Determinants of child mortality in LDCs: empirical findings from demographic and health surveys

Health Policy. 2003 Sep;65(3):277-99. doi: 10.1016/s0168-8510(03)00039-3.


Empirical studies on child mortality at the disaggregated level-by social-economic group or geographic location-are more informative for designing health polices. Using Demographic and Health Survey data from over 60 low-income countries, this study (1) presents global patterns of the level and inequality in child mortality and (2) investigates the determinants of child mortality, both at the national level and separately for urban and rural areas. The global patterns of health outcomes reveal two interesting observations. First, as child mortality declines, the gap in mortality between the poor and the better-off widens. Second, while child mortality in rural areas is substantially higher than in urban areas, the reduction in child mortality is much slower in rural areas where the poor are concentrated. This suggests that health interventions implemented in the past decade may not have been as effective as intended in reaching the poor. The analysis on mortality determination shows that at the national level access to electricity, incomes, vaccination in the first year of birth, and public health expenditure significantly reduce child mortality. The electricity effect is large and independent of the income effect. While in urban areas, access to electricity is the only significant mortality determinant, in rural areas, vaccination in the first year of birth is the only significant factor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Developing Countries / economics
  • Developing Countries / statistics & numerical data*
  • Empirical Research
  • Health Policy
  • Health Status Indicators*
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Poverty / statistics & numerical data*
  • Poverty / trends
  • Residence Characteristics
  • Rural Health
  • Social Justice
  • Socioeconomic Factors
  • Urban Health