Child Mortality

Table CM.2: Early childhood mortality rates by background characteristics

Figure CM.3: Infant and Under-five mortality rates by region, Ghana, 2011

Neonatal, post neonatal, Infant and Under-five mortality rates for the 10-year period preceding the
survey by background characteristics, Ghana, 2011
Child
mortality
rate
(4q1)
[4]

Under five
mortality
rate (5q0)
[5]

140
124

120
100

30

16

46

28

72

Rural

33

23

56

40

94

Region
Western

27

24

50

17

67

Central

36

19

55

36

88

Greater Accra

20

17

37

19

56

Volta

47

21

68

22

89

Eastern

25

14

38

24

61

Ashanti

27

16

43

45

86

Brong Ahafo

44

21

66

41

104

Northern

39

27

66

63

124

Upper East

34

24

58

43

98

Upper West

41

26

67

44

108

Percent

Residence
Urban

80
60

37

40

32

Western Central

97

Primary

36

18

54

31

83

Middle/JSS

34

16

50

28

76

Secondary +

(28)

(2)

(30)

(5)

(35)

Poorest

35

25

61

48

106

Second

28

22

50

37

85

Middle

35

19

54

30

83

Fourth

37

15

52

36

86

Richest

24

14

38

15

52

Total

32

21

53

31

82

Wealth index quintiles

[1] MICS indicator 1.3

[2] MICS indicator 1.4
[3] MICS indicator 1.1; MDG indicator 4.1
[4] MICS indicator 1.5;
[5] MICS indicator 1.2, MDG indicator 4.2
Figures in parentheses () are based on 250-499 unweighted exposed persons.

Greater
Accra

Volta

43

Eastern Ashanti

Under-five mortality rate

Brong Northern Upper

Ahafo
East

Upper
West

Infant mortality rate

As child mortality drops across the world, due to commitment and action, evidence shows that reductions are
predominantly made in deaths occurring past infancy and, increasingly, there is a demand for precision in and
analysis of the period where most deaths occur (UNICEF and all., 2012). Figure CM.4 provides analysis of the
contribution of neonatal mortality rate to the overall infant mortality rate by region. The analysis shows that the
neonatal mortality rate represents more than 60 percent of infant mortality rate in 6 regions out of 10. This means
that in those 6 regions (Volta, Brong Ahafo, Central, Eastern, Ashanti, and Upper West), over 60 percent of all infant
deaths occur in the first month of life.
Figure CM.4: Percent contribution of Neonatal mortality rate to overall Infant mortality rate
by Region, Ghana, 2011
100
90
80

69

65

70
60

53

65

63

53

68
59

59

61

50
40
30
20
10
0
Ce
nt
Gr
ral
ea
ter
Ac
cra

45

67
58

ter
n

54

38

66

20

We
s

26

66

61

56

55

50

98

86

68

67

Percent

28

89

88

Mother's/Caretakers education
None

108

104

an
ti
gA
ha
fo
No
rth
ern
Up
pe
rE
as
Up
t
pe
rW
es
t

Infant
mortality
rate (1q0)
[3]

As
h

Post
neonatal
mortality
rate (PNMR)
[2]

Bro
n

Neonatal
mortality
rate (NMR)
[1]

ste
rn

Background
Characteristics

29

Ea

28

Vo
lta

Child Mortality

Child Mortality

30

Residence and Socio-economic Differentials in Childhood Mortality

Table CM.2 also show differentials in childhood mortality rates by residence and two socio-economic variables:
mothers education and wealth quintiles. From the results, it is apparent that infant and child survival are associated
with the residence and the socio-economic characteristics of mothers.

Child Mortality

31

Figure CM.4: Under-5 mortality rates by residence and socio-economic characteristics, Ghana, 2011

Generally, mortality in urban areas is consistently lower than in rural areas. Under-5 mortality is estimated at 72
deaths per 1,000 live births in urban areas, and 94 deaths per 1,000 live births in rural areas. For infant mortality, this
is estimated at 46 deaths per 1,000 live births in urban areas, and 56 deaths per 1,000 live births in rural areas. The
urban-rural difference is more pronounced for post neonatal mortality and child mortality rates.
Studies have demonstrated a strong relationship between a mothers level of education and the survival of her child
(Hobcraft, 1993), and this is fairly consistent for all childhood mortality indicators, except neonatal mortality rate. The
results show that under-5 mortality rate is estimated at 97 deaths per 1000 live births for children whose mothers
have no education and at 76 deaths per 1,000 live births for mothers with middle/JSS education. For children whose
mothers have no education and/or primary education, infant mortality rate is estimated at 54 deaths per 1000 live
births, and at 50 deaths per 1000 live births for children whose mothers have middle/JSS education. Due to the
fewer exposures (250-499), analysis for children whose mothers have secondary or higher education has not been
presented.
While childhood mortality tends to be differentiated among socio-economic groups, in the MICS 2011, significant
variations are only noted for mortality of children in the poorest 20 percent of households, and the richest 20 percent
of households. The MICS 2011 data reveal that children from the richest households have lower mortality rates,
compared to children from the poorest households (Table CM.2 and Figure CM.5). For example, infant mortality
is estimated at 61 per 1000 live deaths for children from the poorest wealth quintile, and 38 deaths per 1000 live
deaths for children in the richest wealth quintile. This means that the children from the poorest wealth quintile are
more (1.60 times) likely to die before their first birthday compared to those from the richest wealth quintile. Under-5
mortality is estimated at 106 deaths per 1,000 live births for children from the poorest households, compared to
52 deaths per 1,000 live births for children belonging to the wealthiest households. This means that the children
from the poorest households are more than twice as likely to die before their fifth birthday as those from the richest
households (Figure CM.5). However, for the other three wealth quintiles, an erratic pattern is observed, and in some
cases, little differences are noted for all the childhood indicators. This is obviously due to sampling errors.

Demographic Characteristics and Childhood Mortality

Demographic factors such as the sex of the child, age of the mother at birth, birth order, and length of the preceding
birth interval, are strongly associated with the survival chances of young children. These factors include sex of the
child, age of the mother at birth, birth order and length of the preceding birth interval. Table CM.3 and Figure CM.6
show the relationships between childhood mortality and these demographic variables. For all variables, childhood
mortality rates estimates are calculated for a ten-year period before the survey to reduce sampling variability.
Childhood mortality rates are generally higher for males than females for all childhood mortality indicators (Figure
CM.6). For example, under-five mortality rate is estimated at 94 deaths per 1,000 live births for boys, and 75 deaths
per 1,000 live births for girls. This means that male children are 1.25 times more likely to die before the fifth birthday
than females. Neonatal mortality rate is estimated at 37 deaths per 1000 live births for male children, and 27 deaths
per 1000 live births for female children, which means that male children are 1.37 times more likely to die during the
first month of life than their female counterparts.
Research has shown that births to young mothers and older mothers experience an elevated risk of mortality.
Mothers age at the time of child birth influences child survival in all periods as shown in Table CM.3 and Figure CM.6.
For mothers aged below 20 years, infant mortality rate is estimated at 64 deaths per 1,000 live births, compared to 48
deaths per 1,000 live births for mothers aged 20-34 years. Infant mortality is also higher for children born to women
aged 35-49 years (59 deaths per 1,000 live births). The under-five mortality rate is estimated at 105 deaths per 1,000
for women below the age of 20 years, 79 deaths per 1,000 live births for women aged 20-34 years, and 92 deaths per
1,000 live births for women aged 35-49 years.