Determinants of under-Five Mortality in Lesotho

Abstract

Although the social and economic conditions in Lesotho have improved, under-five mortality has remained one of the major problems in the country. Documentation of the factors influencing under-five mortality is an important problem that needs to be addressed. This study aimed to estimate the effect of social, economic, demographic health and environmental factors on under-five mortality in Lesotho. Data source: The study used data extracted from the 2004, 2009 and 2014, Lesotho Demographic and Health Survey to investigate the levels and trends in under-five mortality whereas the 2014 Lesotho Demographic and Health Survey was used to explore the factors influencing under-five mortality in the country. The outcome variable was the child's survival status i.e. the child being either alive or dead. The explanatory variables were the socioeconomic and demographic factors for mother and child, respectively. Variables were selected through conceptualised Mosley and Chen model and relevant literature. Results: Linear regression analysis suggests that Lesotho will fail to achieve goal 3 of the sustainable development goals, should rates of under-5 mortality continue to decline in slower rates as observed in previous years. The chi-square test shows that higher under-5 mortalities were recorded from children residing in rural areas, who were never breastfed, born to uneducated mothers, delivered at home, born to mothers who never attended ante-natal care classes or went for checkup after delivery, residing in a household that access water from a borehole and whose main source of cooking fuel is gas or smoke emitting fuel. The association of under-five mortality and selected variables was further investigated through four binary logistic regression models. First three models were performed to test association between under-five mortality and socio-economic, bio-demographic and environmental factors respectively. In the last model all variables which presented a strong relationship and higher significance level were included. Among all the variables

that were tested, parity and breast-feeding status were significant at 1% while Ante Natal Care visit, check-up after delivery, maternal age, maternal education, type of cooking fuel and source of drinking water were significant at 10%. Conclusion: The study therefore concluded that significant socio-economic and demographic factors in Lesotho are maternal education and type of residences while bio-demographic and health factors are breast feeding status, parity, maternal age, ante-natal visit and checks after delivery and environmental factors include type of cooking fuel and toilet facility. Insignificant factors include the child's sex, birth order, source of drinking water and wealth index.