Survival Analysis of Child Mortality in Kenya: An Analysis of 2014 Kenya Demographic and Health Survey Data

Abstract

Childhood mortality is still a public health issue in Sub-Saharan Africa, with Kenya being among the countries that experience the highest rate of children dying before reaching the age of five. Under-5 child mortality (U5CM) is heavily influenced by demographic, environmental, and socio-economic factors. The study aimed to examine the risk factors of under-5 child mortality in Kenya. The data were based on birth histories from the Kenya Demographic and Health Surveys (KDHS) conducted in 2014. The relative contribution of factors such as the mother's education, mother's occupation, household wealth, place of residence, region, and sex of the child to the variability in the under-five child mortality was assessed using Kaplan-Meier and Cox hazard methods. The outcome variable for the study was the child's survival before the age of 5 and age at death. All children born in the period between 2009 and 2014 (n=83,591) were included in the study. Within the observation period, a total of 6,123 child deaths were recorded. The under-5 mortality rate in Kenya was strongly associated with the mother's education, region, place of residence, preceding birth interval, birth order, the total number of children ever born, mother's occupation, and type of toilet facility. The results indicated that a child born in Nyanza is twice more likely to die than that born in the Central region of Kenya. Male children had a higher risk of dying before the age of five than their female counterparts. The risk of experiencing U5CM increased among children born in rural areas compared to those born in urban areas. The study findings provide evidence in support of prioritizing interventions aiming at improving maternal and child healthcare. The findings also suggest that programs aimed at empowering women and boosting health knowledge among mothers should be scaled up. Furthermore, implementing socio-economic development interventions that reduce regional disparities is a recommendation that the central government should consider. Finally, national and local governments should commit resources to guarantee that modern contraceptives are available and used to increase child spacing.