Determinants of infant mortality in Sierra Leone: applying Cox proportional hazards model

Abstract

PurposeThe aim of this paper is to examine biological, maternal and socioeconomic determinants of infant mortality in Sierra Leone.Design/methodology/approachIt uses an analytical framework and Cox proportional hazards regression to break down the effects of factors determining infant mortality. Factors utilized in the empirical investigation include sex of the child, birth size, birth spacing, mother's working status, age of mother, antenatal care, postnatal care, mother's anemia level, religion, mother's education and wealth status.FindingsResults suggest that birth spacing of three years and above associated with a reduced risk of infant mortality contrasted with short birth intervals. Children born to nonanemic mothers have a lower hazard (22%) of infant mortality compared to those born to anemic mothers (HR = 0.78; 95% CI: 0.64–0.96). At least one antenatal care visit by mothers lowers infant mortality rate by 41% compared to no antenatal visits at all ( HR = 0.59; 95% CI: 0.36–0.96). Similarly, infants whose mothers have received postnatal care are at lower risk (31%) of dying than those whose mothers have not received (HR = 0.69; 95% CI: 0.52, 0.93). Infant mortality is likely to decrease with the increase in the birth order.Practical implicationsThe family health and planning programs should aim at educating men and women about the usefulness of birth spacing methods.Originality/valueThis paper might be the first attempt to analyze the determinants of infant mortality by utilizing a methodological framework and Cox regression.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2019-0478.