Determinants of infant mortality in Luapula province, Zambia : a further analysis of the 2018 Zambia demographic and health survey.

Abstract

Infant mortality still remains a subject of growing interest and debate among researchers as it is an indicator of quality life. Luapula province has been consistently experiencing the highest number of infant deaths in Zambia as evidenced by the Zambian Demographic and Health Survey. Luapula province had the highest infant mortality of 158, 154, 97 and 67 deaths per 1000 live births in 1996, 2002, 2007 and 2018 respectively, with an exception of 2014 when it had the second highest infant mortality of 55 deaths per 1000 live births. Therefore, the study aimed to investigate the determinants of infant mortality in Luapula province by applying the Cox proportional regression model which incorporates the aspect of time. The study used the 2018 Zambia Demographic and Health Survey. The study used descriptive statistics (levels), log-rank tests and multivariate Cox proportional regression model. The study found that 1 in every 15 children dies before the age of 1 in Luapula (67 deaths per 1000 live births). The study indicated that children born in a household with 6 or more members [AHR: 0.45; 95% CI: 0.298-0.691] had significantly reduced hazards of dying compared to children born in households with less than 6 members. The study also showed that children born to mothers aged less than 20 years were two times more likely to die compared to children born to mothers aged 20-29 years [AHR: 2.09; 95% CI:1.354-3.244]. Further, the study revealed that children who were not breastfed by their mothers were 72 per cent more likely to die compared to children breastfed by their mothers [AHR: 1.72; 95% CI: 1.185-2.054] Children born in a preceding birth interval of less than 24 months had significantly increased risks of dying compared to children born to mothers with a preceding birth interval of 24-47 months [AHR: 2.88; 95% CI:2.005-4.146]. The results further reveal that children born to mother’s not using contraceptives were 66 per cent more likely to die compared to children born to mothers using contraceptives [AHR: 1.66; 95% CI:1.157-2.386]. The following maternal and child explanatory factors were not significant: marital status, maternal education, maternal employment status, wealth quintile, sex of household head, paternal education, residence, religion and child’s sex. In conclusion, only bio-demographic factors were significant determinants of infant mortality in Luapula. There is need to examine the dynamics of household size and its relative effect on child survival in Luapula.