Determinants of Child Mortality in Low-Income Countries: Empirical Findings from Demographic and Health Surveys

Empirical studies on child mortality at a disaggregate level, i.e. by social-economic group, or geographic location, can provide useful information for designing poverty focused interventions. Using Demographic and Health Survey (DHS) data, this study investigates determinants of child mortality in low-income countries both at the national level, and for rural and urban areas separately. DHS data from over 60 low-income countries between 1990 and 1999 reveal two interesting observations. First is the observed negative association between the level and inequality in child mortality. Second is the significant gap in child mortality between urban and rural areas, with rural population having a much slower reduction in mortality compared with their urban counterpart. Given that the poor are mainly concentrated in rural areas, the above evidence suggests that health interventions implemented in the past decade may not have been as effective as intended in reaching the poor. The empirical findings in this study both consolidate results from earlier studies and add new evidence. We find that, at the national level, access to electricity, vaccination in the first year of life and public health expenditure can significantly reduce child mortality. There exists a significant and robust electricity effect on mortality and the electricity effect is shown to be independent of incomes. In urban areas, only access to electricity has a significant health impact while in rural areas, increasing vaccination coverage is important for mortality reduction. 1