Infant Mortality Decline in Zambia: To What Extent Did Maternal Education Influence Infant Mortality Rate Decline for the Period 1992 to 2018?
DOI:
https://doi.org/10.47672/ejhs.1985Keywords:
Infant Mortality, Maternal Education, Trend Analysis, Infant Mortality Decline, InfluenceAbstract
Purpose: In Zambia, infant mortality has reduced from 107 per 1000 live births in 1992, to 42 per 1000 live births during the 2018 period. Across the Globe, it is argued that maternal education (ME) contributes to the reduction in infant mortality (IM). However, the extent to which maternal education influenced the decline in infant mortality in Zambia for the period 1992 to 2018 was not clear. Therefore, this study sought to investigate the extent to which ME influenced the decline in IM in Zambia from 1992 to 2018.
Materials and Methods: This study was a secondary data analysis (Trend Analysis). Zambia Demographic and Health Survey (ZDHS) data sets: 1992 to 2018 were used in the analyses. The unit of analysis was IM with sample sizes: 6169, 7066, 6526, 6025,12916 and 9959 respective to the ZDHS years. All analyses were done using SPSS version 25.0. Univariate analysis was done for descriptive statistics. Bivariate analysis, Chi-square was used at 5% level of significance for associations. Point Bi-serial Correction was done between ME and IM at 1% and/or 5% levels of significance. Binary logistic regression at 5% level of significance was used to determine the influence of predictors on IM.
Findings: It was found that ME was (negatively) related to IM from 1992 to 2001-2. The correlation coefficients were smaller negatives indicating a very weak negative relationship between ME and IM. In multivariate analysis ME was found to be negatively associated with IM, from 1992 to 2001-2 only. Among the interactions, only the interactions between ME and contraceptive use; ME and preceding birth interval; ME and breast feeding; and ME and antenatal care (visits) significantly influenced the decline in IM from 1992 to 2018. Singularly, ME influenced the decline in IM rate to a lesser extent (only marginally). When interacted with contraceptive use, preceding birth interval, breast feeding and antenatal care, ME influenced the decline in IM to a larger extent.
Implications to Theory, Practice and Policy: in order to come up with more robust interventions to further reduce IM in the country, these interactions should be considered in the planning and implementation of child health programs such as the child health nutrition, national partnership for maternal, new-born and child health, child health week, Integrated Community Case Management of Childhood Illnesses (ICCM), and the Support to Safe motherhood and New-born Health among others.
Downloads
References
Ali, R., n.d. Global Women's Health (GWH).
Basu, A.M., Stephenson, R., 2005. Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. Soc. Sci. Med. 60, 2011-2023.
Basumatary, K., 2016. Factors Affecting Infant Mortality Rate 2, 10.
Bhandari, P., Bak, J., Lee, K.-S., Chon, Y., Bhattachan, A., Rimal, P., Shrestha, B.R., Bhandari, B., Moon, J.-O., Wu, N., 2019. Assessment of socio-demographic factors, mother and child health status, water, sanitation, and hygienic conditions existing in a hilly rural village of Nepal. Int. J. Environ. Res. Public. Health 16, 3965.
Boehmer, U., Williamson, J.B., 1996. The impact of women's status on infant mortality rate: A cross-national analysis. Soc. Indic. Res. 37, 333-360.
Burdenski Jr, T.K., 2000. Evaluating Univariate, Bivariate, and Multivariate Normality Using Graphical Procedures.
Chan, K.P., 2015. Effects of perinatal meditation on pregnant Chinese women in Hong Kong: a randomized controlled trial. J. Nurs. Educ. Pract. 5, 1-18.
Cheng, H.G., Phillips, M.R., 2014. Secondary analysis of existing data: opportunities and implementation. Shanghai Arch. Psychiatry 26, 371.
Craig, A.L., 2009. "Quality is everything": rhetoric of the transatlantic birth control movement in interwar women's literature of England, Ireland and the United States (PhD Thesis).
Desai, S., Alva, S., 1998. Maternal education and child health: Is there a strong causal relationship? Demography 35, 71-81.
Faso, B., 2007. Testing Approaches for Increasing Skilled Care During Childbirth: Key Findings from Ouargaye, Burkina Faso.
Flood, M., 2015. Men and gender equality.
Gwatkin, D.R., Rustein, S., Johnson, K., Pande, R.P., Wagstaff, A., n.d. Socio-economic differences in health, nutrition, and population in Bangladesh, 2000. Available Online Www1 Worldbank Orgprempovertyhealthdatabangladeshbangladesh Pdfaccessed 15 July 2015.
Hannum, E., Buchmann, C., 2005. Global educational expansion and socio-economic development: An assessment of findings from the social sciences. World Dev. 33, 333-354.
Hazan, M., Zoabi, H., 2015. Do highly educated women choose smaller families? Econ. J. 125, 1191-1226.
Heinrich, C.J., 2014. Parents' employment and children's wellbeing. Future Child. 121-146.
Huffman, S.L., 1984. Determinants of breastfeeding in developing countries: overview and policy implications. Stud. Fam. Plann. 15, 170-183.
Jackson, K.M., Nazar, A.M., 2006. Breastfeeding, the immune response, and long-term health. J. Osteopath. Med. 106, 203-207.
Kalipeni, E., 1993. Determinants of infant mortality in Malawi: A spatial perspective. Soc. Sci. Med. 37, 183-198. https://doi.org/10.1016/0277-9536(93)90454-C
Kornbrot, D., 2014. Point biserial correlation. Wiley StatsRef Stat. Ref. Online.
Mason, K.O., 1987. The impact of women's social position on fertility in developing countries, in: Sociological Forum. Springer, pp. 718-745.
Mathews, T.J., MacDorman, M.F., Thoma, M.E., 2015. Infant mortality statistics from the 2013 period linked birth/infant death data set.
Mathole, T., Lindmark, G., Majoko, F., Ahlberg, B.M., 2004. A qualitative study of women's perspectives of antenatal care in a rural area of Zimbabwe. Midwifery 20, 122-132.
Miller, J.E., Trussell, J., Pebley, A.R., Vaughan, B., 1992. Birth spacing and child mortality in Bangladesh and the Philippines. Demography 29, 305-318.
Mohammadi, Y., Parsaeian, M., Mehdipour, P., Khosravi, A., Larijani, B., Sheidaei, A., Mansouri, A., Kasaeian, A., Yazdani, K., Moradi-Lakeh, M., 2017. Measuring Iran's success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015. Lancet Glob. Health 5, e537-e544.
Nath, D.C., Land, K.C., Singh, K.K., 1994. Birth spacing, breastfeeding, and early child mortality in a traditional Indian society: a hazards model analysis. Soc. Biol. 41, 168-180.
Norton, M., 2005. New evidence on birth spacing: promising findings for improving newborn, infant, child, and maternal health. Int. J. Gynecol. Obstet. 89, S1-S6.
Nyblade, L., Field, M.L., 2000. Women, communities, and the prevention of mother-to-child transmission of HIV: issues and findings from community research in Botswana and Zambia. Wash. DC Int. Cent. Res. Women.
Organization, W.H., 1994. Women's health: towards a better world, report of the First Meeting of the Global Commission on Women's Health, 13-15 April 1994, Geneva, Switzerland. World health organization.
Pamuk, E.R., Fuchs, R., Lutz, W., 2011. Comparing relative effects of education and economic resources on infant mortality in developing countries. Popul. Dev. Rev. 37, 637-664.
Reidpath, D.D., Allotey, P., 2003. Infant mortality rate as an indicator of population health. J. Epidemiol. Community Health 57, 344-346.
Rubin, J.S., 2005. The Maker's diet. Charisma Media.
Saputo, L., Faass, N., 2010. Boosting Immunity: Creating Wellness Naturally. New World Library.
Shoham-Yakubovich, I., BAREL, V., 1988. Maternal education as a modifier of the association between low birthweight and infant mortality. Int. J. Epidemiol. 17, 370-377.
Simkhada, B., Porter, M.A., Van Teijlingen, E.R., 2010. The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy Childbirth 10, 1-10.
Stanfors, M., Larsson, C., 2014. Women's education, empowerment, and contraceptive use in sub-Saharan Africa: findings from recent demographic and health surveys. Etude Popul. Afr. 28, 1022-1034.
Stengler, M., 2001. Nature's Virus Killers. M. Evans.
Thomas, P., 2008. Healthy, Happy Baby: The Essential Guide to Raising a Toxin-free Baby. Pan Macmillan.
Tranmer, M., Elliot, M., 2008. Binary logistic regression. Cathie Marsh Census Surv. Res. Pap. 20.
Varga, C., Brookes, H., 2008. Factors influencing teen mothers' enrollment and participation in prevention of mother-to-child HIV transmission services in Limpopo Province, South Africa. Qual. Health Res. 18, 786-802.
WHO, U., Mathers, C., 2017. Global strategy for women's, children's and adolescents' health (2016-2030). Organization 2016.
Zambia Demographic and Health survey Report, 2013.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Halinga Johnathan , Chabila C. Mapoma
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
