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The Impact of Internal Migration on under-Five Mortality in 27 Sub-Saharan African Countries.

Friday, 28th of October 2016

PLoS One. 2016 Oct 26;11(10):e0163179. doi: 10.1371/journal.pone.0163179. eCollection 2016.

The Impact of Internal Migration on under-Five Mortality in 27 Sub-Saharan African Countries.

Issaka AI¹, Agho KE², Renzaho AM¹.

Author information

¹School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia.
²School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.

Abstract below; full text is at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163179

OBJECTIVE:

The literature on the impact of internal migration on under-five mortality in sub-Saharan Africa has been limited. This study examined the impact of internal migration on under-five mortality rate in 27 sub-Saharan African countries.

DESIGN:

The analysis used cross-sectional data from the most recent Demographic and Health Surveys of 27 sub-Saharan African countries. Information on the number of live births and the number of under-five deaths in the five years preceding the surveys in these countries was examined. Using variables from which migration data were generated, four migration statuses were computed, and the impact of each migration status on under-five mortality was analysed by using multivariate Cox proportional hazards regression models.

RESULTS:

Of the 96333 live births, 7036 deaths were reported. Adjusting for internal migration status revealed a 20% increase in under-five mortality rate among urban-rural migrant mothers [HR = 1.20; 95% confidence interval (CI): (1.06-1.35)], a 40% increase in under-five mortality rates among rural non-migrant mothers, [HR = 1.40; 95% CI: (1.29-1.53)] and a 43% increase in under-five deaths among rural-urban migrant mothers [HR = 1.43; 95% CI: (1.30-1.58)]. Whilst under-five mortality rate did not change considerably when we adjusted for country and demographic variables, there were significant decreases among rural non-migrant and rural-urban migrant mothers when health care service utilization factors were adjusted for [HR = 1.20; 95% CI: (1.07-1.33) and [HR = 1.29; 95% CI: (1.14-1.45)]. The decreased risk of under-five deaths was not significant among rural non-migrant and rural-urban migrant mothers when socio-economic factors were adjusted for. Other factors for which there were significant risks of under-five deaths included household poverty, lack of health care services.

CONCLUSION:

Although under-five child mortality rate declined by 52% between 1990 and 2015 (from 179 to 86 per1000 live births) in sub-Saharan Africa, the continent still has the highest rate in the world. This finding highlights the need to consider providing education and health care services in rural areas, when implementing interventions meant to reduce under-five mortality rates among internal migrant mothers.

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