in under-five year-old mortality rates between rural and urban areas in Ghana as also reported in other sub-Saharan African countries is a critical national concern. The purpose of this study is to examine the relative importance of major biosocial, demographic and economic factors associated with child mortality in Ghana. The study is an analytical cross-sectional design through secondary data analysis of the 2008 Ghana Demographic and Health Survey (GDHS) dataset for children. Series of multivariate Cox regression models were fitted to select the significant factors affecting child mortality both in urban and rural. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Breastfeeding, twins and size of child at birth were key determinants of mortality in the rural areas, but the influence of region of residence was similar in both rural and urban areas. The magnitude of the significance for each selected variable was tested using the Wald’s test, and hence the factors were rank ordered according to their overall P-value. Infant mortality rate in 2008 was 58.489 per 1000. Focus of interventions in child health with a view to achieving the MDG will be on the social and economic empowerment of women via education and employment while breastfeeding promotion will be encouraged. Innovative and targeted strategies are required to address rural poverty and region-specific sociocultural factors in order to improve child survival in rural Ghana, especially twin births.

Keywords: Ghana, rural vs urban, under-five mortality.