|Topographical Differences of Infant Mortality in Nepal|
||Dev R, Williams MF, Fitzpatrick AL, and Connell FA
||Kathmandu University Medical Journal, 14(2): 96-102
Infant mortality is a major problem in Nepal, particularly in the mountainous region
of the country.
To identify factors that contributes to the high rate of infant mortality in the mountain
zone in Nepal.
Data were derived from the 2011 Nepal Demographic and Health Survey (NDHS).
Infant mortality was analyzed across three ecological zones in a sample of 5,306 live
births in the five years preceding the survey. The contribution of risk factors to the
excess infant mortality was assessed using multiple logistic regression.
Infant mortality rate (deaths per 1000 live births) in the ecological zones were 59
(95% CI: 36, 81), 44 (35, 53), and 40 (33, 47) for the mountain, hill and terai zones,
respectively. Women living in the mountain zone were more likely to report that
distance to care was a “big problem” and had a greater risk of infant mortality
compared to the terai zone (OR=1.42, 95% CI: 1.01, 2.02, p=0.04). This increased risk
was observed only among births to mothers who perceived distance to the nearest
health facility as a “big problem” (aOR=1.57, 95% CI: 1.01, 2.40, p=0.04) controlling
for other risk factors.
These findings suggest that the higher Infant mortality rate (IMR) in the mountain
zone was among the women who perceived distance to health facilities as a big
problem. Improved accessibility to health services, particularly in this zone, is an
essential strategy for reducing infant mortality in Nepal.
Access to care, developing country, ecological, geography, infant mortality