Abstract

This research examines determinants of infant and child mortality in rural Egypt, primarily the effects of household economic status and the availability of health services. Certain features of the health service environment affect survival in the neonatal period. In early childhood, survival chances improve markedly as income increases and if the household depends almost exclusively on employment income. In infancy and in early childhood, mortality is strongly associated with region of residence and maternal demographic characteristics, and is weakly associated with parental schooling.

PIP:

Maternity history and household economic data were analyzed for 2783 ever married women from rural areas collected during the February-June 1980 Egyptian Fertility Survey (part of the World Fertility Survey) to examine economic and health service determinants of infant and child mortality. The neonatal, early infant, and early child mortality rates were 78,63, and 128 respectively. Children who lived in Upper Egypt were more likely to die than those in Lower Egypt. Neither household sanitation, maternal risk factors, socioeconomic factors, nor medical facilities or personnel accounted for this difference. It was thought that differences in culture were responsible for the discrepancy. The major determinants of child survival during the 1st month included maternal risk status (maternal age, parity, and months passed since prior birth) and region (p.01). In addition, neonatal mortality was highest in villages with only a traditional birth attendant (daya) and those with no combination health unit (p.05). Combination units provided health services as well as social, educational, and rural economic services. During the early infancy period (1-7 months), just region and maternal risk status considerably influenced child survival (p.01). By the time children reached the early childhood stage (8-59 months), the effect of region tapered off, but maternal risk status remained a significant determinant (p.01). It was only during this period that higher household income, especially if it were mostly employment income, significantly improved child survival (p.05). Children from households making up to top 1/3 of income distribution were 35% less likely to die than those from the remaining households. Maternal and paternal education did not greatly affect child survival. It is concluded that economic position and economic well being considerably influenced child survival.