Childhood morbidity and its determinants: evidence from 31 countries in sub-Saharan Africa

Abstract

BackgroundAlthough under-five mortality reduced globally from 93 per 1000 live births in 1990 to 39 in 2018, sub-Saharan Africa witnessed an increase from 31% in 1990 to 54% in 2018. Morbidity has been reported to contribute largely to these deaths. This study examined the factors that are associated with childhood morbidity in sub-Saharan Africa.MethodsDemographic and Health Surveys of 31 countries in sub-Saharan Africa were used in this study. The study involved 189 069 children who had or did not have fever, cough or diarrhoea in the 2 weeks preceding the surveys. Descriptive statistics and binary logistic regression were applied in the analysis.ResultsAbout 22% of the children suffered from fever, 23% suffered from cough and 16% suffered from diarrhoea. While the odds of experiencing fever increased by 37% and 18%, respectively, for children from poorest and poorer households, children of women aged 15–24 and 25–34 years are 47% and 23%, respectively, more likely to experience diarrhoea. The probability of suffering from morbidity increased for children who are 12–23 months, of higher order birth, small in size at birth and from households with non-improved toilet facility.ConclusionsThis study has shown that childhood morbidity remains a major health challenge in sub-Saharan Africa with socioeconomic, maternal, child’s and environmental factors playing significant roles. Efforts at addressing this problem should consider these factors.

Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

“…These findings imply that in order to reduce under-five morbidity, there is the need to improve the living conditions of mothers as well as children through the implementation of effective sanitation conditions and enhanced access to healthcare for adolescent mothers. In countries where significant associations were not found between adolescent childbearing and under-five morbidity, other maternal characteristics such as mother’s age, marital status, pregnancy intention, place of residence, mother’s education level, and wealth quintile; child characteristics such as sex of child, and child’s weight; and access and use of maternal healthcare services such as number of ANC visits, place of delivery, and assistant during delivery may be responsible for the under-five morbidity [ 3 , 21 , 26 , 27 ]. Another possible reason for the lack of association between adolescent childbearing and under-five morbidity could be the existence of protecting factors such as better access to health care in general, a better system of educational and professional rehabilitation for adolescent mothers in those countries [ 36 , 37 ].…”

“…This variable was derived from the question, “how old were you when you first gave birth to [name]?” The responses to this question were in single years. Based on the findings of previous studies on under-five morbidity [ 3 , 21 , 26 , 27 ], mother’s age, marital status, pregnancy intention, place of residence, mother’s education level, wealth quintile, sex of child, child’s weight, number of antenatal care [ANC] visits, place of delivery, and assistant during delivery were considered as covariates.…”

“…Across LMICs, 10 % of deaths in under-five children is attributable to diarrhoea [ 6 ]. A recent study in 31 countries in SSA also found that about 22 % of children in SSA suffered from fever, 23 % suffered from cough and 16 % suffered from diarrhea between 2010 and 2018 [ 3 ].…”

“…In SSA, numerous studies have established significant associations between several demographic and socio-economic characteristics of women as well as child characteristics and morbidity among children under five. For instance, a number of studies have found associations between maternal age, education, wealth index, employment status, marital status, birth order, child’s age, child’s size at birth and child’s sex as predictors of morbidity among children under five [ 3 , 5 , 7 ]. Specifically, these studies found higher odds of under-five morbidity among older women, women with low level of education, those with poor wealth index, unemployed women, women with higher birth order, younger children, female children and children with small size at birth [ 3 , 5 , 7 ].…”

“…For instance, a number of studies have found associations between maternal age, education, wealth index, employment status, marital status, birth order, child’s age, child’s size at birth and child’s sex as predictors of morbidity among children under five [ 3 , 5 , 7 ]. Specifically, these studies found higher odds of under-five morbidity among older women, women with low level of education, those with poor wealth index, unemployed women, women with higher birth order, younger children, female children and children with small size at birth [ 3 , 5 , 7 ]. One key factor that these studies failed to examine is the role maternal age at first childbirth plays in morbidity among children under five.…”