Socioeconomic, demographic and environmental determinants of infant mortality in Nepal
Gubhaju, B.; Streatfield, K.; Majumder, A.K.
Journal of Biosocial Science 23(4): 425-435
1991
ISSN/ISBN: 0021-9320 PMID: 1939291 DOI: 10.1017/s0021932000019532Document Number: 315537
The analysis of the 1986 Nepal Fertility and Family Planning Survey, based on a representative sample of 5-29 married women 15-50 years, was consistent with the hypothesis that demographic factors are more important in early stages of development, with socioeconomic and environmental factors gaining importance as development proceeds. The 1976 Nepal Fertility Survey also reveals the pattern of high infant mortality rates as a reflection of maternal age, parity, previous birth interval, and survival of preceding child. The infant mortality rates fell between 1976-86 from 150 to 100/1000. Urban areas are beginning to show environmental variables as determinants of infant mortality. In urban Nepal, the logit linear model of the effect of socioeconomic, environmental, and demographic factors show maternal age and birth order as significant determinants of infant mortality, regardless of whether demographic or socioeconomic variables are controlled. Mothers 20 years experience a risk of infant death 51% greater than mothers 20-29 years, and 50% higher than mothers 30 years. 1st born children have the lowest risk of dying during infancy and risk increases with birth order. Drinking water and toilet facilities were also significant factors. The probability of dying is 44% higher for those drinking lake or river water than those using piped or tube well water. Those without a toilet have a 64% higher probability of dying than those with their own toilet facility. These 2 variables are significant and enhanced even after controlling for maternal age and birth order. When a logit linear model is run with only 2 nd and higher order birth with birth interval and preceding child as control variables, only toilet facility has a significant effect. Birth interval and survival of preceding child become the significant demographic variables. The joint model of birth interval, survival of preceding child, and toilet facility has significant effects on infant mortality. Children born after a short interval (19 months) with the preceding child dead have a lower mortality due to lack of competition. The policy implications are to increase the use of contraception, to reduce births of young mothers, and insure adequate birth intervals. High risk households need special attention from family planning and health services.