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J Biosoc Sci. 1992 Jan;24(1):103-12.

Determinants of child mortality in south-west Uganda.

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Centre for Human Nutrition, London School of Hygiene and Tropical Medicine.


Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara, south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle, recent arrival in the village, using candles for lighting, being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both, independently, important predictors of child mortality.


Between April 1988-April 1989, researchers followed 4320 0-59 month old children from 31 villages in Mbarara district in southwest Uganda to examine socioeconomic risk factors for child mortality. They used anthropometric data and socioeconomic data collected during interviews. The major causes of death included diarrhea (23%), acute respiratory infections (20%), measles (14%), and malaria (13%). Fathers who had received 7 years education were more likely to have experienced the death of a child than those with more education (p.05), but mother's education did not significantly affect child mortality. The following poverty indicators were also significantly associated with child mortality: candles used for lighting (p=.003), family did not own a cow (p=.004), and lived in the village for 4 years (p=.052). Further children of birth order 5 were more likely to die than those at birth order of =or- 5 (p=.029). In fact, the children with the greatest child survival were those of birth order 3-5. All these indicators remained significant when the researchers added mid-upper arm circumference to a logistic model. The researchers concluded that nutritional status and certain socioeconomic factors are both independent and important predictors of child mortality. They commented further that even though improvement of family income and the household and the development of primary health care would increase child survival, these integrated changes will not occur effortlessly due to harsh economic conditions in Uganda. Policy makers and program managers should note that this study pointed out that differences in parental education, birth spacing, and child nutrition explained differences in mortality rates between households of basically the same socioeconomic status.

[Indexed for MEDLINE]

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