The DHS Program > Publications > Association between Economic Growth, Coverage of Maternal and Child Health Interventions, and Under-Five Mortality: A Repeated Cross-Sectional Analysis of 36 Sub-Saharan African Countries (English)
Subramanian, S.V., and Daniel J. Corsi. 2014. Association Among Economic
Growth, Coverage of Maternal and Child Health Interventions, and Under-Five Mortality: A Repeated Cross-Sectional Analysis of 36 Sub-Saharan African Countries. DHS Analytical Studies No. 38. Rockville, Maryland, USA: ICF International.
In this report, using data from 99 Demographic and Health Surveys (DHS) conducted in 36 sub-Saharan African countries, we investigate factors that have contributed to the declines in under-five mortality rates (U5MR) in sub-Saharan Africa. Specifically, we focus on the extent to which changes in country-level economic growth and changes in the coverage of key maternal, neonatal, and child health (MNCH) interventions have contributed to reductions in under-five mortality.. Our results show that changes in country-level per capita GDP (pcGDP) are not consistently associated with a reduction in U5MR across different model specifications. In ecological time series models, a unit increase in pcGDP is associated with a reduction in U5MRof 11.6 deaths per 1000 live births (95% CI: -29.1, 5.9), while a composite index of MNCH interventions is associated with a reduction in U5MR of 31.9 deaths per 1000 live births (95% CI: -48.6, -15.3). The results of the multilevel repeated cross-section data structure suggest that MNCH coverage indicators are important. For example, pcGDP is associated for a decreased likelihood of child mortality with an odds ratio of 0.96 (95% CI: 0.92 -1.00) and an increase of 1 standard deviation in the composite coverage index (CCI) is also associated with a decrease in child mortality [odds ratio 0.92 (95% CI: 0.88 - 0.96)]. A measure of improvements in sanitary facilities is associated with an odds ratio of 0.57 (95% CI: 0.50-0.65) for child mortality.