THE CONTRIBUTION OF THE GEOGRAPHICAL AREA OF RESIDENCE ON RURAL-URBAN DIFFERENTIALS IN INFANT MORTALITY IN KAKAMEGA CENTRAL SUB-COUNTY, KAKAMEGA COUNTY, KENYA
Authors: Gilbert Omedi*, Irene Mutavi & Joyce Obuoyo
ABSTRACT
Background: Infant mortality remains an indaba in Sub-Saharan Africa, a region currently producing over half of global infant deaths. Kakamega Central Sub-County, a region within Sub-Saharan Africa, has an infant mortality rate of 37. This study examined the contribution of the geographical area of residence on rural-urban differentials in infant mortality in Kakamega Central Sub-County, Kakamega County, Kenya.
Methods: A cross-sectional research design was adopted. Primary data were collected from mothers between the childbearing ages of 15 to 49 years who had an experience of childbirth between 2013 and 2022. Secondary data were obtained from the 2019 Kenya population and housing census. Cross-tabulation and multinomial logistic regression analyses were conducted on the statistical package of the social sciences version 25 computer software program.
Results: Rural areas with mud roads had higher odds of neonatal (aOR – 2.067) and infant (aOR – 3.867) mortalities when compared to those with tarmacked roads. Areas with 3 to 4 health facilities had 8.248 and 2.651 higher adjusted odds ratios of post-neonatal and infant mortality when compared to areas with at least 5 health facilities in rural and urban areas, respectively. Residing in good housing was associated with lower odds ratios of rural neonatal (aOR – 0.016), urban post-neonatal (aOR – 0.265), and infant (aOR – 0.312) mortalities when compared to residing in durable housing.
Conclusion: There is a need for concerted efforts towards road improvement in rural areas; increased access to functional and well-equipped health to ensure an acceptable density of health facilities; and enlightening people on the importance of proper hygiene in the household environments and on good, affordable, dietary practices.
Keywords: Geographical area of residence; Nature of roads; Number of health facilities; Population density; Type of housing.
REFERENCE
- Agarwal, S. & Taneja, S. (2005). All slums are not equal: child health conditions among the ruban poor. Vol. 42; pp. 233-244.
- Armstrong, S. J., Mrisho, M., Manzi, F., Shirima, K., Mbuya, C., Mushi, A., et al. (2008). Health and survival of young children in southern Tanzania. BMC Public Health, 8:194.
- Black, R. E., Morris, S. S. & Bryce, J. (2003). Where and why are 10 million children dying every year? Lancet, 361: 2226-2234.
- Da Vanzo, J., Butz, W. P. & Habitcht, J. P. (1983). How biological and behavioural influences on mortality in Malaysia vary during the first year of life. Population Studies 37.
- Falchetta., G., Hammad, A. T., & Shayegh, S. (2020). Planning universal accessibility to public health care in Sub-Saharan Africa. Proc. Natl. Acad. Sci. 117 (50), 31760.
- Ghosh, S. (2005). Does economic inequality matter in cases of infectious childhood diseases? An analysis for India. Asia Pac Popul J; 20:37-62.
- Gruebner, O., Lautenbach, S., Khan, M. M. H., Kipruto, S., Epprecht, M., & Galea, S. (2015). Place of residence moderates the risk of infant death in Kenya: evidence from the most recent census 2009. PLOS ONE 10(10).
- Hathi, P., Haque, S., Pant, L., Coffey, D. & Spears, D. (2017). Place and child health: the interaction of population density and sanitation in developing countries. Demography, 54:337-360.
- Karra, M., Fink, G., & Canning, D. (2017). Facility distance and child mortality: a multi-country study of health facility access, service utilization, and child health outcomes. International Journal of Epidemiology, Volume 46, Number 3.
- Kenya National Bureau of Statistics. (2022). 2019 Kenya population and housing census volume VII: analytical report on mortality. KNBS.
- Kenya National Bureau of Statistics. (2019). 2019 Kenya population and housing census volume II: distribution of population by administrative units. KNBS.
- Kruk, M. E. et al. (2018). Mortality due to low quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. Lancet (London, England), 392 (10160), 2203-2212.
- Kuse, K. A., Chikako, T. U., Hagan, J. E., Seidu, A. A. & Ahinkorah, B. O. (2022). Assessing individual and community-level variability in predictors of neonatal, infant and under-five child mortality in Ethiopia using a multilevel modelling approach. Children, 9, 1071.
- Leon, D. A. (2008). Cities, urbanisation and health. International Journal of Epidemiology, 37, 4-8.
- Macassa, G. & Ghilagaber, G., Charsmar, H., Walander, A., Sundin, O. & Soares, J. (2012). Geographical differentials in mortality of children in Mozambique: their implications for achievement of Millenium Development Goal 4. J Health Popul Nutr. (3):331-45.
- Madise, N. J., Banda, E. M., & Benaya, K. W. (2003). Infant mortality in Zambia: socioeconomic and demographic correlates. Social Biology, 50 (1-2), 148-166.
- Magadi, M. A., Zulu, E. M., & Brockerhoff, M. (2003). The inequality in maternal healthcare in urban sub-Saharan Africa in the 1990s. Population Studies, 57, 347-366.
- Masuma, M., & Bangser, M. (2009). Poor people’s experiences of health services in Tanzania. Dar es Salaam, Tanzania: Women’s Dignity Project.
- Matthew, Z., Channon, A., Neal, S., Osrin, D., Madise, N., & Stones, W. (2010). Examining the urban advantage in maternal healthcare in developing countries. PLoS Medicine, 7(9).
- Meehan, S., Beck, C. R., Mair-Jenkins, J., Leonardi-Bee, J., & Puleston, R. (2014). Maternal obesity and infant mortality: a meta-analysis. Paediatrics, 133:863-871.
- Mutunga, C. J. (2007). Environmental determinants of child mortality in Kenya. WIDER Research Paper, Number 2007/83. The United Nations University World Institute for Development Economics Research, Helsinki.
- Okwaraji, Y. B. et al. (2012). Effects of geographicalal access to health acilities on child mortality in rural Ethiopia: a community based cross sectional study. Plos one, 7(3): p. e33564.
- Omedi, G., Mwaila, M., & Wanja, S. (2020). Vaginal or caesarean delivery? A comparative study of factors associated with the choice method of childbirth delivery in Kenya and Egypt. European Journal of Medical and Health Sciences, Volume 2, Issue 6, 2020.
- Omedi, M. G. (2011). A comparative study of infant mortality: the case of Kenya and Tanzania. Unpublished Master of Arts Thesis, University of Nairobi.
- Ouma, P. O. et al. (2018). Access to emergency hospital care provided by the public sector in Sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis. Lancet Glob. Health, 6(3), e342-e350.
- Root, G. (1997). Population density and spatial differentials in child mortality in Zimbabwe. Soc Sci Med; 44:413-21.
- Sanou, A., Simboro, S., Kouyate, B., et al. (2009). Assessment of factors associated with complete immunization coverage in children aged 12-23 months: a cross-sectional study in Nouna district, Burkina Faso. BMC Int Health Hum Rights; 9(suppl 1):S10.
- Simmons, R. A., Anthopolos, R., & O’Meara, W. P. (2021). Effect of health systems context on infant and child mortality in Sub-Saharan Africa from 1995 to 2015, a longitudinal cohort analysis. Scientific Reports, 11:16263.
- Sombie, I., Bouwaye, A., Mongbo, Y., Keita, N., Lokossou, V., Johnson, E., Assogba, L., & Crespin, X. (2017). Promoting research to improve maternal, neonatal, infant and adolescent health in West Africa: the role of the West African Health Organisation. Health Research Policy and Systems, 15 (Suppl 1):53.
- Toda, M., Opwora, A., Waweru, E, Noor, A, Edwards, T., Fegan, G., et al. (2012). Analysing the equity of public primary care provision in Kenya: variation in facility characteristics by local poverty level. Int J Equity Health, 11:75.
- United Nations Children Fund, World Health Organisation, The World Bank & United Nations Development Programme. (2020). Levels and trends in child mortality. estimates developed by the UN Inter-Agency Group for Child Mortality Estimation. UNICEF, New York, USA.
- United Nations Development Programme. (2000). United Nations Millennium Declaration. UNDP, New York.
- United Nations Development Programme. (2015). transforming our world: the 2030 Agenda for Sustainable Development. UNDP, New York.
- United Nations. (2014). The millennium development goals report. New York.
- UN-Habitat. (2003). Slums of the world: the face of urban poverty in the new millennium? Nairobi.