Ecological Study to Set Alternative Strategies for Reducing Child Mortality

Abstract

Background:  Infant and child mortality are indicators of population wellbeing. Although, Child mortality rates are declining in Egypt, national averages mask regional disparities. For that, identification and quantification of factors contributing to mortality, at the local level, through ecological correlation studies could provide a guide to more focused public health interventions for reducing mortality. The study aims to improve child health and decrease child mortality rate through recognizing ecological/environmental factors predicting child mortality among municipalities in Giza governorate. Methodology: Ecological, cross sectional study, adopting the municipalities (n=215) as unit of analysis, was conducted to examine associations between child mortality and some human development indicators. Results: High negative significant correlation between U5MR and   access to water (r=-0.966) was found. Access to sanitation and access to electricity are negatively correlated with U5MR with r=-0.955 and - 0.905 respectively. The results with IMR were similar to that with U5MR. An increase in one percentage access of household to safe water predict 1.05and 0.78 fewer U5MR and IMR (R2=0.97 and 0.98; P≤0.001) respectively. U5MR and IMR decrease, significantly, by 0.82 and 0.61deaths, respectively, with increase access to sanitation by 1%. Conclusion: Access to safe water and sanitation are strong predictors of U5MR and IMR. Increase coverage of households by safe water has the largest impact in reduction of children mortality rate. For that, the study recommends advocacy to ensure coverage of household with safe water and sanitation system.