Household Wealth Differential and Under-five Child Deaths in Ghana: Implications for Child Health Policy

Abstract

Background At the end of the MDG era, although Ghana was one of the few countries commended to have halved extreme poverty, the under-five mortality rate (U5MR) was dire. Currently, U5MR is still below the national and global SDG target. Government has over the years introduced various social and policy interventions to improve on the socioeconomic status of households to aid in better health outcomes. In this regard, we hypothesize that household wealth should therefore not influence under-five child deaths significantly. Methods The paper first reports under-five mortality trend over the past 30 years in Ghana. It uniquely analyses the levels and trends in wealth as measured by the Gross National Income per capita at purchasing power parity (ln GNI/p, ppp) as a proxy of the mean Comparative Wealth Index (CWI) against under-five child deaths in Ghana. Using data from the 2014 Ghana Demographic and Health Survey and employing the logistic regression estimation technique, the paper further estimates the effect of household wealth and other control variables on under-five child deaths. Results The trend analysis reveal that if the current rate of reduction of U5MR persists, Ghana may not achieve the SDG target. Our empirical estimations also show that household wealth still has a negative and significant relationship with under-five child deaths despite existing poverty alleviating policies. In addition, the results show that regional differences, maternal age, the number of children alive and maternal attendance to postnatal healthcare services are crucial for child survival. Conclusion The results imply that targeted government interventions towards improving household wealth should be intensified especially at the Northern Savannah regions. A new child health policy is imminent to reflect strategies towards achieving the SDG target on U5MR. Additionally, intensive education on active maternal participation in postnatal care should be given critical consideration to improve child survival.