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  • Title: Risk factors for child mortality in northern Ghana: a case-control study.
    Author: Binka FN, Maude GH, Gyapong M, Ross DA, Smith PG.
    Journal: Int J Epidemiol; 1995 Feb; 24(1):127-35. PubMed ID: 7797334.
    Abstract:
    BACKGROUND: A population-based case-control study was carried out to investigate potential risk factors for post-neonatal and child mortality in northern Ghana were child survival rates are among the lowest in Africa. METHOD: Cases were post-neonatal infant and child deaths identified within a large population under continuous demographic surveillance. For each case, one living control, matched for age, sex and locality, was selected from the demographic database. Mothers of each case and control were interviewed to obtain information on social, enconomic, demographic, environmental and other possible risk factors. Matched analyses of the 317 cases and their controls were performed using discordant pairs analysis and conditional logistic regression. RESULTS: The mortality rate for children aged 6 months to 4 years was estimated as 23.9/1000 children/year. An increased risk of death was observed where the delivery was not performed by a trained person (OR = 1.8, 95% CI: 1.0-3.2), if the preceding birth interval was < 24 months (OR = 2.2, 95% CI: 1.1-3.9), if the father beat the child's mother (OR = 4.3, 95% CI: 1.2-15.6) or if the water source was unprotected (OR = 1.6, 95% CI: 1.0-2.7). No association was found between weaning practices, parental education, or any of the socioeconomic or hygiene variables considered. CONCLUSIONS: Few strong risk factors for mortality were identified, perhaps because living conditions within the study population are relatively homogeneous. While mortality rates may be reduced by targeted interventions, such as increasing deliveries by trained people, more general improvements in the socioeconomic status in the region are essential. A population-based case-control study was conducted in the Kassena-Nankana district of the Upper East Region of Ghana to investigate potential risk factors for post-neonatal and child mortality in northern Ghana where child survival rates are among the lowest in Africa. 317 cases of post-neonatal infant and child deaths were matched with controls, with matched analyzes subsequently conducted using discordant pairs analysis and conditional logistic regression. Mothers of each case and control were interviewed to obtain information on social, economic, demographic, environmental, and other possible risk factors. The mortality rate for children aged six months to four years was estimated as 23.9/1000 children/year. An increased risk of death was observed where the delivery was not performed by a trained person, if the preceding birth interval was less than 24 months, if the father beat the child's mother, or if the water source was unprotected. No association was found between weaning practices, parental education, or any of the socioeconomic or hygiene variables considered. The authors note that few strong risk factors for mortality were identified possibly due to the relatively homogeneous living conditions within the study area. While mortality rates can be reduced by targeted interventions, general improvement in the socioeconomic status in the region is needed.
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