Abstract
Objectives: Globally, there has been a considerable decline in under-five mortality in the past years. However, it remains a critical issue among low- and middle-income countries, especially in sub-Saharan Africa. In Ghana, under-five mortality is a critical public health issue that requires national interventions. In the present study, we examined the trends of under-five mortality in Ghana from 1993 to 2014.
Methods: Using the World Health Organization's Health Equity Assessment Toolkit, we analyzed data from the 1993–2014 Ghana Demographic and Health surveys. We disaggregated the under-five mortality rate by five equity stratifiers: wealth index, education, sex, place, and region of residence. We measured the inequality through summary measures, namely difference, population attributable risk, ratio and population attributable fraction.
Results: In 1993, under-five mortality among children in poor households (172.90, uncertainty intervals [UIs = 153.21–194.53]) was more than twice the proportion of children from the richest households who died before their 5th birthday (74.96; UI = 60.31–92.81) and this trend continued until 2008. However, in 2014, the poorest had the lowest rate (30.91, UI = 78.70–104.80). Children of women with no formal education consistently recorded the highest burden of under-five mortality. Although in 2014 the gap appeared to have narrowed, children of mothers with no formal education record the highest under-five mortality rate (91.61; UI = 79.73–105.07) compared with those with secondary or higher education (54.34; UI = 46.24–63.77). Under-five mortality was higher among rural residents throughout the years. Men repeatedly had the greatest share of under-five mortality with the highest prevalence occurring in 1993 (137.52; UI = 123.51–152.85) and the lowest occurring in 2014 (77.40; UI = 69.15–86.54). The Northern region consistently accounted for the greatest proportion of under-five mortality.
Conclusion: Ghana has experienced a decline in under-five mortality from 1993 to 2014. Context-specific appropriate interventions are necessary for various disadvantaged sub-populations with risks of health disparities.
Original language | English |
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Pages (from-to) | 95-100 |
Number of pages | 6 |
Journal | Public Health |
Volume | 196 |
Early online date | 24 Jun 2021 |
DOIs | |
Publication status | Published - Jul 2021 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2021 The Author(s)
Funding
This work was supported by University of California San Francisco Population Health and Health Equity Scholar award under Grant number 7504575 .
Keywords
- Demographic and health surveys
- Ghana
- Global health
- Inequality
- Under-five mortality rate