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Decomposing the rural-urban gap in the factors of under-five mortality in sub-Saharan Africa? Evidence from 35 countries
Authors: Sanni Yaya, Olalekan A. Uthman, Friday Okonofua, and Ghose Bishwajit
Source: BMC Public Health, 19: 616; DOI: 10.1186/s12889-019-6940-9
Topic(s): Childhood mortality
Children under five
Rural-urban differentials
Country: Africa
  Multiple African Countries
Published: MAY 2019
Abstract: Background Understanding urban-rural gap in childhood survival is essential for health care interventions and to explain disparities in the determinants of Under-5 mortality. There is dearth of information about the factors explaining differentials in urban-rural Under-5 mortality especially in sub-Saharan Africa (SSA). In this study, we sought to quantify the contributions of bio-demographic, socioeconomic and proximate factors in explaining the urban-rural gap in Under-5 mortality in SSA. Methods This study utilized secondary data from Demographic and Health Survey (DHS) in 35 sub-Saharan countries conducted between 2006 and 2016. Child (aged 0 and 59?months) death was the outcome variable in this study. Oaxaca-Blinder decomposition was used to decipher urban-rural gap in the factors of Under-5 mortality. Results Significant urban-rural differentials were observed in Under-5 mortality across bio-demographic, socioeconomic and proximate factors. In the decomposition model, about 44.27% of urban group and 74.71% of rural group had Under-5 mortality in sub-Saharan countries. Maternal age, education, use of newspaper, TV, wealth index, total children ever born, size of baby and age at first birth contributed towards explaining urban-rural gap inUnder-5 mortality. Conclusion These findings could be contributory to health care system improvement and socioeconomic developmental plans to address under-5 mortality in SSA. Strengthening maternal and child health (MCH) programmes, specifically in rural areas and improving health care services would help to ensure overall child survival. Keywords Under-5 mortality Global Health Sub-Saharan Africa Decomposition Urban-rural