Determinants of under-five mortality in Ghana: Evidence from the Ghana demographic and Health Survey

Abstract

Background and Objectives: This study aims to investigate the strength of the association between socio-economic, maternal and environmental determinants and under-five mortality in Ghana. Methods: We utilized data from the 2014 Ghana Demographic and Health Survey, a population-based cross-sectional study, which included 4151 children born alive to women aged 15-49 years. The primary outcome variable was under-five mortality. Descriptive statistics and multivariate logistic regression were applied to assess the relationship and relative association of the independent variables with the outcome variable. Results: Children of women with secondary education and above and women within the middle wealth status were 0.593 and 0.886 less likely to experience under five deaths compared to women with no education and women of low wealth status (OR=0.593; 95% CI 1.690 to 2.063; p< 0.01) (OR =0.886; 95% CI 1.48 to 1.63; p<0.01). Women who had their first birth at age 20-29 years were 0.764 less likely to experience under-five deaths compared to those aged 15-19 years (OR= 0.764; 95% CI 0.994 to 1.191; p<0.01). Children born in households with pit toilets were more likely (OR= 1.51; 95% CI 1.20 to 2.30; p<0.01) to die before age five compared to children born in households with flushed toilet. Women who used bore hole /well water were more likely (OR= 1.686; 95% CI 2.94 to 3.01; p< 0.05) to experience under-five deaths compared to women who used piped water. Conclusion and Implications for Translation: This study identified the determinants that significantly predicted under-five deaths and the magnitude of the influence on under-five deaths in Ghana. It accentuates the need for increased maternal education, delayed child bearing, provision of improved drinking water and toilet facilities to reduce under-five deaths in Ghana