Determinants of under-five mortality in rural and urban Kenya

Rural Remote Health. 2012;12:1812. Epub 2012 Mar 13.


Introduction: The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya.

Methods: Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas.

Results: Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province.

Conclusions: The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding / statistics & numerical data
  • Child Mortality*
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Infant, Newborn
  • Kenya / epidemiology
  • Maternal Age
  • Multivariate Analysis
  • Risk Factors
  • Rural Population / statistics & numerical data*
  • Socioeconomic Factors
  • Urban Population / statistics & numerical data*
  • Young Adult