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Determinants of infant mortality in Sierra Leone: applying Cox proportional hazards model

Lubna Naz (Department of Economics, University of Karachi, Karachi, Pakistan)
Kamalesh Kumar Patel (Indian Institute of Health Management Research, Jaipur, India)

International Journal of Social Economics

ISSN: 0306-8293

Article publication date: 3 June 2020

Issue publication date: 2 July 2020

306

Abstract

Purpose

The aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.

Design/methodology/approach

It uses an analytical framework and Cox proportional hazards regression to break down the effects of factors determining infant mortality. Factors utilized in the empirical investigation include sex of the child, birth size, birth spacing, mother's working status, age of mother, antenatal care, postnatal care, mother's anemia level, religion, mother's education and wealth status.

Findings

Results suggest that birth spacing of three years and above associated with a reduced risk of infant mortality contrasted with short birth intervals. Children born to nonanemic mothers have a lower hazard (22%) of infant mortality compared to those born to anemic mothers (HR = 0.78; 95% CI: 0.64–0.96). At least one antenatal care visit by mothers lowers infant mortality rate by 41% compared to no antenatal visits at all ( HR = 0.59; 95% CI: 0.36–0.96). Similarly, infants whose mothers have received postnatal care are at lower risk (31%) of dying than those whose mothers have not received (HR = 0.69; 95% CI: 0.52, 0.93). Infant mortality is likely to decrease with the increase in the birth order.

Practical implications

The family health and planning programs should aim at educating men and women about the usefulness of birth spacing methods.

Originality/value

This paper might be the first attempt to analyze the determinants of infant mortality by utilizing a methodological framework and Cox regression.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2019-0478.

Keywords

Acknowledgements

The authors are grateful to DHS program and ICF international for granting permission to access the Sierra Leone Demographic and Health Survey 2013 from its Website. The Data is Publicly available at the following link, and can be accessed with the due permission. https://dhsprogram.com/data/dataset/Sierra-Leone_Standard-DHS_2013.cfm?flag=0. The authors are also thankful to anonymous reviewers for providing the valuable comments on our article, and the editors for responding to our queries oftentimes.Funding Source: This study has not received any financial support.

Citation

Naz, L. and Patel, K.K. (2020), "Determinants of infant mortality in Sierra Leone: applying Cox proportional hazards model", International Journal of Social Economics, Vol. 47 No. 6, pp. 711-726. https://doi.org/10.1108/IJSE-08-2019-0478

Publisher

:

Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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