Determinants Of Under-Five Mortality In Namibia: An Analysis Of The 2013 Namibia Demographic And Health Survey Data

ABSTRACT

This thesis reports on a statistical analysis on risk factors associated with under-five mortality in Namibia.

Secondary data were obtained from the 2013 Namibia Demographic and Health Survey data. Children

survival was measured by age at death and the event variable was whether the children were still alive or

dead after the first five (years) of their lives. Variables included were maternal education, mother’s marital

status, the age of the mother at first birth, preceding birth interval, type of birth, place of residence,

household wealth index, status of breastfeed and the place of delivery. Descriptive summary statistics in

the form of tables and graphs were used to profile the background characteristics of the children. Survival

analysis techniques (Kaplan-Meier curves, Log Rank Test and Cox Proportional Hazards model) were used

to establish the determinants of survival among under-five children. Frailty model with regions as a

random effect was fitted- to determine the influence of unobserved risk factors on under-five mortality.

Results revealed that maternal highest level of education (higher/tertiary level), status of breastfeed

(children who have been breastfeed), the place of delivery (those born in private medical facilities) and

type of birth (single births), were found to be the risk factors associated with under-five mortality in

Namibia. Policy efforts should focus on encouraging mothers to breastfeed the children as children who

were breastfed are 54 times less likely to die below the age of five (5) compared to those who were not

breastfed and more focuses on programs that empower women such as free education to all, especially

tertiary education. Children born at private facilities are at lower risk of death compared to those born at

home and this calls for further research on the reasons behind.