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Document Type
Further Analysis
Publication Topic(s)
Child Health, Infant and Child Mortality
Shea Rutstein, Mohamed Ayad, Ruilin Ren, Rathavuth Hong and ICF Macro, Calverton, Maryland, USA
Publication Date
April 2009
Publication ID

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In most countries in sub-Saharan Africa, infant and under-five mortality has been decreasing over the last few decades. Benin is one of the countries where there is evidence of a decline in childhood mortality. This paper examines various socioeconomic factors and maternal and child care interventions that are likely to have influenced the level of infant and under-five mortality in Benin, using data from three DHS surveys implemented in 1996, 2001, and 2006. Survival analysis is applied to the 2006 data set to determine the important factors that have an impact on the levels of infant and child mortality in Benin. Then by using the changes in the prevalence of these factors, the proportion of change in the mortality rates between the surveys is estimated. The analysis reveals that the significant predictors of infant mortality are mother’s education, vaccination, the preceding birth interval, the age of mother at birth, the multiplicity of birth, birth weight, medical antenatal care, antenatal tetanus toxoid injections, medical delivery assistance, and bed net possession. These predictors explain about 57 percent of the reduction in infant mortality. The results for analysis of factors related to under-five mortality are similar to those for infant mortality, with an addition of the mother’s marital status to the list of significant health conditions. The changes in these factors over time explain about 60 percent of the actual decline in under-five mortality between the 2001 and 2006 surveys. By removing any change in bed net possession, one can see how much of the decline is due to bed nets. With no change in bed net possession, there would have been an 8 percent increase in both infant and under-five mortality, principally due to the fall in vaccination levels. Thus the increased possession of bed nets led to a decrease of about 21 percent in what mortality would have been without the increased possession. Indeed the results indicate that in an area where half of the households have bed nets, infant mortality would be 40 percent lower and under-five mortality would be 36 percent lower than that of areas where no households have a bed net. It is evident from this analysis and previous studies that bed net use is very strongly associated with the reduction in childhood mortality, and therefore that bed net distribution should continue to be increased. It is also very important to ensure increasing coverage of vaccinations. Furthermore, improving other health care such as medical delivery, medical antenatal care, and antenatal tetanus toxoid injections is essential to further reducing the risk of infant and under-five mortality. Heretofore untapped efforts to avoid short birth intervals and births to young adolescent mothers would also play increasingly important roles in reducing infant and under-five mortality.