Determinants of Infant Mortality in Bhutan: Evidence from the 2012 National Health Survey Data

Abstract

This study examined the bio-demographic, socioeconomic, environmental, and health-related determinants of infant mortality in the Kingdom of Bhutan. The nationally representative dataset of the 2012 National Health Survey (NHS), Ministry of Health of Bhutan, was used. Cox proportional hazards regression from survival analysis, accounting for the complex study design of the NHS, was performed using a stepwise approach to identify the determinants associated with infant mortality. The weighted infant mortality rate from November 2009 to October 2011 was 34 per 1,000 live births. Children born to uneducated mothers (aHR=2.27; 95%CI=1.16-4.47) and mothers who experienced domestic violence during pregnancy (aHR=4.24; 95%CI=1.45-12.41) were more likely to die before reaching their first birthday. Those infants born in households that used solid fuel were 2.16 times (95%CI=1.21-3.85) more likely to die than their counterparts. Relative to those born in the central region, children born in western (aHR=6.13; 95%CI=2.84-13.20) and the eastern (aHR=5.13; 95%CI=2.81-9.35) regions had a greater risk of dying. The results showed that education, domestic violence experience, solid fuel use, and region of residence are the key determinants of infant mortality in Bhutan. Policies that facilitate education and empowerment of women, prevent domestic violence, reduce solid fuel use, and equitable regional socioeconomic development policies may help accelerate the reduction of child mortality.