Levels, Differentials and Key Determinants of Under-five Mortality in Ghana

Aims: The disparity in under-five mortality between rural and urban areas in Ghana and other sub-Saharan African countries is a critical national concern. The main purpose of this study is to identify and analyze the levels, differentials and key determinants of under-five mortality in Ghana based on selected socio-economic and demographic variables.

Study Design: This is an analytical cross-sectional study design of the 2008 Ghana Demographic and Health Survey (GDHS) dataset for children.

Methodology: Under-five Mortality rates were calculated based on some selected socio-economic and demographic variables, and segregated into infant and child mortality headings. Also, series of multivariate Cox regression models were fitted to these selected variables segregated into rural and urban headings.

Results: Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Breastfeeding, twins and size of child at birth were key determinants of mortality in the rural areas, but the influence of region of residence was similar in both rural and urban areas. Infant mortality rate in 2008 was 58.489 per 1000.

Conclusion: Focus of child health strategies to achieving the MDG IV will be on the social and economic empowerment of women through education and employment. Also, breastfeeding promotion should be encouraged. Innovative and targeted strategies are required to address rural poverty and region-specific sociocultural factors in order to improve child survival in rural Ghana, especially twin births.