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  • Title: Individual and environmental influence on infant and child mortality in rural Sierra Leone: a multivariate analysis.
    Author: Bailey M.
    Journal: Ren Kou Xue Kan (Taipei); 1989 Jun; (12):155-85. PubMed ID: 12159724.
    Abstract:
    Estimates of infant mortality rates in Sierra Leone are extremely high. A 1986 UN estimate is 215/1000 for 1975-1980. This study uses data from the 1979 fertility and family planning survey in rural Sierra Leone sponsored by the International Development Research Centre in Canada. The sample consists of 2000 women. Results show that substantial differences exist in infant and child mortality ratios among subgroups of background variables: 1) non-Mendes have lower mortality ratios (198/1000) than the Mendes (256/1000); and 2) residence in the largest rural area has the lowest ratio (173/1000), compared to those in the smallest (259/1000) and medium (264/1000) sized rural places. Mortality ratios increase from 197/1000 for mothers under 20 years old to 268/1000 for mother 30 and over. The distribution of infant-child mortality ratios by mother's age at marriage follows an inverted U-shaped form, increasing from 242/1000 for mothers married below 16 years, to 273/1000 for those married between ages 21 and 25, and declining to 260/1000 for mothers married at 26 and over. Mortality ratios decline with increase in mother's education. Mothers engaged in traditional sector jobs have a lower mortality ratio than those engaged in farming or modern sector jobs. Finally, households in rural communities with trained trained midwifery services show higher mortality ratios than those with either health centers, dispensaries or untrained midwifery services. The results of analysis suggest that variables such as maternal education, duration of breast feeding, number of live births, place of residence, family income, health care facilities, sex of infant, and mother's tribal affiliation play a dominant role in infant and child survival chances in Sierra Leone. An integrated approach to reducing mortality in the rural sector could be more effective by manipulating the individual and environmental variables simultaneously. The author recommends 1) compulsory education for females; 2) provisions of informal education programs on maternal and child health, family planning, and nutrition; 3) promotion of breast feeding; 4) expansion of family planning services, especially into rural areas; 5) increase in income for rural families; and 6) emphasis on primary health care.
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