Association between maternal income status and infant mortality in Tanzania: Findings from the 2015-2016 Demographic Health Survey Open Access
Jones, Rachelle (Spring 2019)
Abstract
BACKGROUND: The 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) found infant mortality rates to be higher among wealthier women living in Tanzania compared to less wealthy women. This was a surprising finding, considering the survey found that wealthy women aged 15-49 are more likely to engage in behaviors that protect against infant mortality (e.g., antenatal care, education, family planning). We performed a secondary analysis To assess potential effect modifiers on the association between maternal wealth and infant mortality women age 15-49 who had live births in Tanzania.
METHODS: To evaluate the association between maternal wealth and infant mortality for the current study, we analyzed the survey responses of mothers aged 15-49 using the Birth Recode dataset from the 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey. Using logistic regression, we estimated odd ratios and 95% confidence intervals to examine interactions between wealth index and covariates, maternal age, maternal education, birth index, birth order, delivery location, and assistance with delivery.
RESULTS: The unadjusted odds ratios for household wealth were 43% (95% C.I. 1.05-1.94), 16% (95% C.I. 0.89-1.53), 37% (95% C.I. 1.01-1.85), and 75% (95% C.I. 1.19-2.59) more likely to not survive infancy (poorest, poorer, richer, and richest, respectively) than the odds of not surviving infancy if born to mothers in the middle wealth quintile. When not adjusting for other variables, there does appear to be significant evidence that the highest wealth quintile, richest, is significantly more likely to have infants not survive infancy than the middle wealth quintile.
CONCLUSION: As expected, wealth index is associated with infant mortality for children born to women age 15-49 years in Tanzania, but no significant effect modifiers were identified. Maternal age, maternal education, and birth interval were found to have a significant association with infant mortality.
Table of Contents
Contents
CHAPTER I: Introduction ........................................................................................................................ 1
Global Infant mortality .......................................................................................................................... 1
Problem statement .................................................................................................................................. 3
Specific Aim ............................................................................................................................................. 4
Purpose statement ................................................................................................................................... 4
CHAPTER II: Review of Literature ......................................................................................................... 5
Infant Mortality in Tanzania ................................................................................................................. 5
Factors Associated with Infant Mortality in Tanzania ........................................................................ 6
Household Wealth in Tanzania and Infant Mortality ......................................................................... 8
CHAPTER III: Methodology ................................................................................................................... 10
Data Source and Study Population ...................................................................................................... 10
Outcome Variable ................................................................................................................................. 10
Primary Exposure Variable ................................................................................................................. 11
Covariates .............................................................................................................................................. 11
Statistical Analysis ................................................................................................................................ 12
CHAPTER IV: Results ............................................................................................................................. 13
Descriptive analysis of birth records ................................................................................................... 13
Covariates among Living Infants ........................................................................................................ 14
Covariates among Deceased Infants .................................................................................................... 14
Association between household health and infant mortality ............................................................. 15
CHAPTER V: Discussion ......................................................................................................................... 17
References .................................................................................................................................................. 22
Appendix .................................................................................................................................................... 25
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