Childhood mortality in Kenya: Effects of environmental risk factors
Abstract
Despite Kenya having experienced reduced childhood mortality rates over the years,
this decline in mortality has not been sufficient enough to enable the attainment of
Millennium Development Goal 4 (MDG4). About 47% of U-5 deaths are as a result
of pneumonia, diarrhea and malaria whose causes can largely be attributed to
environmental risk factors. Nonetheless, much emphasis is geared towards
immunization programs and administration of effective drugs, ignoring levels of
exposure to environmental health risks. In this study, we establish the effects of
environmental risk factors on infant and U-5 mortality using Kenya Demographic and
Health Surveys (KDHS). We use survival models to determine association and then
simulate using measures of Population Attributable Risk (PAR) and Potential Impact
Fractions (PIF). The following inferences are made: first, children who were not
exclusively breastfed, use of firewood for cooking, use of non-improved sources of
drinking water, residing in houses with wooden floors and low socio-economic status
of households are significantly associated with reduced child survival. Second, the
effects of environmental risk factors have generally remained the same over the 19
year period between 1989 to 2008. Third, for all risk factors except use of nonimproved
sources of drinking water, reduced exposure levels promise greater gains in
infant mortality than U-5 mortality and fourth, environmental health risks have a huge
impact on childhood mortality as only modest reductions in exposure translate to
substantial gains in mortality. Based on these findings, we recommend the adoption
of less polluting cooking fuels, e.g. Liquid Petroleum Gas (LPG), electricity and
biogas among others, the use of clean and safe sources of drinking water and exclusive
breastfeeding of infants for their first six months of life. We also urge policy makers
to first address environmental risk factors before embarking on other risk factors