Environmental risk and socio-economic factors influencing infant and mortalitv in Siaya district: a child case study of Jera sub-location

Abstract

The study of infant and child mortality is important in that, its level can be used as a measure of social and economic development of an area. The infant/child mortality rate in Kenya has declined since independence, to less than 70 per 1000 live births. This country's rate aggregate masks wide variations across districts and among the divisions within a district. Such regional variations in infant and child mortality rates have been shown to be related to a number of social, economic, cultural and environmental characteristics of a given area. To specify such linkage we move in this study, from the district level analysis to the divisional and individual level in Siaya district, which is one of the three districts with the highest infant and child mortality in Kenya. The divisional data is derived from the 1979 census data and the individual data from a survey conducted in Jera Sub-location of Ukwala Division by interviewing 415 women aged between 15 and 49 and have given birth. The objective of this study is to determine the socioeconomic and environmental risk factors among others which are associated with infant and child mortality at the divisional and individual level in Siaya District. The socioeconomic factors at the divisional level are maternal education, place of residence and marital status. At the individual level, the socioeconomic factors measured were maternal and paternal education; maternal labour

participation; religion; marital status; and the number of domestic animals. The environmental risk factors investigated are housing conditions; availability and use of a toilet; water source; cooking and lighting energy; and the concentration in the home. Apart from these two main factors, maternal and infant/child care from the time of conception to the early childhood such as quality of family nutrition; antenatal, natal and postnatal care; and immunization of children were investigated. The measures used to estimate infant and child mortality at the divisional level are infant mortal ity rate, 1qO; chi ld mortal ity rate, 4q1; probability of dying at age x , q(x); and the life expectancy at birth, eo . Trussell's technique for estimating child mortality was used to calculate q(x) and the other estimates were obtained from a life table which was constructed by the use of q(x) and the Coale-Demeny life tables. At the individual level the Preston and Trussell's (1982) technique- of estimating infant and child mortality index was used to determine the mortality index of an individual woman. The findings at the district is as expected, that is infant and child mortality rates are very high (1QO = 173/1000 and qt z ) = 208.8/1000) resulting in a life expectancy at birth of only 41.2 years. At the divisional level, infant and chi ld mortal ity are still high although there are variations with Bondo Division having the lowest and Ukwala Division the highest while Yala Division had

an advantage of Boro Division. An interesting finding at this level is observed in the time trends which shows a drastic decline in infant/child mortality between 1963 and 1967. After 1967. the mortality increased with no sign of decline although the increase was steady after 1975. The socioeconomic differentials revealed that infant and child mortality is inversely proportional to the level of mother's education. Urban residents had a lower infant and child mortality rates than the rural except in Bondo Divion while marital status showed that the single women have a low infant and child mortality rates followed by married, divorced/separated and finally the widowed. At the individual level, all the hypothesized relationships were confirmed. The stepwise regression analysis reveal 1s that pIace of cooking, father's occupation and maternal 1 education have a significant effect on infant and child mortality at a level of 0.05. At 0.1 level of significance, place of cooking; father's occupation; maternal education; source of cooking energy; age at which supplementary food is introduced and visits to antenatal care significant effect on infant and child mortality.