Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-30T15:33:07.529Z Has data issue: false hasContentIssue false
  • English
  • Français

MATERNAL HEALTH-SEEKING BEHAVIOUR AND UNDER-FIVE MORTALITY IN ZIMBABWE

Published online by Cambridge University Press:  21 June 2016

Nyasha Chadoka-Mutanda  and
Clifford O. Odimegwu
Nyasha Chadoka-Mutanda*
Affiliation:
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
Clifford O. Odimegwu
Affiliation:
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
*
1Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Under-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe.

Type
Research Article
Information
Journal of Biosocial Science , Volume 49 , Issue 3 , May 2017 , pp. 408 - 421
Copyright
Copyright © Cambridge University Press, 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adetunji, J. (2000) Trends in under-5 mortality rates and the HIV/AIDS epidemic. Bulletin of the World Health Organization 78(10), 1200–1206.Google Scholar
Arifeen, S., Black, R. E., Antelman, G., Baqui, A., Caulfield, L. & Becker, S. (2001) Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 108(4), e67–e67.Google Scholar
Bangure, D., Chirundu, D., Gombe, N., Marufu, T., Mandozana, G., Tshimanga, M. & Takundwa, L. (2015) Effectiveness of short message services reminder on childhood immunization programme in Kadoma, Zimbabwe – a randomized controlled trial, 2013. BMC Public Health 15(1), 1.Google Scholar
Becher, H., Müller, O., Jahn, A., Gbangou, A., Kynast-Wolf, G. & Kouyaté, B. (2004) Risk factors of infant and child mortality in rural Burkina Faso. Bulletin of the World Health Organization 82(4), 265–273.Google Scholar
Bhutta, Z. A., Chopra, M., Axelson, H., Berman, P., Boerma, T., Bryce, J. et al. (2010) Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. The Lancet 375(9730), 2032–2044.CrossRefGoogle ScholarPubMed
Black, R. E., Cousens, S., Johnson, H. L., Lawn, J. E., Rudan, I., Bassani, D. G. et al. (2010) Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet 375(9730), 1969–1987.Google Scholar
Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., De Onis, M. et al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 382(9890), 427–451.Google Scholar
Bryce, J., Black, R. E. & Victora, C. G. (2013) Millennium Development Goals 4 and 5: progress and challenges. BMC Medicine 11(1), 225.Google Scholar
Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A. & Innis, J. (2006) Family planning: the unfinished agenda. The Lancet 368(9549), 1810–1827.Google Scholar
Cox, D. R. (1972) Regression models and life tables. Journal of the Royal Statistical Society: Series B 34(2), 187–220.Google Scholar
D’Souza, R. M. (2003) Role of health-seeking behaviour in child mortality in the slums of Karachi, Pakistan. Journal of Biosocial Science 35(1), 131–144.Google Scholar
Forste, R. (1994) The effects of breastfeeding and birth spacing on infant and child mortality in Bolivia. Population Studies 48(3), 497–511.CrossRefGoogle Scholar
Fotso, J-C., Ezeh, A. C., Madise, N. J. & Ciera, J. (2007) Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water. BMC Public Health 7(1), 218.CrossRefGoogle ScholarPubMed
Garenne, M. & Gakusi, E. (2006) Health transitions in sub-Saharan Africa: overview of mortality trends in children under 5 years old (1950–2000). Bulletin of the World Health Organization 84(6), 470–478.Google Scholar
Howlader, A., Kabir, M. & Bhuiyan, M. (1999) Health-seeking behavior of mothers and factors affecting infant and child mortality. Demography India 28(2), 225–238.Google Scholar
Ikamari, L. D. (2013) Regional variation in neonatal and post-neonatal mortality in Kenya. African Population Studies 27(1), 14–24.CrossRefGoogle Scholar
Kayode, G. A., Adekanmbi, V. T. & Uthman, O. A. (2012) Risk factors and a predictive model for under-five mortality in Nigeria: evidence from Nigeria Demographic and Health Survey. BMC Pregnancy and Childbirth 12(1), 10.Google Scholar
Kembo, J. & Van Ginneken, J. K. (2009) Determinants of infant and child mortality in Zimbabwe: results of multivariate hazard analysis. Demographic Research 21, 367–384.Google Scholar
Lamberti, L. M., Walker, C. L. F., Noiman, A., Victora, C. & Black, R. E. (2011) Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health 11 (Supplement 3), S15.Google Scholar
Liu, L., Johnson, H. L., Cousens, S., Perin, J., Scott, S., Lawn, J. E. et al. (2012) Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. The Lancet 379(9832), 2151–2161.Google Scholar
Mahmood, M. A. (2002) Determinants of neonatal and post-neonatal mortality in Pakistan. Pakistan Development Review 41(4, Part II), 723–744.Google Scholar
Mosley, W. H. & Chen, L. C. (1984) An analytical framework for the study of child survival in developing countries. Population and Development Review 10, 25–45.Google Scholar
Mturi, A. J. & Curtis, S. L. (1995) The determinants of infant and child mortality in Tanzania. Health Policy and Planning 10(4), 384–394.CrossRefGoogle ScholarPubMed
Palloni, A., Pinto Aguirre, G. & Lastiri, S. (1994) The effects of breast-feeding and the pace of childbearing on early childhood mortality in Mexico. Bulletin of the Pan American Health Organization (PAHO) 28(2), 93–111.Google ScholarPubMed
Rudan, I., El Arifeen, S., Black, R. E. & Campbell, H. (2007) Childhood pneumonia and diarrhoea: setting our priorities right. The Lancet Infectious Diseases 7(1), 56–61.CrossRefGoogle ScholarPubMed
Rutstein, S. O. (2000) Factors associated with trends in infant and child mortality in developing countries during the 1990s. Bulletin of the World Health Organization 78(10), 1256–1270.Google ScholarPubMed
StataCorporation (2011) Stata Statistical Software: Release 12. StataCorp LP, College Station, TX.Google Scholar
Titaley, C. R., Dibley, M. J., Agho, K., Roberts, C. L. & Hall, J. (2008) Determinants of neonatal mortality in Indonesia. BMC Public Health 8(1), 232.Google Scholar
Uchudi, J. M. (2001) Covariates of child mortality in Mali: does the health-seeking behaviour of the mother matter? Journal of Biosocial Science 33(1), 33–54.CrossRefGoogle ScholarPubMed
UNICEF (2012) Immunization Summary: A Statistical Reference Containing Data Through 2011. UNICEF, New York.Google Scholar
UNICEF (2013) Pneumonia and Diarrhoea: Tackling the Deadliest Diseases for the World’s Poorest Children. UNICEF, New York.Google Scholar
UNICEF (2015) Committing to Child Survival: A Promise Renewed. Progress Report 2014. UNICEF, New York.Google Scholar
United Nations Human Rights Council & WHO (2013) Study by the World Health Organization on Mortality Among Children Under Five Years of Age as a Human Rights Concern. United Nations, New York, pp. 1–22.Google Scholar
Victora, C. G., Barros, F. C., Huttly, S. R., Teixeira, A. M. B. & Vaughan, J. P. (1992) Early childhood mortality in a Brazilian cohort: the roles of birthweight and socioeconomic status. International Journal of Epidemiology 21(5), 911–915.Google Scholar
WHO & UNICEF (2012) Countdown to 2015: Maternal, Newborn and Child Survival; Building a Future for Women and Children. WHO, Washington DC. URL: http://www.countdown2015mnch.org/documents/2012Report/2012-complete-no-profiles.pdf Google Scholar
You, D., New, J. & Wardlaw, T. (2012) Levels and Trends in Child Mortality. Report 2012. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. URL: http://www.childinfo.org/files/Child_Mortality_Report_2013.pdf Google Scholar
Zahid, G. M. (1996) Mother’s health-seeking behaviour and childhood mortality in Pakistan. Pakistan Development Review 35(4), 719–731.Google Scholar
Zimbabwe National Statistics (ZIMSTAT) (2014) Multiple Indicator Cluster Survey 2014, Key Findings. ZIMSTAT, Harare, Zimbabwe. URL: http://www.childinfo.org/files/Zimbabwe_2014_KFR.pdf Google Scholar
ZIMSTAT & ICF International (2012) Zimbabwe Demographic and Health Survey 2010–11. URL: https://dhsprogram.com/pubs/pdf/FR254/FR254.pdf Google Scholar
Zimbabwe Central Statistical Office (2009) Multiple Indicator Monitoring Survey (MIMS) 2009: Preliminary Report. ZIMSTAT and UNICEF. URL: https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/assessments/MIMS%202009.pdf Google Scholar